HPV

What is HPV?

Synonyms: human papilloma virus

HPV is a virus that affects the skin and mucous membranes and can cause warts or cancer precursor lesions, such as cervical uterine cancer, throat or anus. HPV name is an English acronym for "Human Papilloma Virus" and each type of HPV can cause warts in different parts of the body.

HPV is a virus that is transmitted in the skin contact, so it can be considered a sexually transmitted disease. In the first sexual contact 1 in 10 girls come into contact with the virus. As time goes on, between 80 and 90% of the population has come into contact with the virus at some time in life, even if it has not developed injury. But it is important to remember that over 90% of people can eliminate the virus from the body naturally, without clinical manifestations.

                    

types

There are over 200 types of HPV. To date 150 of them have been identified and genetically sequenced.

Among these types, only 14 can cause cancer precursor lesions, such as cervical uterine cancer, throat or anus. 70% of these lesions are caused by HPV types 16 and 18, while HPV 31, 33, 45 and other less common types are found in all other cases.

Already the HPV type 6 and 11 are also quite common in women, but cause only genital warts.

The type of HPV is detected through the two types of tests: genetic testing and hybrid capture PCR test. These tests may provide information such as the type, viral load or to check whether or not this HPV oncogenic, i.e., it can progress to cancer.

causes

HPV is a virus that is transmitted in the skin contact, so it can be considered a sexually transmitted disease, because 98% of transmissions occur through sexual contact. But unlike other STDs, there need be exchange fluids for the transmission to occur: only the contact of the penis with the vagina, for example, already causes the transmission of the virus.

                      

                      

The use of condoms is an important safeguard to prevent the transmission of HPV and should not be forgotten even during anal sex or oral sex. The female condom is a good ally, because it allows a smaller contact yet between the skin of the partners.

Other forms of transmission, much more rare, are by contact with skin warts, sharing underwear or towels, and finally, vertical transmission, ie from mother to fetus, which may occur during childbirth.

The virus can be transmitted even when the person realizes not have symptoms. Another point on HPV is that although the symptoms usually manifested after between two and eight months of infection, it may be incubates, or present in the body, but not manifest, for up to 20 years. So it is virtually impossible to know when or how the person has been infected with HPV.

                             


                          

Risk factors

Any people who have an active sex life are at risk of contact with any of the HPV types. However some risk factors increase the chance that contact occur:

Unprotected sex
Early sex life
multiple partners
No routine screening
Immunosuppression, i.e., the fall of the immune system
Presence of other sexually transmitted diseases (STDs).
Moreover, risk factors for cancer associated HPV are changes in the immune response of our organism, such as:

multiple pregnancies

Use of high-dose oral contraceptives for a long time
smoking
HIV infection
Chemotherapy, radiotherapy or immunosuppressant
Presence of other sexually transmitted diseases such as herpes simplex and chlamydia.

HPV Symptoms

Over 90% of people can eliminate the HPV virus from the body naturally, without clinical manifestations.

The main symptom of HPV, when expressed, is the appearance of skin lesions or warts, usually a white or brownish smudge it itches. Often, however, the damage may not be visible to the naked eye, appearing as colposcopy examinations, and vulvoscopia peniscopy.

Usually the lesions appear in the genital region, but can occur in other parts of the body. See the most common:

In the female body, the lesions usually develop on the vulva, vagina, cervix
In the male genitals, the penis is the most common place for appearance of HPV

In both genders, the anus, throat, mouth, hands and feet are places where the HPV virus usually manifests.

HPV diagnostics

Usually the discovery of HPV happens in a routine examination, such as Pap smears, colposcopy, vulvoscopia, peniscopy or anoscopy. In these tests it can be used a coloring reagent that will facilitate the search for lesions made with a special device that allows viewing with increased surface skin and mucous membranes.

When the lesion is found, a biopsy is taken of that lesion is removed for analysis of tissue and DNA from causative lesion virus. Tests such as genetic testing PCR and hybrid capture test may provide information such as the type, viral load or to check whether or not this HPV oncogenic, i.e., it can progress to cancer.

In addition, genetic tests are able to detect the presence of HPV in the body, called the HPV test. Usually it is recommended for women over 30 years, a time when most women have had a chance to eliminate the virus may have acquired at the beginning of sexual life.

HPV Treatment

HPV is a disease that usually scare, mainly because of its relationship to cancer, such as cervical uterine cancer, throat or anus. However, if HPV is detected early, it is highly treatable. Moreover, it does not work like the herpes virus, the body never eliminates and keeps protester when immunity falls. HPV is usually completely eliminated from the body after a year and a half or two years, especially in younger people.

Importantly, the treatment of HPV is done against the symptoms, there is no therapy that eliminates the virus alone, this work needs to be done by the immune system alone. So if the test detects the presence of the HPV virus, but there are no manifestations of it in the body, even subclinical, the doctor can only ask monitoring more closely, with routine tests done more often.

There are several treatment options that vary according to the type of HPV manifestation (if it is an injury or a wart) and also the degree and location of the lesion or wart. They can be made on clinical and sub-clinical lesions. The following are the most common forms of treatment:

creams

Small lesions in small amount or more can be treated as external creams and acids. One of the most used is trichloroacetic acid, but there are other options.

Furthermore, immunotherapy creams are also options, but usually used for a longer period.

Removal of the lesion

The removal of the lesion can be done in several ways. One of the most widely used techniques is laser cauterization, wherein the light beam is directed at the lesion burning it. Furthermore, it can also be made with ice sex (cryotherapy), acid (common cauterization) or using radio frequency.

The person with whom I relate also have to deal with?

Yes, the partner or partner of someone diagnosed with HPV should go to the doctor to investigate also has the disease. If there is any clinical or subclinical injury, he must also deal to avoid the dangers of the disease and not passing it back to the partner already diagnosed.

possible complications

Among the 150 types of HPV viruses cataloged, 14 may cause only precursor lesions of cancer, such as cervical uterine cancer, throat or anus. 70% of these lesions are caused by HPV types 16 and 18, while HPV 31, 33, 45 and other less common types are found in all other cases. The main HPV-related cancers are the cervix, a much more common problem in women.

However, in men, HPV can also cause problems. Recent research indicates that the virus can affect the movement of the sperm and its fertilization capacity.

Moreover, HPV is also related to lesions in the oral region and the upper respiratory system such as the tongue, tonsils, palate and even the nose.

Finally, there is the vertical transmission of HPV that may occur during childbirth. This transmission is rare, occurs in one in 10,000 pregnancies house with HPV warts. However, the consequences can be serious because they can cause laryngeal papillomatosis juvenile, disease in which the child develops warts and lesions in the respiratory system.

expectations

About 90% of patients with HPV can complete healing of the lesion and only 10% of people keep the virus without relapses. The most important is to diagnose HPV lesions early, and this is only possible when you have routine follow-up with your doctor is a gynecologist or urologist.

Prevention

Moreover, the HPV vaccine is an interesting way to prevent the disease. There are two vaccines for HPV prevention approved and registered by the National Health Surveillance Agency (ANVISA) and are commercially available: the quadrivalent vaccine, which protects against HPV 6, 11, 16 and 18. The other option is the bivalent vaccine, which protects against HPV 16 and 18.

According to scientific literature, the HPV vaccines prevent about 70% of cases of cervical cancer, those caused by HPV 16 and 18. This does not eliminate, however, the need for women to go through routine visits to gynecologist for preventive examinations.

The HPV vaccine is another possible strategy to address the problem and an important time to assess whether there is existence of STDs. It works by stimulating the production of antibodies specific for each HPV type. The protection against infection will depend on the amount of antibodies produced by vaccinated individual, the presence of such antibodies at the site of infection and persistence over a long period of time.

The most recommended preventive measure for HPV is the use of condoms. Most of the transmission of this virus are sexual and prevent skin contact between partners, condoms are one of the best ways to prevent the problem.