HPV Infection, Cervical Cancer and Vaccine
HPV Infection, Cervical Cancer and VaccineHPV infection is a viral disease and its incidence is increasing. Although it is most often seen between the ages of 16-25, when sexual activity is highest, it can be encountered at any age, even in children. Sexual habits and being with multiple and different partners are the most important risk factors.
Reasons for the Increase in HPV Infection:
Changes in sexual habits
Disruption of family structure
Increase in smoking
Birth at a young age increasing frequency of control pill use
Relationship between HPV Genotypes and Cervical Cancer:
Low risk group: HPV 6,11,40, 42,43,45,54,61,70,72 and 81
Possible high risk group: HPV 26,53,66
High risk group: HPV ,18,31,33,35,39,45,51,52,56,58,59,68, 73 and 82< br /> Observations of HPV Infection:
Classical genital warts: It is the most common form
Flat condyloma: They are not visible to the naked eye, they are detected by colposcopic examination
Kerotic papules: They are seen in dry skin areas, especially in the groin
br /> Giant condylomas: The possibility of atypia (cancer) is high
Ways of Transmission of HPV Infection:
Sexual transmission: It is the most important mode of transmission
Genital HPV lesions are seen in 60-66% of the spouses of those who have genital HPV. . The most important factor in transmission in this way is the number of sexual partners and the age at which the infection is acquired. Early age of first sexual intercourse is the most important factor in acquiring the infection and developing cancer. HPV testing in men is difficult, it usually does not show any symptoms. Extra genital transmission: HPV 16 and 35 types It can live between nails and plays a role in non-sexual transmission. Environmental surfaces, clothes, towels, toilets, biopsy tools and gloves may play a role in transmission
Vertical transmission: HPV is transmitted from mother to baby during birth, and the rate of HPV is 4-87% in the babies of women carrying this infection. Its DNA has been found. It has been shown to cause "Laryngeal Papillomatosis" disease in babies.
Its transmission to the fetus during pregnancy is controversial.
Diagnostic Methods in HPV Infection:
Cervical cytology (PAP smear): In those with genital warts It must be done
HPV DNA test: Reliability (?) An expensive and difficult method
Treatment for HPV Infection:
Treatment of underlying vaginal infections
Investigation for diabetes
Keeping the vulva dry
Modern treatment options
Ways to Prevent HPV Infection:
/> Delaying the age of sexual intercourse
Having fewer sexual partners
Using condoms
Not smoking,
Performing PAP smear scans for early diagnosis
Vaccination
HPV Vaccines:
70% of cervical cancer is due to HPV 16 and 18 infection
Mortality rates have decreased with early diagnosis and treatment with PAP smear screening
There are Quadrivalent HPV vaccine and Bivalent HPV vaccine
Quadrivalent Vaccine:
Provides protection against diseases associated with HPV types 6, 11, 16 and 18
It is administered to women aged 9-26 at 0, 2 and 6 month dose intervals
Its protection is at least 5 years. , the need for a booster dose will be shown in the future
Bivalent Vaccine:
Provides protection against HPV 16 and 18 and provides cross-protection against HPV 31 and 45
With this vaccine, 0, 1 and 6 month doses
HPV Vaccine in Pregnancy and Breastfeeding:
HPV vaccine is classified as pregnancy category B
Although it is not recommended during pregnancy, no teratogenic effect has been reported
HPV vaccine can be administered to breastfeeding women
Such inactive vaccines do not affect the safety of breastfeeding mothers and their babies
RECOMMENDATIONS:
For maximum protection, the vaccine should be given before ever encountering HPV
It is recommended that women between the ages of 9-26 be vaccinated and the target age for the first vaccination is 11-12 years. It is recommended that PAP smear screenings should be continued regardless of vaccination status. It should be emphasized that HPV vaccines protect against only 70% of cervical cancers and 90% of genital warts.
Women with the disease can receive the vaccine in smear screening, but they should be informed that the vaccine will be less effective in these women.
Women previously infected with HPV will benefit from the vaccine by being protected against other HPV types.
Annual PAP smear screening is important in this group.
HPV vaccine does not aim to treat genital warts and cancers, appropriate treatments should not be applied to these patients.
Protecting and keeping the family structure strong in societies, and providing the necessary education, especially to our young girls and all individuals, in a correct and effective manner will be the most important protection method.
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