HPV, Human Papilloma Virus, is a virus family that localizes to the human epithelium, of which more than 200 types have been identified so far. It has "Human" in its name because it can only infect humans.
Low-risk types (such as HPV Type 1,2,4) cause warts on the hands and feet, and other low-risk types (HPV types 6 and 11) in the genital area. While causing warts, high-risk types (such as HPV 16, 18, 31, 33, 35) can cause preinvasive lesions in the cervix and cervical cancer.
HPV infection ranks first among sexually transmitted diseases all over the world. Like all sexually transmitted diseases, HPV infection peaks between the ages of 18-30. As the number of partners increases, the probability of HPV infection also increases.
Genital Warts
The most common age range for genital warts is 20-24 years. HPV types 6 and 11 are responsible for 90% of genital warts. Although genital warts do not increase the risk of cancer, they should be checked for the presence of preinvasive and invasive lesions in the cervix, against the possibility of low-risk HPV infection causing warts as well as high-risk types.
HPV Infection and Cervical Cancer
More than 90% of cervical cancers are associated with HPV infection. The most common HPV types are types 16, 18, 31, 33, 45, 52 and 58. Reasons such as smoking, having multiple partners, and impaired immunity increase HPV infection and HPV persistence, resulting in an increased risk for cervical cancer.
Transmission Routes of HPV
As HPV can almost always be found live on human skin, it is most commonly transmitted by skin contact. The most common mode of transmission of genital HPV is sexual contact. Although it is most commonly transmitted by close skin contact, HPV can remain alive in the external environment for a certain period of time. In addition, HPV can survive against frequently used disinfectants (such as Glutaraldehyde, ethanol, isopropyl alcohol). In fact, the most common cause of genital HPV infection in young children and infants is that of parents who care.
Another situation is the presence of active genital HPV infection in the mother during pregnancy, which can cause warts on the baby's vocal cords after normal delivery.
Natural Course of HPV Infection
The infection disappears in 80% of patients within 1 year and in 90% of patients within 2 years without any intervention after HPV infection. In 8-9% of these patients, the infection persists for more than 2 years, and less than 1% of all patients develop invasive cervical cancer over the years. permanent immunity against This indicates that it is possible to become infected again with the same virus type. In addition, the immunity formed is specific to the HPV type and does not protect against other HPV types.
How High-Risk HPV Causes Cervical Cancer?
The most important difference of high-risk HPV types from low-risk types is that they are genetically fused to the cell they infect and the DNA of the cell is the ability to change. This situation is not observed in low-risk HPV infection.
The combination of HPV with the DNA of the infected cell both causes the infection to be permanent and allows it to escape from the immune system.
Cell DNA' The HPV DNA placed in the tissue enables the synthesis of some proteins. Two of these proteins disrupt the cell's cancer-fighting system (tumor suppressor), causing tumor growth.
There are some factors that increase the likelihood of HPV causing permanent infection, these are:
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Being infected with high-risk HPV
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Smoking
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Conditions that weaken the immune system
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Use of immunosuppressant drugs (steroids etc.)
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Patients with organ transplants (kidney transplant, liver transplant etc.)
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Acquired immunodeficiency (HIV-AIDS)
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Familial immunodeficiency syndromes
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Advanced age (in case of persistence of HPV over 30 years of age
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Multi-partner life
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Age of first sexual intercourse� �n being under 21
Effects of HPV Infection and Genital Warts on Daily Life
Women aged 18-45 years The most common sexually transmitted infection is HPV. In addition, the most common genital lesions in this age group are genital warts. Although genital warts pose a serious health problem, they cause serious psychological and social effects in patients.
The presence of genital warts undoubtedly affects sexual life negatively. The fear of contracting warts through sexual intercourse can reduce sexual desire in spouses. The perception that the disease can only be transmitted sexually by the society causes sexual activity to be seen as a taboo. Therefore, the presence of genital warts negatively affects the sexual life of people. The use of barrier methods such as condoms during sexual intercourse reduces both genital wart transmission and high-risk HPV infection rates. There is a risk of progression to cancer with HSIL or CIN3).
Another social condition related to HPV is that if the HPV DNA test used in cervical cancer screening is positive, uneasiness and anxiety may occur between the couples.
Thanks to the HPV vaccines, which have become widespread today, the risk of both genital warts and SIL lesions in vaccinated people is reduced almost completely.
HPV Tests
In our country along with developed countries HPV tests are also used in cervical cancer screening. The main purpose of using the HPV test is to determine the presence of high-risk HPV types associated with cervical cancer. In case of abnormality in any of the tests taken, your doctor should provide you with the appropriate treatment plan.
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