Human Papilloma Virus (HPV) is the most important etiological agent in the development of cervical cancer. Studies have found that 99% of cervical cancer cases are caused by some types of HPV. Since HPV infection is sexually transmitted, any sexually active woman or man can get HPV infection. It has been reported that 3 out of every 4 people between the ages of 15-49 have had HPV infection at some point in their lives.
HPV is one of the leading sexually transmitted viruses. It is not necessary to have a full sexual intercourse for HPV to be transmitted, even short-term contact of infected areas with each other is sufficient for transmission. The latent period of this slowly reproducing virus is 9-12 months, but the disease can be transmitted sexually during this period when no lesions are observed. Contagiousness is very high in cases where there are active genital lesions.
Human Papilloma Virus (HPV) causes warts in humans. There are more than 50 types of HPV transmitted to humans, some of them are sexually transmitted and cause the formation of wart-shaped masses called condyloma acuminatum in the genital area. 15% of sexually transmitted HPV types are carcinogenic.
The person with HPV is often unaware that he is infected. The infection may not cause symptoms for years and does not always cause genital warts. Therefore, the absence of warts in the genital area does not mean that the person does not carry the virus. Oncogenic types of HPV, which are associated with cancer, can cause cervical cancer in women.
HPV is a small, circular, double-stranded DNA. virus and belongs to the papovaviridae family. More than 200 types of HPV have been identified and 40 of them are known to infect the genital tract.
HPV types with low oncogenic risk: 6, 11, 42, 43, 44, 54, 61, 70, 72, It consists of 81, and
High risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, 82.
While low-risk groups mostly cause anogenital condylomas, which we call warts, and low-grade squamous intraepithelial lesions (LGSIL), high-risk groups cause anogenital cancers and are responsible for 99.7% of cervical cancers. detection
Among the oncogenic HPV types, types 16 and 18 are responsible for 52% of cervical intraepithelial neoplasia (CIN) and 77% of cervical cancers, while HPV 6 and 11 are responsible for 90% of anogenital condylomas.
Entry of the infection usually occurs through damaged skin due to friction. Although the use of a condom reduces transmission somewhat, it is not completely protective.
Genital warts often occur after unprotected sexual intercourse with a previously infected partner, as well as They are painless masses that appear cauliflower in the genital area of both men and women, in a single area or widely distributed, sometimes reaching a size of up to 5 cm (sometimes 15-20 cm in diameter) than the size of a pinhead. It is most commonly observed between the ages of 18-25, which are the active sexual ages. Condylomas are most commonly found in the vulva (external genitalia), anus (around the anus), vagina and cervix (cervix) regions in women, and in the penis and groin area in men. While warts cause visual distress for people, they can also cause complaints such as pain, bleeding and itching. These lesions must be treated to prevent transmission to sexual partners and because of the complaints they cause.
In treatment: Surgical removal, Electrocauterization (burning), Cryotherapy (freezing), CO2 laser ablation, chemical destruction (bichloroacetic acid, trichloroacetic acid, podophyllin, podophyllotoxin) can be applied. However, treatment with cautery and burning of HPV foci is the most accepted treatment method today. It is especially ideal for eliminating condylomas in the external genital area. Generally, all foci can be destroyed at once. The treatment process is short. Chemical methods are substances that have an irritating effect on healthy skin, inflammation, erosion, pain and ulceration may occur. It is very difficult for the patient to apply it himself; touching healthy skin will cause damage there as well. It is also a long treatment option that requires days and repeated applications. r.
Warts have the chance of recurring at certain periods of life after burning, freezing and other treatments. The reason is due to the reactivation of the viral infection if the body's immune system decreases from time to time for various reasons.
Cervix Cancer (cervical cancer) is among the female cancers in the world, after breast cancer. It is the second most common type of cancer. It is most common in women aged 35-55. According to WHO data, approximately 493,000 cases of cervical cancer occur in the world every year, and approximately 270,000 of them result in death. More than 80% of these deaths occur in developing countries due to the lack of adequate screening programs. However, these rates are rapidly decreasing with the emphasis on cervical cytology and screening (pap smear).
Annual pap smear test and gynecological examination are recommended for all women who are sexually active or 18 years of age. The Pap Smear test may give 20% false negative results, so if there is an infection, the smear should be taken and evaluated again after appropriate antibiotic treatment. In patients with cervical dysplasia, "Colposcopy" should be performed to determine the depth, width and spread of the lesion. Colposcope, It allows examination of the cervix, that is, the mouth of the cervix, at a magnification of 6-40 times.
In summary, regular gynecological examination and pap smear should be performed. A biopsy may be taken from the warts and HPV type determination may be requested. During the treatment, regular check-ups should not be neglected with the treatment your gynecologist deems appropriate.
Since HPV is a sexually transmitted disease, general precautions must be taken in this regard. However, the contagiousness of HPV is so high that even using a condom in questionable sexual intercourse may not protect against infection. During sexual contact, transmission to a woman or man may occur from parts of the male genital area that are not protected by a condom. Therefore, it is very important to avoid sexual contact with those who have obvious condyloma lesions. In addition, in order to prevent contamination, it is mandatory to pay utmost attention to hygienic rules in toilets, spas and hotels open to general public use.
; The bivalent and quadrivalent HPV vaccines used today are well tolerated, the vaccines are highly immunogenic and provide high antibody levels.
Vaccination against HPV is recommended for all girls starting from the age of 11. Since girls who are not yet sexually active are expected to benefit fully from vaccination, it is preferable to do it up to the age of 26. Women who are older than 26 and sexually active can be vaccinated by taking certain criteria into consideration. The vaccine is given IM in three doses. Patients who have been vaccinated must continue their normal gynecological examination and screening programs.
The vaccine is administered intramuscularly in 3 doses. Even if vaccinated, screening programs should be continued.
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