Genital HPV Infection

Genital HPV Infection

Human Papilloma Virus (HPV) is a 100-year-old virus that can cause warts on the skin, precancerous lesions and cancer in various parts of the body, especially in the genital area. It is a DNA virus that has more than one type. In gynecology practice, HPV infection is important because it can cause genital warts, precancerous lesions and cancer in the genital area. The difference in the genetic structure of the virus determines the type of virus and therefore the location and shape of the lesion caused by the virus. Some types cause infection only in the genital area, while others cause infection in other parts of the body. However, some of them cause precancerous lesions and cancer, while others cause warts.

Genital HPV infection is a very common condition and the most common sexually transmitted viral infection is HPV infection. More than 70% of sexually active adults are exposed to HPV at some point in their lives, and more than 70% of them are reported to be between the ages of 15 and 24.

HPV infection causes three main conditions;

  • Silent HPV infection:In this case, although the person is infected with HPV, no clinical condition occurs. In other words, silent HPV infection may not be detected by examination, smear test (cytology) or even HPV test. People with silent HPV infection are not contagious because the HPV load is low. However, it should not be forgotten that; The virus may transition from a silent state to a clinical state (warts and precancerous lesions / cancer).
  • Anogenital warts: They are seen at a rate of 1-5% in the society, 90% of which are HPV type 6 and It is associated with 11. After HPV infection, warts appear approximately 1-8 months later. Warts are benign lesions (not cancer) and their treatment varies depending on the number and size of the wart. While treatment methods such as excision, cauterization, and chemical destruction can be applied for large lesions, medical treatment (drug therapy; cream) can be applied for small lesions. Genital warts cause two clinical problems. The first of these; When warts are ignored, their treatment becomes difficult if they increase in number or cause extremely large masses, and the treatment of many and large lesions is a last resort. This is because it may cause negative effects in terms of cosmetics and sexual function. Another important situation is that although warts are caused by non-cancerous HPV types, cancerous HPV types may also be transmitted during the same transmission period.
  • Genital precancerous lesion and cancer: Among genital cancers, HPV is associated with The cancer most closely related is cervical cancer. Approximately 500 thousand women in the world get cervical cancer every year. In our country, this number is around 1500. 70–80% of sexually active women are infected with oncogenic HPV, usually shortly after sexual activity begins. Natural infection in the later period does not provide protection. Therefore, a person can become infected many times throughout his life. After high-risk HPV infection, most of it is eradicated by the immune system, while a small part of it turns into precancerous lesions and cancer in the long term. In persistent infections, the time it takes for precancerous lesions to form is 3-5 years, and the time it takes for cancer to develop is 5-10 years.
  • HPV is transmitted through sexual intercourse through the skin and mucosa. The risk of HPV transmission during sexual intercourse with a person with clinical HPV infection is approximately 50%. In addition, it is thought that it can rarely be transmitted from toilets, towels, soap, swimming pools or bathtubs. The types of HPV that cause hand and skin warts are different from those that cause genital warts. However, there may be exceptional cases.

    The only way to prevent HPV transmission is to completely avoid sexual intercourse (genital / oral-genital). Using condoms is one of the options to reduce the risk of HPV transmission. Since a condom only prevents contamination from the area of ​​skin it covers, it cannot prevent all contamination. Continuous use of condoms reduces HPV transmission by 70%.

    Prophylactic HPV vaccines are another option that can be used to prevent the development of infection. Prophylactic HPV vaccines provide protection against the HPV types they contain. In other words, it does not provide protection against all HPV types. Vaccines only prevent the development of new infections, they do not treat existing infections in the body. It has high protection properties, especially when applied before starting sexual life. This Therefore, it is recommended that the HPV vaccine be given to 11-12 year old girls. The earliest age for vaccination is 9 years old. In addition, vaccines can also be given to girls and women aged 13-26 (catch-up vaccine).

    While the risk of HPV transmission from people with genital warts is high, the probability of transmission after treatment is quite low. is happening.

    Condom use and HPV vaccines greatly reduce HPV transmission.

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