The human papillomavirus (HPV) is the most common viral infection of the genital tract.
General Information
HPV is an extremely extended virus group worldwide. There are more than 190 types of this virus, of which at least 13 lead to the development of cancer (they are known as high risk types). The human papillomavirus is mainly transmitted with sexual contacts, and most people are infected with them shortly after starting sex. Two types of HPV (16 and 18) cause 70% of all cases of cervical cancer (RSHM) and precancerous pathological states of the cervix.
The probability of getting sick
The human papillomavirus is mainly transmitted with sexual contacts, and most people are infected with them shortly after starting sex. But penetrating sex is not required to transfer the virus. The genital contact of the belly is a well -established transmission route of papillomavirus infection. HPV infection risk groups are children and adolescents aged 15 to 18.
Cervical cancer develops as a result of the sexual media acquired in infection with certain types of HPV. RSM development risk factors: the first sexual relationship at an early age; Numerous sexual partners; Immunity suppression (for example, HIV infected people suffer a higher risk of HPV infection and are infected with a broader range of VPV types).
Symptoms and nature of the disease course
Most HPV infections do not lead to the appearance of symptoms or diseases and pass (around 90% pass within 2 years). However, a stable infection with certain types of HPV (more frequently with the types of 16 and 18) can lead to the development of precancerous pathological conditions. Without treatment, these conditions can become cervical cancer. Today, cervical cancer is the most common disease associated with human papillomavirus. Cervical cancer is the fourth among the most common types of cancer in women, and the seventh in general: according to estimates, 528, 000 new cases in the world were in 2012.
RSM's symptoms usually appear only in the advanced stage of cancer and may include the following:
- Irregular, intermenstrual (between menstruation) or pathological vaginal bleeding after sexual intercourse;
- Back pain, legs or pelvis;
- Fatigue, weight loss, loss of appetite;
- Unpleasant sensations in the vagina or discharge with an unpleasant smell;
- A swollen leg.
In the posterior stages, more serious symptoms may appear.
Papillomavirus infection is also involved in 20-90% of cases of flat cell cancer, oropharynx, vulva, vagina and penis. According to estimates, up to 90% of all cases of anal cancer are due to HPV-16 and HPV-18, and 40% of vulva cancer cases, which are mainly in advanced women, are associated with HPV-16.
HPV infection due to low risk risk causes. The average time between infection with HPV-6 or 11 types and the development of sexually transmitted warts is 11-12 months in men and 5-6 months in young women 16. Anogenital condylomas are difficult to treat.
HPV-6 and HPV-11 can also cause a rare condition known as recurrent respiratory papillomatosis (RRP), in which warts are formed in the larynx or other parts of the respiratory tract. The PVP is mainly observed in children under 5 years (youth PRP) or in people in the third life of ten (adult PVP). In rare cases, women with genital HPV infection can transmit the virus to the baby during childbirth. An absurd RRP can lead to a serious problem due to the obstruction of the respiratory tract.
Complications after the disease
It was established that RSM in 100% of cases is due to oncogenic as the types of human papillomavirus (HPV). In women with a normal immune system, cervical cancer develops in 15-20 years. In women with a weakened immune system, for example, with HIV infection in the absence of treatment, its development can take only 5-10 years. Despite limited data on Angeenital, cancer, different from cervical cancer, a growing number of real data indicates the relationship of human papillomavis with anus, vulva, vagina and penis. And although these types of cancer are less common than RSHM, their connection with HPV makes them potentially capable of preventing through the use of the same primary prevention strategies as for cervical cancer.
HPV types that do not cause cancer (especially types 6 and 11) can cause pointed condylomas and respiratory papillomatosis (a disease in which tumors grow in the respiratory tract that leads from the nose and mouth to the lungs). And although these conditions rarely lead to death, they can often lead to disease. Acute condylomas are widespread and extremely infectious.
Mortality
There is a high global mortality of cervical cancer (52%), whose cause is human papilloma. In 2012, approximately 270, 000 women died of RSM, and more than 85% of these deaths occurred in countries with a low and average income.
Treatment
RSM detection is testing precancerous conditions and cancer among women who have no symptoms and feel completely healthy. If the detection reveals precancerous pathological conditions, they can be treated easily and, therefore, prevent cancer. Detection can also identify cancer at an early stage with a high probability of cure.
Given the fact that the precancerous conditions have been developed for many years, all women from 30 to 49 years are recommended to undergo a projection at least once in a life, and better often. The detection is effective in reducing the mortality of cervical cancer only in the case of a significant number of women.
Currently 3 different types of detection are available:
- The usual papaser test (PAP) and liquid cytology (LBC);
- Visual verification using acetic acid;
- Tests on high risk VPV types.
In developed countries, there are programs that provide women with opportunities for detection, which allows them to identify most of the precancerous conditions in the stages when they can be easily treated. The early treatment of human papillomavirus allows you to prevent up to 80% of CSR development cases in these countries.
In developing countries, limited access to effective detection means that the disease is often detected only in the posterior stages, when symptoms are developed. In addition, the treatment of the disease in such posterior stages is ineffective, which leads to high levels of RSM mortality in these countries.
Vaccination effectiveness
The results of the clinical trials indicate that the two existing vaccines today are safe and very effective in the prevention of HPV infection 16 and 18. Both vaccines are more effective if vaccination is carried out before human papilloma is exposed. Therefore, it is preferable to carry out vaccination before the first sexual contact. Vaccines do not treat HPV infection or disease associated with HPV (such as cancer).
In some countries, children's vaccination against human papillomavirus is introduced, taking into account the fact that it allows it to prevent genital cancer in both men and women, and one of the available vaccines also prevents the development of genital warts in men and women. In addition, children's vaccination serves to avoid HPV circulation in the population of adolescents and young adults. WHO recommends the vaccination of girls from 9 to 13 years, since this is the most effective, in terms of costs, a public health measure against cervical cancer.
HPV vaccination does not replace cervical cancer detection. In countries where the VPV vaccine is promulgated, it may also be necessary to develop detection programs. At the end of 2013, the human papillomavirus vaccine was introduced into 55 WHO countries.
Modern mathematical models show that in the coverage of girls from 12 to 13 years, a complete primary immunization course (3 doses) with a vaccine against infection of papillomavirus, it is possible to predict the risks of developing cervical cancer in 63%, cervical appointments of the age of the age of the age of the age of the age of the age. The age of age. 30 years - for 27%.
Vaccines
Currently, there are two vaccines that protect from 16 and 18 types of human papilloma, which causes at least 70% of cervical cancer. These vaccines can also provide some cross protection against other less common HPV types that cause RSM. One of these vaccines also protects from HPV 6 and 11 types, which cause anogenital condylomas.
The development and registration of vaccines against infection by papillomavirus determined the possibility of primary prevention of the RSM.
The latest epidemics
Cervical cancer is the second most common type of cancer among women; According to estimates, 530, 000 new cases of disease are recorded annually, around 270, 000 patients are dying.
The incidence retains the growth trend.
The probability of the CRM disease of each woman on average during her life is 0, 53%.
Historical information and interesting facts
In the mid -seventies of the twentieth century, scientist Harold Tsur Hausen discovered that women suffering from cervical cancer are invariably infected with human papilloma. In 1983, he discovered the DNA of Papillomavirus in a biopsy of cervical cancer, and this event can be considered the opening of the Oncogenic virus HPV-16. In 2008, the Nobel Committee awarded the Nobel Prize in the field of Physiology and Medicine Harald Zur Hausen to discover that the papilloma virus can cause cervical cancer.