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La The Human Papillomavirus (HPV) family includes more than 200 types of viruses, 12 of which (16/18/31/33/35/39/45/51/52/56/58/59) are associated with cancers or immediate precursor or high-grade lesions. Other types, such as HPV 6 and 11, are associated with benign processes such as genital warts or recurrent respiratory papillomatosis.
HPV is the most common sexually transmitted infection in the world. In fact, from numerous studies we know that approximately half of all women will be infected within 2-3 years of becoming sexually active. risk factor's the number of sexual partners you have had, risky relationships, and, most importantly, the age at which you begin sexual relations due to the immaturity and weakness of the cervix at these stages.
The risk of acquiring new HPV infections remains significantly high throughout life in sexually active individuals, and although the risk decreases with age, it remains significantly high even after age 45.
The persistence of HPV infection has also been shown to increase with age.
La HPV infection It is a necessary cause for the development of cervical cancer and is related to a high proportion of cancers of the anus, vulva, vagina, penis and oropharynx.
Globally, HPV is the causative agent of approximately 5% of human cancer cases.
HPV is transmitted through skin-to-skin or mucous membrane contact. The main route of transmission is sexual intercourse (vaginal and/or anal penetration and, less frequently, skin-to-skin contact in the genital area and oral sex).
It is estimated that approximately 80% of sexually active women will come into contact with at least one type of HPV at some point in their lives (this percentage is even higher for men).
However, it should be noted that More than 90% of these infections are transient and resolve within two years of infection.
After HPV infection, it can remain inactive for a long time, so detection of the virus may go unnoticed until years after transmission.
Most infected individuals have a transient infection that poses no risk, as HPV is eventually completely eliminated.
Generally, these infections go unnoticed. However, in a small percentage of cases (around 10-15%), the HPV infection persists over time without being eliminated by the body's immune system.
It is important to note that being infected with high-risk HPV does not imply that cervical cells have undergone premalignant transformation; in most cases, it will be a transient contamination.
The vast majority of HPV infections are asymptomatic, but in some cases, symptoms may occur, such as:
Genital warts or condylomas: They are benign tumors that do not become malignant, but they represent a great concern for the patient and have a high tendency to recur. We have different forms of treatment to stimulate the immune system and eliminate the lesion without scarring.
The absence of symptoms in precancerous lesions and failure to undergo regular gynecological checkups are major risk factors for developing cervical cancer.
There is currently no specific medical treatment for HPV infection.
The Vaccines They protect very effectively against the main types of HPV that cause diseases and are also very safe.
All marketed vaccines include HPV types 16 and 18, which cause 70% of cervical cancers and a significant proportion of vulvar, vaginal, anal, and oropharyngeal cancers.
The vaccine prevents infection but does not affect the elimination of a virus existing at the time of vaccination.
However, the vaccine may also be useful for people who have had sexual relations with or been exposed to HPV, since, unlike with other infections, a history of a previous infection does not fully protect against acquiring new infections with these same HPV types.
El condom It provides significant protection against infection. However, even with correct use, protection is not complete, because the area protected by the condom is limited and all skin in the perineal region is potentially infectious.
Correct condom use has been shown to significantly reduce the incidence of both genital warts (or condylomas) and premalignant lesions.
In addition, condoms protect against other sexually transmitted infections, such as HIV (Human Immunodeficiency Virus), syphilis, or gonorrhea, and against possible unwanted pregnancy.
In our country, HPV vaccination is funded for 12-year-old girls, with a coverage rate of 74,3%.
When HPV causes changes, these can be observed in the cytology. Hence the importance of periodic reviews so that, in case of infection and alteration of the cervical cells, we can identify it and try to differentiate whether it is a transient infection - in most cases - or whether it produces alterations that will be detailed with the corresponding colposcopic.
They are recently being established screening or early detection programs For the entire cervical cancer population, HPV screening is performed directly from certain ages. For these individuals, this test is recommended every 5 years starting at age 30-35.
From the Gynecological Cancer Prevention Unit at the UDM, we recommend performing this test every 5 years starting at age 30-35.
Vaccinated women will also need to undergo regular check-ups.
In the case of persistent infection, HPV can cause cellular alterations that lead to the development of premalignant lesions which, over time, can develop into cancer.
Whether an infection persists or not depends primarily on factors that prevent the immune system from doing its job of eliminating the infection, such as smoking, alterations in the body's defenses or immune system (immunosuppression), and the type of HPV involved.
The cervix is the genital area most at risk for persistent HPV infections. This is because it contains cells with a high capacity for turnover, making it an ideal entry point for the virus.
Other tissues in the anogenital area—such as the vagina, vulva, anus, and penis—or extragenital areas—such as the oropharynx, larynx, and esophagus—are less susceptible, but recent research suggests they may also undergo a similar process.
Since HPV infection is asymptomatic, its detection is based on a sample analysis that will allow us to detect the presence of the virus (HPV test), minimal cellular changes indicative of the current infection, or more significant cellular changes suggestive of premalignant lesions.
The vaccine is recommended for adolescents of both sexes aged 9 to 15, requiring only two doses. After this age, three doses are required, administered at the recommended schedule over a period of one year. Efficacy and safety studies are available up to age 2.
Three different vaccines are available on the Spanish market, the most recent being indicated for the prevention of genital warts, precancerous vaginal and vulvar lesions, precancerous cervical lesions, and cervical cancer related to HPV strains.
Although it is recommended to administer it before the beginning of sexual relations, the vaccine can be administered after the beginning of sexual relations. It is especially recommended for patients undergoing conization for a high-grade lesion.
The vaccine cannot, under any circumstances, cause a reactivation of the infection.
It is important to know that HPV infection does not confer immunity if it has been eliminated by the body itself, meaning that we can be infected again with the same HPV strain.
It is a effective and safe vaccine that offers virtually complete protection against viruses.
Vaccines are made up of virus-like particles, formed from proteins, and are therefore not infectious.
It's a preventative vaccine, not a curative one. Vaccines generate significant levels of immunological memory, which suggests long-lasting protection, possibly lifelong.
It is an intramuscular vaccine. It is usually administered in the deltoid muscle of the arm, with few adverse effects, such as redness, mild muscle discomfort, or fever.
