Human Papillomavirus (HPV): Frequently Asked Questions
On live video offered on the Instagram account of the Women's Unit of the Ruber International Hospital, Dr. Alfonso Duque Frischkorn, specialist in Gynecology and Obstetrics, answers the questions of the Dr. Isabel Rodríguez-Piñero Cebrián related to the Human Papillomavirus. This way, we get answers to the most common questions about the most common sexually transmitted infection in men and women, and we understand the importance of preventing this disease.
What is HPV?
It is a virus that has the ability to infect skin and mucous membranesWhen it infects the skin, it causes common warts, but although its name is Human Papillomavirus (HPV), it actually also has surnames in the form of numbers. There are more than 200 variants, 40 of which can affect mucous membranes.
Among these we distinguish between those of high risk, which are the ones that worry us the most, because they can cause significant alterations, and the low-risk ones that, without causing such significant alterations, will give us some annoying condylomas.
How is it transmitted?
The one that concerns us now, which is the High-risk HPV, caused by sexual contact, through contact with infected mucous membranes, primarily through penetration, which is where it is most infectious. We also shouldn't rule out skin-to-skin contact or oral sex, as in these cases there may also be a small amount of transmission.
This is important: there must be contact. Sometimes our patients ask us if they could have been infected in a public restroom, and the answer is no. They also worry about transmitting the virus to their children, and the answer is also negative. It's not possible because this virus needs to come into contact with mucous tissue to infect, and this only happens through sexual contact.
How does cancer occur? Does having the high-risk virus mean I'll get this disease?
First of all, we must take into account several considerations. First, it is estimated that virtually everyone who has sex will come into contact with this virus at some point in their lives. But this doesn't mean, by any means, that there will be a problem.
We have a immune system which is our best weapon to defend ourselves of this virus and practically 85%-90% of infections are passed without the affected person noticing or will pass it temporarily and without after-effects.
However, In 10%-15% of cases, we have a problem And it's not the infection itself, but the persistence of the infection. As time goes by—we're talking years—and the immune system fails to eliminate the virus, it produces premalignant changes that go through several stages: low-grade, intermediate-grade, high-grade... and what we have to do is detect the first stages to prevent serious changes from occurring.
What are the chances that the injuries will develop into cancer?
It has been described that, in many cases, low-grade lesions are the infected cell itself, which is fighting the virus. In 80% to 90% of cases, as we mentioned, the cell—the immune system—wins. Thus, these are lesions we monitor to ensure that the cell wins.
When we move on to high-grade injuries, that's when we have to do a more concrete action.
How do we detect that we have HPV and these lesions?
Fundamentally, through two forms: ultrasound and test.
This virus is asymptomaticAs a patient, you won't know you have the HPV virus, as it won't alter your discharge or cause bleeding or pain. However, we will detect it during routine checkups through conventional Pap smears and the HPV test, which is usually performed every three years.
If this test is positive it does not mean that we are going to have any problem, in fact the vast majority of the time nothing happens, but we are going to enter a group of patients who must be treated. track.
Besides cervical cancer, what other cancers can HPV cause?
We emphasize the neck of the uterus why are especially sensitive cellsThere's an area inside the cervix called the 'transformation zone,' where cells change, and during this rapid change, the virus enters and takes control of the cell.
It can also cause cancer in less sensitive areas, such as the vulva, vagina, anus, penis, oropharynx... although in these cases the incidence is much less important.
Can we say that 100 percent of cervical cancers are caused by HPV?
Yes, practically all of them, by 99%.
What treatment do we apply to a premalignant lesion?
It must be made clear that the virus itself has no treatmentThe best medicine to combat it is a strong immune system, so we should avoid certain habits like tobacco or alcohol, which depress the immune system and encourage this persistent virus to do more harm. A good diet and vitamin supplements, along with natural treatments, help us maintain a strong immune system.
Likewise, the use of condoms is essentialThis doesn't mean that using a condom prevents 80% of the infection, but we're at levels close to XNUMX%, because with condoms, the viral load is contained and the immune system is better able to fight and defeat the virus.
What vaccines are currently available?
Without a doubt, the best way to avoid the virus is through vaccination. Currently, We can find three vaccines, which are safe, effective and combat the virus 16-18, responsible for 70%-80% of cervical cancers. There is another one that also covers warts, and a new one that increases effectiveness by almost 90%.
It's best to get vaccinated before you start having sex, although you can also get vaccinated even if you've already had sex.
If we get everyone vaccinated, we'll definitely win. In Australia, they've managed to virtually eradicate cervical cancer thanks to strict vaccination criteria.
Why aren't boys vaccinated against HPV?
Fortunately, in Spain we have the possibility of give girls an effective vaccine around the age of 12-14. Boys are not vaccinated because resources are not unlimited and because HPV-related cancers are not as common in boys. That's why girls have been vaccinated first, although It will also be included in the vaccination schedule for boys.If we want to stop the spread of the virus, we must also vaccinate men, since, like women, they act as transmitters.
Does it make sense to vaccinate after having a premalignant lesion?
Yes, it makes perfect sense because in 10%-20% of cases, the immune system can't defeat the virus. And for those people who have been affected by the virus and have developed severe alterations, let's say that HPV already has a known pathway. If we have managed to detect and treat a premalignant lesion in these people, the best way to prevent a new lesion is vaccination, which will prevent reinfection.
So, can reinfections occur?
Yes. Having had the disease gives you antibodies against the virus, but it has been proven that this amount of antibodies is minimal compared to what we get from the vaccine.
It should also be noted that the virus can remain silent for years and appear when you have a depression of the immune system.
What factors can help eliminate the virus?
If we have been detected alterations, I would send a message to say that we can take advantage of this moment of nerves and certain chaos to change and improve lifestyle habits: moderate exercise, a good diet rich in fruits and vegetables, taking certain natural supplements, using condoms, abstaining from alcohol and tobacco, vaccinations... In general, it's a good time to rethink some things and start on a good path. We can turn adversity into a much healthier life.
Related articles
- Human Papillomavirus (HPV): Its Destructive Process
- Types of Human Papillomavirus (HPV)
- HPV prevention and regression: the Messi of the immune system
If you found this article interesting and would like to be seen by a professional expert in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized unit in this area. You can request more information by calling 917303673. make an appointment for an in-person consultation Or make an appointment for an online consultation if you prefer remote consultations—always with the best specialists.