Although it is usually mentioned in the singular, human papilloma virus (HPV) are many: there are more than 200 kinds. And they are responsible for the most frequent sexually transmitted infections in the world. Such infections are associated with one in twenty human cancers, a figure that doubles if only women are considered: the relationship appears in one in ten cases.
Health will not include the papilloma vaccine in the calendar of children, despite the WHO recommendations
Of the two hundred existing HPVs, only slightly more than forty affect the genital area. They are divided into two large groups: low risk and high risk. Those of low risk are the majority and can produce benign lesions – like warts – in areas such as the genitals, the anus, the mouth or the throat. However, in most cases, these types of viruses do not cause symptoms or problems.
The problem is caused by high-risk HPV. In proportion, they are not many. But they add up to at least fourteen and according to studies Are responsible for virtually all cases of cervical cancer. Two types of the virus, called HPV16 and HPV18, are responsible for 70% of this total and the same proportion of precancerous lesions in that part of the body. Furthermore, as the World Health Organization adds (who), “there is data linking HPV to cancers of the anus, vulva, vagina and penis.”
An infection present in almost everyone
HPVs are so common that – says the WHO – most people get infected with them shortly after starting your sex life. And according to the National Cancer Institute of the United States, about half of those infections are due to a high-risk virus. Fortunately, in most cases the immune system of the human body controls them and, thanks to that, cancer or other important consequences do not occur.
The problem arises when one of these infections persists for many years. What usually happens in these cases is that cellular changes occur, which – if not treated – over time they get worse and they turn into cancer. For this reason, tests and controls for the early detection of these problems are key to possible treatments and thus avoid the development of the disease.
Can the transmission of HPV be prevented?
HPVs are transmitted through sexual intercourse, both vaginal and anal and oral. And while using latex condoms and dental dams lowers the risk, it doesn’t completely eliminate it. In fact, viruses can be transmitted even through the intimate skin-to-skin contact.
So, in this sense, the only 100% effective form of prevention would be to avoid sexual intercourse. But abstinence can generate other negative consequences, so it is not seen as a viable solution. The most recommended prevention method is the vaccine.
The Vaccine Advisory Committee of the Spanish Association of Pediatrics (AEP) recommends its application “to all adolescent girls and boys living in Spain, preferably at twelve years“Why at such a young age? Well, because vaccination is more effective if it is carried out before the infection occurs.
And since this almost always occurs shortly after starting sexual life, if the vaccine is applied at that age, its preventive effects will be superior. Thus a study A large-scale study published last month by Swedish scientists confirmed that the application of the HPV vaccine substantially reduces the incidence of cervical cancer.
The study, which analyzed data from almost 1.7 million women between the ages of 10 and 30 over a period of 11 years (between 2006 and 2017), highlighted the efficacy of the vaccine when applied before the age of 17. age: in these cases, the chances of suffering from this type of cancer decrease by about 90%.
Facts about the vaccine
However, beyond the convenience of administering the vaccine during preadolescence or adolescence, throughout the sexually active life the risk of acquiring new infections remains, due to the wide variety of HPV types that exist.
That is why the application of the vaccine, although not as effective after the beginning of sexual life, is still justified. There are three types of HPV vaccines: Gardasil, Cervarix and Gardasil 9. The three vaccines act by generating protection against the two most harmful types of the virus, the aforementioned HPV16 and HPV18.
But the Gardasil 9, the most recently developed, expands its coverage: it reaches, according to AEP experts, at 90% of viruses. In addition, the latter and the former Gardasil also protect against low-risk viruses, those that cause warts and other benign lesions.
The first programs free HPV vaccination They were implemented in 2007, and generally since then have focused on women and girls. In 2018, the Ministry of Health indicated the need to expand coverage also to men, particularly those who have sex with other men.
Secondary prevention and treatment
Vaccination is, for this reason, the most effective method for the primary prevention of HPV transmission. A form of secondary prevention it is the aforementioned early detection of precancerous lesions. This early detection is generally done through two tests: HPV-specific and conventional cytology, also known as the Papanicolaou test.
Otherwise, an HPV infection itself cannot be treated. Yes you can act against its consequences. For precancerous lesions, as well as warts and other benign lesions, topical medications (creams) or excision procedures, such as surgical excision, cryosurgery, and loop electrosurgical excision (known by its acronym in English as LEEP). In general they are effective and safe.
When cancer has already developed, treatments are generally similar to non-HPV cancers. This is almost always the case, except in certain particular cases, such as oropharyngeal cancer.
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