Human papilloma virus is known to be an important causative factor of cervical cancer, and is a double helix DNA virus belonging to the Papovaviridae family. To date, more than 100 human papillomaviruses are known. Among them, 40 species are found in the reproductive organs and are known to cause pathological changes in the cervical epithelium. Among them, the high-risk group, carcinogenic human papillomavirus, is known to be highly associated with cervical cancer. Of the carcinogenic human papillomaviruses, 16 and 18 are the most relevant and are found in more than 70% of cervical cancers worldwide.
In addition, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 69, 73 belong to high-risk virus. The low risk group viruses found in condyloma, which are benign pathological changes in the cervix, are 6, 11, 34, 40, 42, 3, 44, 54, 61, 70, 72, 81, etc.
Symptoms
Most of the cases are asymptomatic. In case of infection by 6 or 11 of the low-risk virus, warts appear on the vulva or genitals. Symptoms such as pain and pruritus may be accompanied, and tissues may be easily broken.
Diagnostics
Although the Pap smear test can be used as a test method for human papillomaviruses, it is not suitable because of its low detection rate. In addition, culture tests are also not suitable because conventional virus culture techniques cannot distinguish human papilloma virus infections. Recently, methods for testing the presence and genotype of human papillomavirus using virus DNA have been developed and are being used as useful testing methods. Hybrid Capture II and cobas® HPV Test have received FDA approval. The cobas® HPV Test is an FDA-approved test method that is also the primary screening test. Hybrid Capture II is a simple outpatient method that can simultaneously detect 13 types of high-risk human papillomaviruses. In addition, this test method has the advantage of being able to obtain test results in a short time and predicting the extent and severity of pathological changes. In addition, there is a test method using a human papilloma virus gene chip (HPV DNA chip). This method is simple and can be tested with a small amount of specimen. In addition, this method has the advantage of being able to simultaneously check whether the human papilloma virus is infected and the type of the infected virus.
Treatments
1) There is no known treatment for asymptomatic human papillomavirus infection. Vaccines against several types of human papillomavirus have been developed and used to prevent cervical cancer, but the effectiveness as a therapeutic vaccine has not been known.
2) Treatment for genital warts: As a treatment for benign pathological changes related to human papillomavirus, there is a palliative removal method. Cytotoxic substances such as podophyllin and 5-Fluorouracil (5-FU) and cytokines such as interferon are used, and new drugs are being developed recently. However, there is still no way to completely destroy the virus. Current treatment goals are to eliminate lesions, reduce recurrence rates, and reduce the likelihood of developing cancer.
Progress and complications
In most cases, the human papillomavirus that has infected the human body is eliminated by the immune system. The average duration of infection is about 9 months, and 90% of infected people heal naturally without special treatment within 2 years. However, people who are constantly infected with the high-risk human papilloma virus are very likely to develop cervical cancer. The following cases, known as cofactors of carcinogenesis, are known to accelerate the progression of cervical epithelial neoplasia and cervical cancer.
- Cigarette smoking
- Taking long-term contraceptives
- A lot of childbirth experiences
- Immunocompromised state
Prevention methods
Human papillomavirus can be prevented with a prophylactic vaccine known as a cervical cancer vaccine. The multinational pharmaceutical company MSD’s tetravalent vaccine for cervical cancer has been approved for vaccination to girls and young women aged 9 to 26 years old. This vaccine is re-vaccinated 2 and 6 months after the first vaccination. Research is still underway on how long the drug will last after three doses of vaccination. In December 2006, a study was published in the British Journal of Cancer, a medical journal, that the efficacy of a vaccine to prevent HPV could last up to 5 years. This is the result of a follow-up study of the effect for 5 years after the vaccine was developed, and it is expected to be able to prove that the effect will last for a longer time in the future.
The American Academy of Pediatrics (AAP), Center of Disease Control and Prevention (CDC), and Advisory Committee for Immunization Practice (ACIP) recommend mandatory HPV vaccination for girls aged 11-12 years old. They also said that it is possible to vaccinate girls between the ages of 13 and 18.
The most important thing is to get vaccination before HPV infection, and women who have already had sexual experience or who are 26 years of age or older can get a preventive effect through vaccination if they are not infected with HPV. It is recommended that women between the ages of 9-14 and 27-45 can be vaccinated based on medical judgment. Details related to this can be determined by consulting an expert.
In addition, Gardasil, a tetravalent vaccine for preventing human papillomavirus, has been approved for vaccination in men. The best time for vaccination for men is between 11 and 12 years old, before the start of the sexual experience. Men who have not been vaccinated before are also recommended to be vaccinated at the ages of 13 to 21, and men aged 22 to 26 can also be vaccinated.
Living tips that will help
Human papillomavirus has not yet been fully identified, but most cervical infections are known to occur through sexual intercourse. Therefore, it can be said that it is most effective to limit the number of intercourse subjects to prevent infection. However, since infections in women with no sexual experience are also reported, it is not possible to determine the sexual partner as the source of infection when infected with the HPV.
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