Human papillomavirus (HPV): how it is transmitted, what it causes and how to protect yourself

What is human papillomavirus?

Human papillomavirus (HPV) is one of the most common sexually transmitted infections, and at the same time one of the key risk factors for the development cervical cancer, anogenital warts and some other oncopathologies.

There are over 150 types of HPV, of which approximately 40 affect the mucous membranes of the genital organs. They are conventionally divided into:

• low-oncogenic types (e.g. 6, 11) — cause warts, condylomas

• highly oncogenic types (e.g. 16, 18, 31, 33, 45) — associated with cancer

According to WHO, over 80% people are infected with HPV during their lifetime, most are asymptomatic. But some infected with the virus remains in the body, becomes active or becomes chronic, causing pathological changes in cells.

How is HPV transmitted?

• Sexual path — most common: vaginal, oral, anal contact

• Contact-household route — due to microtraumas to the skin, especially in conditions of high humidity (saunas, swimming pools)

• Vertical path — from mother to child during childbirth

• Through personal hygiene items — rare, but possible infection

Immunologist Larisa Vishneva notes: «"The virus does not enter the bloodstream — it is localized in the cells of the skin or mucous membrane. But this is what allows it to be a long-lasting and inconspicuous parasite in the tissues."»

Symptoms of HPV infection

In most cases, HPV does not cause symptoms and is only detected during examination or screening. However, possible manifestations:

• genital warts (condyloma)

• flat warts, papillomas on the skin

• cervical dysplasia (detected only during cytological examination)

• tumor-like formations in the area of the larynx, pharynx, anal canal

• feeling discomfort during sexual intercourse (if warts are present)

HPV diagnostics

Gynecologist Natalia Shevchenko notes: «"The mere fact of the presence of the virus in the analysis is not a verdict. What is important is the oncogenic type and whether there are already cellular changes. In most cases, the body itself "extinguishes" the infection in 6–24 months."“

HPV and the risk of developing cancer

Highly oncogenic HPV types have the ability to to integrate into the cell's genome, disrupting the mechanisms of apoptosis (natural cell death) and stimulating their uncontrolled division. This is the main mechanism of development:

• cervical cancer

• cancer of the vulva, vagina, penis, anal canal

• oropharyngeal cancer (especially in men)

HPV treatment

The virus itself not excreted from the body, but its manifestations and the changes it causes are treated:

• wart removal: laser, cryodestruction, radio wave method

• antiviral drugs (topical/systemic) — do not have 100% efficacy, but may reduce activity

• immunomodulators — used to stimulate local immunity

• dysplasia treatment: surgical, conization, observation (depending on stage)

• regular monitoring — a key factor in preventing progression to cancer

HPV prevention

• vaccination — the most effective method of prevention

• barrier methods of contraception (condoms do not guarantee complete protection, but they reduce the risk)

• hygiene and monogamous relationships

• giving up bad habits (smoking reduces local immunity of mucous membranes)

• regular screening — PAP test every year after the start of sexual activity

HPV vaccination

Available vaccines:

• Cervarix — against types 16 and 18

• Gardasil — against types 6, 11, 16, 18

• Gardasil-9 — extended spectrum: types 6, 11, 16, 18, 31, 33, 45, 52, 58

Recommended:

• for children 9–14 years old — before the start of sexual activity

• women under 26 years old — even if there is already contact with HPV

• to men — for the prevention of warts, rectal cancer, oropharyngeal cancer

The human papillomavirus is not a sentence, but a diagnosis that can and should be worked with. Timely diagnosis, vaccination, and self-care are the best allies in maintaining health.