After her husband’s urinary infection, which required several medical investigations, Ioana P. received the recommendation to do a Pap test. Her surprise was not small when she found out that she had a human papilloma virus (HPV) infection, which led to moderate cervical dysplasia. The doctor’s recommendation was to treat this infection carefully, as the consequences can be serious, and its worsening could even lead to a more serious diagnosis, namely cervical cancer.
At that time, Ioana did not know that a common virus can cause cancer and another one of the most aggressive, which annually causes more than 1,500 deaths, only in our country. After a few months of treatment, her test results are good, but she remains vigilant because a weakened immune system or other health problem could reactivate the infection. Moreover, because she also has an 11-year-old daughter, she is already interested in the family doctor to vaccinate her against HPV, because she wants her daughter to be protected from cervical cancer and not to go through the emotions and worries what she went through as a mother.
HPV infection, a public health problem
HPV infection, a health problem seemingly as common as a cold, is the cause of death of more than a quarter of a million people worldwide, especially women, annually. It has no symptoms, but unfortunately for a certain number of cases, the infection turns into a relentless cancer.
HPV is short for human papilloma virus, a group of nearly 200 related viruses that are spread primarily through sexual intercourse, whether vaginal, anal, or oral. This large family of viruses includes very aggressive types (specifically types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59), which can cause forms of cancer. When the HPV infection persists in the body for years, the virus affects the cells of the mucous membranes and those on the surface of the organs (epithelial cells), causing the form of cancer called carcinoma. This is a certainty now.
The discovery dates back to 1970, when a German virologist, Harald zur Hausen, detected HPV viruses in cervicals attacked by cancer, but also in some warts in the genital area. From the diseased organs, the doctor was able to identify two very widespread strains, namely HPV 16 and 18, which were found in most patients. For his research, zur Hausen was awarded the Nobel Prize in 2008.
What you need to know about HPV
Papilloma viruses are very common. “All sexually active people, regardless of gender, race, or sexual orientation, will become infected with HPV within a few months to a few years of starting their sexual life. Even using a condom does not completely protect against infection, because the virus is also active on the skin around the genitals. About half of the infections are caused by strains with a high oncogenic risk – that is, they are a potential danger of causing cancer”explains Dr. Mihaela Steriu, Primary Obstetrics-Gynecology Physician at the MedLife Grivița Hyperclinic.
Most HPV infections go away on their own. A normal human’s immune system is perfectly capable of eliminating the infection after a year or two.
Persistent infections can cause cancer. Sometimes those dangerous strains cannot be eliminated by the immune system. The infection remains in place for many years, produces small changes in the cells that, untreated, can worsen and become precancerous lesions, and then cancer.
There are several locations of cancer caused by HPV. In addition to cervical cancer, cancers can also occur in the vulva and vagina, oropharyngeal cancer, if the infection is in the mouth, but also the anus, penis, bladder and prostate.
Cancer can be prevented by anti-HPV vaccination. The anti-HPV vaccine is able to eliminate the most dangerous and common strains of the virus and thus prevent the occurrence of cancer. The vaccine can be given both before the start of sexual activity and later, in young adults who do not have persistent HPV infection .
The mechanism by which HPV infection turns into cancer
HPV infection causes small changes in the cells, which in medical language is called dysplasia. If they are not treated, over time, they turn into cancer cells, which grow anarchically. Once infected, cells stop multiplying normally, being diverted to multiply the virus and communicate “wrong” messages to other cells, leading to the growth of abnormal cells. Normally, this is stopped by the immune system, but there are cases where the immune mechanisms do not work 100% -DRand the aberrant cells continue to live and lead to the appearance of precancerous lesions.
If they are not treated in time, they will turn into full-blown cancer. These changes sometimes last for years: it can take 5-10 years for precancerous lesions to appear and even 20 years for genital cancer to appear.
When cells become infected with HPV, there are also some factors that increase the risk that the infection will become persistent and lead to precancerous lesions, such as infection with a highly oncogenic strain, especially HPV16 or HPV18, smoking, a weakened immune system, infection pre-existing HIV or drug treatments that weaken the immune system, such as after a transplant, in the presence of another form of cancer or in autoimmune diseases.
Dysplasia, the local cellular change, can be classified as mild, moderate, or high. Mild dysplasia usually goes away on its own, meaning the infection is gone. Moderate and high dysplasias are precancerous conditions and require treatment before they irreversibly turn into cancer. Not all precancerous lesions become cancer, and researchers are currently trying to identify biomarkers that can predict this transformation of precancerous lesions into cancer.
How do you know if you are infected with HPV or not?
Since HPV infection does not cause symptoms, the only way to find out whether or not you are a carrier of the virus – and thus at risk of developing cervical cancer – is to undergo screening tests.
For the other types of cancer caused by HPV, penile, anal, oropharyngeal, vulvar or vaginal cancer, there are no standardized screening tests.
For cervical cancer screening, in young women (21-30 years old), good doctors recommend the annual Pap test for the early detection of this type of cancer. After the age of 30, the gynecologist may recommend a full screening for cervical cancer, which consists of both a Pap test and a genetic test for human papillomavirus (HPV) infection.
Learn more about when and how the Pap test is performed.
If the test results are good and there are no pathological changes, the doctor will indicate the interval at which the screening tests should be repeated.
If, however, the results are unfavorable, the treatment will be decided by the doctor depending on how advanced the disease is, but also on other conditions that the patient may have.
Cancer can be prevented by anti-HPV vaccination
The anti-HPV vaccine, capable of preventing persistent infection and cancer caused by this type of virus, is recommended for girls and boys from the age of 11, and it is free until the age of 19. It is a vaccine that is given by injection, with two or three doses.
The vaccine is currently also recommended for women between the ages of 19 and 45, being compensated 50% by the state, through the National Program.
The vaccine is safe and effective, proven by data from countries that have been using it for over 10 years (Nordic countries or Great Britain). For example, Australia looks set to become, in just a few years, the first country with no cases of cervical cancer. By comparison, in Romania, in 2020 alone, more than 95,000 new cases of cervical cancer were diagnosed, this being the third cause of death for women in our country.
That is why a simple screening, carried out periodically, prevents diseases that are mostly silent, but which can become fatal.
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This article is supported by MedLife, the largest network of private medical services in Romania, and aims to be a source of information and inspiration for a healthy and balanced life.
Health is the main source of happiness for Romanians. At MedLife, people’s happiness makes us happy and motivates us to provide medical solutions at the highest standards.
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Tags: sexually active people infected HPV infections clear immune system HPV infection lead cervical cancer
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