When it comes to HPV, everyone is no stranger. Its Chinese name is human papillomavirus. Although there have been many reports on the past and present of this star vocabulary in recent years, people are still worried about it. Often patients will rush into my clinic and panic: “Doctor, big things are bad, I am infected with HPV. What do you say if I am so young? I want to get pregnant…”
“Cow of the cervix”
HPV is a virus that is very susceptible to infection of human epidermis and mucosal squamous epithelium. It is widely found in nature and is mainly transmitted through sexual activity. But it needs to be emphasized that sexual behavior is the main route of transmission, not the only one.
HPV can also be infected by direct contact, such as hand contact with HPV-contaminated items, it may bring the virus into the reproductive organs when going to the toilet or bathing; or the genital organs may be exposed to HPV-contaminated bath towels, underwear, etc. be infected.
About 80% of people are infected with HPV throughout their lives, usually shortly after their first sexual activity. Therefore, you don’t have to panic, HPV infection is very common, doctors often nickname it “the cold of the cervix.” After HPV infection, the body’s immune system responds to HPV and removes it. That is, most HPV infections are transient and have no clinical signs. About 90% of HPV infections will resolve within two years.
HPV is a big family
HPV has now found more than 100 different genotypes, more than 40 of which can infect male and female reproductive tracts. HPV is divided into two categories: high-risk and low-risk. Different types of HPV have different pathogenic abilities. The high-risk types that the World Health Organization (WHO) have identified are: HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68. These types are associated with high-grade lesions of the cervix, vulva, vagina, and anus, and the onset of malignancy, of which 70% of cervical cancers are caused by HPV16/18. Low-risk HPV types 6, 11, 40, 42, 43, 44, 54 are mainly associated with low-grade squamous intraepithelial lesions and genital warts (condyloma acuminata).
It is often asked: Can cervical cancer occur in HPV infection? The answer is: not necessarily. About 90% of HPV-infected individuals rely on their own immune function to automatically remove the virus within two years. The time of removal is mainly determined by the HPV type. The low-risk type takes about 5 months to 6 months, and the high-risk type HPV needs to be 8 months to 24 months. Infection with low-risk HPV does not develop into cervical cancer. Even if high-risk HPV is persistently infected (generally defined as two years), only 10% of people may develop precancerous lesions after 10 to 20 years. Cervical cancer. Moreover, the progression from HPV infection to low-grade lesions and high-grade lesions is reversible. In other words, even high-grade lesions can be reversed to a lower level, while low-grade lesions can be resolved without any treatment, but must be followed up. High-grade lesions must be treated promptly (except during pregnancy).
Therefore, getting cervical cancer is really not a one-off thing. First, you need to infect HPV high-risk virus; next, the autoimmune system can not naturally eliminate the virus, causing persistent infection, and missed the stage of treatment of cervical precancerous lesions; eventually it will develop into cervical cancer. After clearing these, do you think that HPV infection is not so terrible?
Is there any discomfort after infection?
Most HPV-infected people do not have any symptoms or signs and do not know they are infected. The virus can be lurking in the human body for many years, and infected people can continue to transmit the virus to their sexual partners. But you need to be reminded that in recent years, studies have shown that vaginal microflora dysregulation is closely related to HPV infection. Small vaginitis will increase the susceptibility of HPV if it is not diagnosed and standardized. Therefore, when women with sexual life between the ages of 25 and 64 have genital itching, vaginal discharge, yellowing, and odor, they should be treated promptly to determine whether there is vaginal inflammation and regular cervical cancer screening.
In addition to this, it is necessary to point out that HPV infection is not a “special favor” for women, and men can also contract HPV. For men, low-risk HPV infection can cause diseases such as condyloma acuminata, and high-risk HPV infection is closely related to the occurrence of anal cancer and penile cancer. HPV 16 or 18 can be detected in the diseased tissue of 50% of patients with penile cancer.
Because men are more difficult to collect samples, the means of detecting HPV is still being explored, so it is often missed. It is currently not recommended for asymptomatic men to routinely detect HPV. Therefore, male HPV infection has become a hidden threat. Studies have shown that male penis foreskin is too long or phimosis, which is an independent risk factor for cervical HPV infection in female partners. HPV is often hidden in smegma, so men with prepuce or phimosis are recommended to undergo circumcision, leaving these hidden killers without a place to go. In addition, once a male has any new or unusual sputum, abnormal hyperplasia, mass or ulcer in the penis, scrotum, anus, mouth or throat, he should go to the hospital in time.
Clear HPV mainly by itself
As mentioned earlier, HPV infection is transient and can rely on the autoimmune system to clear it, so no special treatment is needed. Clinical application of interferon and some proprietary Chinese medicines in the cervical cavity have certain effects in helping to eliminate the virus. There is currently no effective treatment for HPV infection, and the marketed prophylactic HPV vaccine cannot treat already infected HPV. Therefore, enhancing the body’s immunity is an effective way to speed up the clearance of HPV infection.
What are the ways to enhance the body’s immune function? Existing literature indicates that smoking is an independent risk factor for HPV infection. Female cervical precancerous lesions and cervical cancer are also associated with passive smoking. Therefore, smoking cessation and reduction of passive smoking are important for HPV clearance. Secondly, vaginitis and cervicitis can affect the local immunity of the cervix, thereby prolonging the clearance period of HPV infection, and increasing the possibility of persistent infection of HPV. Third, staying up late and overworking can reduce autoimmune function and is a risk factor for HPV infection clearance. Therefore, HPV is infected, exercise is strengthened, bad living and hygiene habits are changed, immunity is improved, and treatment is heavier.
What to do if HPV is positive
The expert consensus issued by the China Association for Eugenics, the recommendation for abnormal HPV screening results, is that high-risk HPV testing is recommended for women over the age of 30 because young women are high-risk people with HPV infection. HPV16/18-positive women, or non-16/18 high-risk positive combined cytology screening (TCT) for ASC US (unclear squamous epithelial lesions), require direct referral for colposcopy. If necessary, take a biopsy to see if there is a precancerous lesion or cancer. If a cervical biopsy is found through tissue biopsy, it may be necessary to receive laser, microwave, cervical ring electrosurgery (LEEP) and cervical conization under the guidance of a gynaecologist.
Found that HPV infection can still be pregnant?
Women who are pregnant should be diagnosed with HPV (HPV16 and HPV18) if they are diagnosed with HPV during a physical examination. Combined with TCT screening results, a comprehensive analysis of whether colposcopy is needed is needed. If there is no lesion, it is only HPV infection, and it is better to wait for HPV infection to clear after pregnancy. If you are pregnant, you will find HPV infection during pregnancy, without excessive panic, and you don’t have to terminate your pregnancy.
HPV infection is very common, HPV infection does not mean cervical cancer, I hope everyone can maintain a healthy lifestyle: quit smoking, drinking, staying up late and other bad habits, delay the time of first sexual life, use condoms correctly, minimize sex The number of partners, and inoculation of prophylactic HPV vaccine before sexual behavior to achieve etiology prevention and control.