HPV

HPV

HPV, Human Papillomavirus, screening, STI, STD, sexually transmitted infection, unsafe sex

Often without symptoms, GET TESTED! AND BETTER STILL, GET VACCINATED!

The Human Papillomavirus (HPV) are among the most common sexually transmitted infections: about 70-80% of the sexually active population have about 70-80% of the sexually active population will will come into contact with these viruses during their sexual life.

There are different types of HPV viruses.

Certain types of viruses cause condyloma (HPV-6 and 11 strains), also known as genital warts or cockscomb. These warts, single or in groups, usually develop in the ano-genital area (anus, perineum, penis, vulva) and are highly contagious. They do not develop into cancer but can be physically and psychologically embarrassing.

Other types of HPV cause precancerous lesions (HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82 strains) and can cause cervical, vulvar, anal, penile and throat cancers cervical, vulvar, anal, penile and throat cancers.

However, there are vaccines that protect everyone against certain types of HPV. In Belgium, the vaccine is free for 13 and 14 year olds, in secondary 2, 1 or born after 2006, through the school medical service or at their GP's. The vaccine is only partially reimbursed for young people between 12 and 18 years old.

The effectiveness of the vaccine is increased if it is given before the first sexual intercourse.

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Transmission modes

HPV is transmitted by :

  • sexual contact (vaginal, anal and oral)
  • by skin contact (rubbing, sexual fondling)

Transmission of HPV is possible even without an apparent wart or any symptoms.

HPVs are spread through direct contact with the infected area. Thirty types of HPV can be transmitted during sexual intercourse (of which there are 200). These can be caught from any intimate contact with an infected area.

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Symptoms

For condyloma

  • One or more warts (condyloma) on the anus, perineum, vulva, penis.
  • Irritation, itching

Condylomata have an incubation period that varies from person to person, Symptoms appear between 3 weeks and several years after infection. These condylomas are usually visible to the naked eye.

For cancers

Some types of HPV can cause precancerous lesions, which in turn can develop into cancer of the cervix, anus, vulva, penis or throat. Cervical cancer is the most common of these cancers.

These precancerous lesions are not not visible to the naked eyeTherefore, a cervical smear should be taken. Depending on the practice, for the throat, anus and penis, a specialist may perform a visual examination.

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Consequences if undetected and untreated

  • Condyloma proliferation
  • If precancerous lesions develop, they can lead to cancer of the cervix, vulva, anus, penis or throat. There is a risk of infertility and even death.

Cervical cancer is one of the most common cancers caused by HPV. Early detection and treatment of precancerous cells helps prevent cervical cancer. In 2018, more than 200 people died of cervical cancer in Belgium.

Other HPVs cause common warts, for example on the hands and feet.

Contraception, prevention, protect, STI, screening, STD, sexually transmitted infection, unsafe sex

Screening

At present, HPV screening is generally only carried out on the cervix via a smear test (reimbursed every 3 years from the age of 25). 

For those who practice anal sex, a preventive proctological examination with a smear test may be recommended. 

Screening of the penis, vulva, mouth and throat is not recommended on a routine basis. Keep an eye on your body and in case of suspicious lesions, it is advisable to consult a doctor.

For condyloma

The diagnosis of condyloma is made by a medical examination by a general practitioner, gynaecologist, dermatologist or proctologist. The doctor inspects the patient's anogenital area and may apply a liquid to make the infected area react.

For cancers

Screening for precancerous lesions is carried out by a cervical smear by a gynaecologist.

Screening for precancerous lesions in areas other than the cervix is not yet sufficiently advanced to be performed.

Warn your partners

If you are hit- ·If you are affected by HPV (condyloma, lesions, cancers) and your partners have a uterus you can warn them and advise them to have a cervical smear.

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Treatment

For condyloma

Condylomata can be treated with ointments applied locally ointments to be applied locally or by removing the warts using liquid nitrogen, acid, laser or electric scalpel treatments. Very often, warts reappear even after local treatment.

For cervical cancer

A positive HPV test after a cervical smear does not mean that you will necessarily develop cancer! The virus disappears in most cases through natural immunity This is why the gynaecologist will not treat you directly.

If the virus progresses over the months and is not eliminated naturally, the gynaecologist will propose a local laser treatment on the areas of the cervix affected by the virus.

If the virus has spread widely, the gynaecologist will then perform surgery: conization. This involves removing a cone-shaped portion of the cervix. This surgery can lead to complications during pregnancy, miscarriages, etc.

It is important to detect these lesions early so that they do not develop into cervical cancer. If cancer is present, the surgeon removes part or all of the uterus (called a hysterectomy). This surgery causes the person to become infertile.

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Protection

The only safe way to avoid HPV would be to never have sex... Even if a person has only one partner, that person could be infected without knowing it because there are often no symptoms. The best strategy is vaccination, if possible before becoming sexually active, in combination with periodic testing.

In 2020, there are three different vaccines vaccines that protect against against certain types of HPV that cause cancer and condyloma: some protect against more types of HPV than others.

However, these vaccines do not protect against all types of HPV, so it is important to examine yourself with the naked eye and visit a gynaecologist or doctor to have a cervical smear.

The best thing to do is to get the vaccine that protects against 9 strains of HPV, it will be much more effective.

The vaccine contains particles that are identical to most types of virus. But these particles are not active and therefore cannot cause an infection. Once the vaccine is injected, the person's immune system reacts by building up antibodies against these particles. The body then builds a defence system that will fight the real virus in the event of transmission.

Vaccines :

Gardasil (2006)

Ø Protects against 4 types of HPV (6,11,16,18)

Ø Protects against genital warts

Cervarix (2007)

Ø Protects against 2 types of HPV (16,18)

Gardasil 9 (2014)

Ø Protects against 9 types of HPV (6, 11, 16, 18, 31, 33, 45, 52, 58)

Ø Protects against genital warts

  • Types 16, 18: 71% of cancer cases
  • Types 6, 11: 90% of genital warts

Even if they offer only partial protection, condoms (external or internal) condoms (external or internal), the latex square or the nitrile glove can protect against HPV. As a reminder, the internal condom (formerly called the "female" condom) covers a larger area of the vulva or anal region, which limits the transmission of HPV.

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Internal condom, contraception, prevention, protect, STI, screening, STD, sexually transmitted infection, unsafe sex
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Recommendation

It is recommended to have a cervical smear (reimbursed) every 3 years or in case of lesions.

In case of regular practice of anal sex, an examination by a proctologist may be recommended every 2 years in certain cases.