The human papilloma virus and its various manifestations

Written by: Dr. Carlos Amselem Amselem
Published:
Edited by: Top Doctors®

What is HPV

The human papillomavirus (HPV) is a DNA-like virus, of which more than 100 different varieties are currently known.. Of these, some are related to simple warts, which for example affect the hands, feet, or neck and have little pathological significance. Two other varieties are related to genital warts ( condylomata ) and, although they are very annoying, they also have little pathological significance. The rest of the strains can be classified as low risk or high risk to produce epithelial cancer .

Special attention should be paid to high-risk strains that, by affecting skin and mucous membranes, can progress to a type of cancer. They especially affect the cervix, vagina, anus, penis and oropharynx (oral cavity).

It is usually a sexually transmitted virus , and can be analyzed by tests that are already well proven due to their effectiveness as cytology.. If its presence is detected, the strain to which it belongs must be cataloged by in situ hybridization , or better by PCR , since the management is very different if it is a high or low risk strain.

 

What symptoms does it present?

The symptoms also vary according to the type of strain. Those that produce the so-called common warts, which are usually located on the hands, feet and neck, are shaped like a small cauliflower and tend to disappear on their own. Nor are they linked to the development of cancer. There are other types of strains that produce genital, anal and oropharyngeal warts. They also tend to evolve favorably in people without immunological depression, although sometimes they require some type of medical intervention for their elimination, and they are not associated with the development of cancer.

On the other hand, the rest of the strains, and especially those at high risk, cause cell affectation and are potentially generators of cancer. Before they produce dysplasia , which is evolving in different degrees of severity, over the years. The lesions are not clinically detectable and can only be evidenced by cytological analysis ( Papanicolau ).

Relationships with several sexual partners, early onset of sexual intercourse, infection by a high-risk virus, persistence of infection over time, some state of immunosuppression and smoking are some of the risk factors for develop a cancer

Existing treatments

Common warts do not usually need treatment, in any case it is enough to remove them by topical application of specific creams or liquid nitrogen , or through the electric scalpel. The same can be said for genital warts, and you should be careful in the application of creams for the delicate areas to be treated.

Regarding the infection of the rest of the strains, the priority is prevention. This is achieved by avoiding risky sex, using condoms and lately with anti-HPV vaccination. At present there are two vaccines on the market, one that protects against infection of viruses 6, 11, 16 and 18 (GardasilÒ) and another that protects against viruses 16 and 18 (CervarixÒ). It is recommended to use them to women between 11 and 25 years old, although the indications are increasing every time.

Once the infection has developed, if it persists in time or due to a high-risk virus, the exeresis of the affected area should be indicated (usually surgical slicing), and as a result the healing and analysis of the possible extension is achieved. through anatomopathological investigation of the excised area.

*Translated with Google translator. We apologize for any imperfection

By Dr. Carlos Amselem Amselem
Obstetrics & Gynecology

*Translated with Google translator. We apologize for any imperfection

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