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Dr. Argay István

Papilloma viruses are species-specific, therefore human papilloma virus (HPV) is dangerous only for humans. They connect to the lower layer of the epithelium released due to tiny injuries and they infect the cells migrating there for restoring the epithelium

HPV types 16., 18., 31., 33 and 45 out of the more than 120 HPV species are of „high risk” (carcinogenous) (they are linked with the establishment of cancers of the cervix, vulva, anus, colon, mouth and oropharynx.) Viruses of „low risk (types 6 and 11) cause mainly warts (condyloma).

HPV is the most frequent agent infecting by sexual contact known today. Infection of the oral mucosa is established mainly by oral sex, but during delivery it can be transmitted from the infected mother to the oral mucosa of the infant. Although condom can reduce the risk, it does not give complete protection and safety, because the virus can be transmitted from any infected skin surface to the skin of the partner! According to certain data, a new HPV infection is related to every fifth change of a partner!

Risk groups of HPV types:

  • high risk 16, 18, 31, 33, 35, 39, 45, 52, 53, 56, 58, 59, 66, 67, 68, 70
  • temporary risk: 40, 42, 43, 51, 54, 61, 62, 69, 71, 72, 73, 77, 82, 83, 84, 86, 87
  • low risk: 6, 11, 44, 55, 74

Cell-transmitted immune processes destroy the HPV-infected cells („transient infection”), consequently HPV-s can remain in the organism only by avoiding or suppressing them („remaining, persistent infection). Smoking – by retarding immune processes – can increase malignant transformation of the HPV-infected cells. The majority of the infections remain unnoticed, they do not cause inflammation. HPV infection can be prolonged in 5-10 %.

The development of cervical cancer is a gradual process: HPV infection →remaining HPV infection →precancerous condition →cancer. Linking is fatal („accident”) for the virus because HPV-DNS linked to the cell DNS will not be transposed any more, no new virus can be produced (because there is no multiplication and therefore the cancer cells do not get infected). The establishment of cancer cells is induced by the formation of HPV E6-E7 proteins in the proliferating epithelial cells for years, by causing chromosomal defects. The virus does not intend to establish cancer, that is the development of cancer is a rare event of HPV-infection: only 1 % of the HPV infections with high risk transform into tumours.

Prophylactic vaccine is available: Silgard (Merck) gives protection against HPV-6, HPV-11 HPV-16 and HPV-18 strains, and Cervarix (Glaxo – SmithKline) against HPV-16 and HPV-18 genotypes. The development of therapeutic vaccine is in progress. In HPV infections almost only specific antibody is produced against the given HPV strain – however the antibodies produced by the vaccine are different, because the injected proteins carry different kinds of antigens – this is the explanation for cross-protection, meaning that usually the vaccination protects not only against HPV contained by the vaccine. However the vaccination cannot replace actual, annual regular gynaecologic screening. Vaccination is recommended for the age group between 10 and 25; always ask the opinion of your gynaecologist, especially when your daughter is concerned.

HPV-testing: During routine gynaecological examination - similarly to the cytological test, sample is taken painlessly from the cervix with a small brush, from an area where there are no nerves. Epithelium taken this way is suitable for determining possible HPV infection. This examination is not a part of the routine cancer screening, it should be asked for separately, or the gynaecologist will offer it on the basis of the clinical status.

In case annual gynaecological screening is made then HPV-infection-related diseases and in particular cervical cancer can be avoided, or successfully cured in time.>

Dr. István Argay

Dr. István Argay
obstetrician-gynecologist

 

Phone number: +36(06)1-213-4222

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