HPV means Human Papilloma Virus. HPV is a group of virus types that can affect skin and mucus membranes in the body. They are the most common skin-to-skin contact transmitted virus types worldwide. There are numerous sub-types which have been discovered and can be detected. Many of these sub types cause no symptoms, while others may cause genital warts. High risk sub types are more often associated with precancerous tissue changes of the cervix (cervical dysplasia) that may lead to cervical cancer, if left untreated over years. An HPV screening test can be performed together with a PAP smear test. The sample is collected from the surface of the cervix just like PAP smear testing.
Protection from HPV
The most effective way to protect oneself from HPV affection is not to get in touch with HPV. Once there is an HPV contact, depending on a person's individual immune response and local immune competence, it may lead to an infection. HPV infection commonly does not show any symptoms or cause complaints. In up to 90% of the cases, it is a self-limiting infection resolving within 2 years by itself. There is still in 10% of the cases women stay chronically infected and may therefore develop abnormal intra-epithelial cervical lesions over time. The risk of an HPV affection and infection can be decreased but not 100% eliminated by protecting oneself.
HPV Vaccination
An additional option of primary prevention is an HPV vaccination against the high risk sub-types HPV type 16 and HPV type 18. About 70% of all cervical cancer lesions are caused by these two virus types. With the option of a targeted HPV vaccination, this risk can effectively be minimized. The greatest benefit of an HPV vaccination can be obtained by applying a first vaccination loading dose and its consecutive follow up boosting doses prior to onset of sexual activity in teenagers. Vaccination is recommended to both, girls and boys. The antibodies build up as an immune response to vaccination can thereafter protect from virus invasion into the skin and body mucous membranes and prevent from a chronic virus infection.
Two vaccines are available and they do both target HPV high risk virus types HPV 16 and HPV 18. Vaccination does not cover all high risk HPV sub-types known. A yearly check up and regular PAP smear testings therefore remains crucial for women. Still, experiences with vaccinating women against HPV 16 and HPV 18 over the past years has shown, that vaccination may also be beneficial and protective against other potentially oncogenic virus types in addition. This so-called cross-protection can be explained by similarities in virus surface structure and mode of action, that allows immune response cells identify and attack several virus types.
One of the two vaccines available additionally prevents from infection with HPV low risk types HPV6 and HPV 11, known to be causing non-malignant genital warts. A new vaccination that was recently introduced is targeting nine virus types and therefore seems to be a promising option. All vaccines itself do not contain any oncogenic or cancerous changes causing ingredients. Risks and side effects of a vaccination are comparable with those of other well established recommended vaccinations in childhood and teenage years. Vaccination is a highly recommended option of primary prevention in teenagers, both boys and girls in the age from 9 to 15years. But also later in life vaccination is advisable. Also women in her fertile ages exceeding this main target group can profit from a boost in their local immune response and should ask their gynecologist for more information and an individualized consultation. Still, a regular check up and PAP smear remains crucial in all women.
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Dr. Amelie Hofmann-Werther
Specialist in Obstetrics & Gynaecology
(Facharzt Germany)
Cervical Dysplasia & Coloscopy
Master Class in Fetal Medicine
http://www.fetalmedicine.ae/#dr-amelie
