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HPV is a microorganism comprising DNA affecting epithelia . Has been considered a sexually transmitted disease but can be transmitted without sex ( 5%). It has a great impact on women's health as it has been shown to cause cervical cancer , dysplasia and genital warts. It can complicate pregnancy .

The International Agency for Research on Cancer ( IARC) considers that HPV types 16, 18 , 31, 33, 35 , 39, 45, 51 , 52, 56, 58 , 59 and 66 are carcinogenic to human -type high cancer - risk than other types, including HPV 6 and HPV 11 , are possibly carcinogenic to humans types of low - risk cancer .

HPV disease can be detected by methods such as cervical cytology or Pap smear , the polymerase chain reaction and hybrid capture ( HC2 ) , colposcopy , cervical biopsy directed by colposcopy.

Treatment depends on the virus involvement in the lower genital tract, includes immunostimulatory drugs , cryotherapy, electrosurgery, diathermy loop , laser vaporization , hysterectomy , among others.

Currently we have very modern techniques for HPV detection and staging such as immunohistochemistry and P-16 , hybrid capture , PCR. Colpocytological a semiannual monitoring is recommended in patients who have had HPV after treatment .

Vaccine against Human Papillomavirus (Gardasil ) is endorsed by the Food and Drug Administration as a safe and effective vaccine against cervical cancer and in the lower genital tract warts.

Epidemiological evidence , clinical and laboratory suggests that the Human Papilloma Virus HPV plays an etiologic role in the development of squamous cell carcinoma of the cervix , therefore accepted as a valid strategy screenig or search for HPV DNA , especially to detect the high oncogenic risk genotypes ( HPV 16 - 18-31 - 33-35 - 39 - 45 etc. . ) .

HPV infections can be located at : CERVIX , VAGINA , VULVA , anus, penis , etc. . By molecular biology techniques (PCR , Hybridization - digene second - generation ) can identify and characterize HPV high-risk groups ( HPV - DNA).

Highlights HPV

HPV is the necessary cause , but not enough of cervical cancer and its precursor lesions , as well as other cancers of the lower genital tract ( vulva, perineum ) .

HPV infection is primarily a sexually transmitted disease and sexually transmitted disease more prevalent in sexually active people .

The presence of HPV , even high oncogenic risk , not necessarily a process of neoplastic transformation. Must take place a series of biological events associated , as the persistence of the infection to high-grade intraepithelial lesions and cervical cancer from developing. Other co - factors , snuff or prolonged use of oral contraceptives, HPV interact with and modulate the risk of progression . The snuff multiplied by 2 the risk of neoplastic progression in women infected with HPV.

There is a genetic predisposition to the disease. Immunosuppressed women, HIV infection or immunosuppressive therapy have a higher risk of developing an HPV infection , clinical and subclinical lesions and more extensive risk and evolve faster .

The most accurate for typing techniques are HPV Hybrid Capture DNA and PCR. However as routine clinical techniques are not widely available and are expensive . Therefore, Hybrid capture , while not allowing an individualized definition , is the current method of choice for routine detection of HPV.

For cytological report using the Bethesda 2001 system is recommended .

Colposcopy and biopsy are necessary to diagnose intraepithelial lesions and cancer in women with abnormal cytology (ASC -US, ASC- H , AGC, LSIL , HSIL or cancer ) . However, in women with ASC -US , is justified prior selection HPV test and refer only positive for high oncogenic risk types of colposcopy.

Cytology or Pap smear is a screening technique for cervical cancer , not diagnostic . To improve sensitivity should be complemented with colposcopy and biopsy.

Initial treatment of small and some large condylomas , preferably should be medical Imiquimod . In old extensive and / or recurrent lesions condylomatous surgical methods should be employed. In case of suspicion of invasion of the cervical canal should be performed microcolpohisteroscopía .

After treatment, the patient must be in a semi colpo cytological follow .

The HPV vaccine may also prevent cancer of the oropharynx and rectal cancer.

Treatment

Depending on the case ( extent and severity ) may propose the following treatments:

Colposcopic following Pharmacological treatment with local and systemic immunostimulatory action.

Surgical treatments such as electroesferolisis , LEEP , laser. Hysterectomy. cryotherapy It will always be necessary to individualize each case for proper solution and better prognosis.

Read article The cure HPV .

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Human Papilloma Virus / HPV / HPV / vaginal warts / genital / gynecological Cancer Warts / abnormal Pap smear / Dysplasia / condilomatosis / micropapilomatosis / STI