Papillomavirus: symptoms of the HPV virus, screening test, vaccine

"Papillomavirus: symptoms of the HPV virus, screening test, vaccine"

Transmitted during intercourse, papillomavirus (HPV) can cause different more or less serious lesions, going to the cervical cancer.How is its transmission?How to do a screening test?All about Professor Olivier Graesslin, head of gynecology-obstetrics at the CHU de Reims.

Definition: What is papillomavirus?

This virus belongs to the large family of human papillomavirus (HPV) which has around 200 members (genotypes).These are very contagious viruses that affect men as well as women and who are present on the whole planet."Some of these viruses can remain in the body without causing symptoms (latent infection) and are often spontaneously eliminated," observes Professor Olivier Grasselin, chief of gynecology-obstetrics at the CHU de Reims.Several types of HPV can infect the skin or mucous membranes and colonize certain parts of the skin, mouth, external genitals or anal region.

How do you get a papillomavirus?

The papillomavirus present in the genital region are transmitted almost exclusively by sexual contacts (even when a report is protected by a condom).They are the most frequent cause of STI, sexually transmitted infection.

• Papillomavirus in women

"During their life, more than 80% of sexually active women will be in contact with one or more HPV and, in the majority of cases, will spontaneously get rid of them within 2 years to 3 years (development of'natural immunity).The persistence of this infection beyond several years can be the cause of certain pathologies (diseases) ", continues the specialist.Transmission can exceptionally be carried out by infected laundry or clothes, much more frequently during contact between an infected mucosa and a healthy mucosa during a vaginal, oral or anal sexual intercourse.Risk factors in women are the early age of first sexual intercourse, relations with multiple partners and the presence of another sexually transmitted infection (IST).

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Symptoms and location: mouth, throat, tongue?

"Most of the time, HPV infection in the tissues does not cause any symptoms.The virus is present within the mucous membranes without causing lesions.In some cases, we can observe a papilloma (or wart) which defines a lesion located on the skin or mucous membranes, tissues lining the interior of certain organs ", underlines the gynecologist.It is a small benign tumor, generally flush on the surface of the skin, produced by an abnormal increase in the size of the taste buds, small roughness located on the skin or the mucous membranes."This benign lesion is very contagious and can cure spontaneously or thanks to the help of treatments applied directly to the lesion (laser, cryotherapy, medicine).The appearance of warts in the external genitals, in men or women, must lead to medical consultation.In case of collar cancer, the most frequent symptoms are vaginal losses or abnormal bleeding, apart from rules, often caused by sex ", specifies the specialist.

Diseases associated with papillomavirus

The associated risks vary according to the papillomavirus (low -risk and high risk genotypes).Some do not cause any problems, others cause benign manifestations like warts on the skin or condylomas.Other viruses can cause precancerous lesions, or cancers, one of the most common is cervical cancer."In a large number of cases, the infection of the cells of the organism by the HPV will only be transient.Indeed, the immune defenses of infected individuals can allow spontaneous elimination of the virus before it has caused lesions, "said Professor Olivier Graesslin.

• Precancerous lesion and cancers

"Among high-risk HPVs (HPV-HR), type 16 and 18 HPV viruses are the most frequent (responsible for 70 to 80% of collar cancers) and the most at risk of leading to the formation of precancerous lesions(dysplasia) at the level of the cervix, "notes the specialist.These dysplasia are of variable severity and qualified as light or severe depending on the proportion of infected cells which develop abnormally in the mucosa.Some of these dysplasia may disappear spontaneously and others evolve if they are not treated.For a small part of them, the evolution towards a cervical cancer in several years is possible."These pre-cancer (dysplasia) and cancerous lesions can also be observed in other organs such as anus, vagina, vulva, tonsils (at the throat) or the penis, but with a frequencylesser that at the level of the cervix ", nuances Pr Graesslin.

What exams to detect it?

HPV virus screening is done through the smear and the HPV test."The goal of the smear is to identify abnormal cells at the level of the cervix, even before they become cancerous.If the existence of a precancerous anomaly on the collar is confirmed by means of a biopsy produced by the gynecologist, it is removed (conization) which prevents the appearance of cancer.Screen smear is therefore a very good way to fight against cervical cancer, "notes the specialist.The more an anomaly is detected early, the better it is treated.The smear is a simple and painless sample which takes only a few minutes, and can be carried out by a gynecologist, the attending physician or a midwife, even by a biologist at the medical analysis laboratory.To date, screening for cervical cancer is proposed under the following conditions:

Papillomavirus: the vaccine

Two vaccines can be offered against several types of papillomavirus, including HPV 16 and 18 and be administered to young girls between 11 and 14 years old, who have not yet started their sex life."It can also be prescribed, in catch -up, to women between 15 and 19 years old.This vaccine is also recommended in men under 26 with sex with men, "added the gynecologist.

This vaccination does not protect against all types of HPV and its duration of action is not yet exactly known.However, its effectiveness has been demonstrated by several scientific studies.It should not prevent the creation of smear for the screening of the cervical cancer, these 2 measures being complementary to fight against these pathologies.The countries in which the rate of vaccination coverage is significant gradually see the rate of precancerous and cancerous lesions of the collar decrease very significantly (example of Australia).The wider use of this vaccine in France could make it possible to significantly reduce the number of conservation (30,000/year) and cervical cancer (3,200/year).

Note: the High Authority for Health proposed to expand vaccination to all boys aged 11 to 14 in a statement on October 30, 2019.

Treatments: How to treat a papillomavirus?

"There is no drug that is active to treat HPV infection when it is installed.However, it should be remembered that many of these infections are completely asymptomatic and transient, the host defenses to eliminate the virus.When the infection causes precancerous lesions (at the level of the cervix or the vulva for example), these must be detected, diagnosed precisely and can be subject to surgical or laser treatments, or even treatmentstopical (local application of active products on lesions and virus).Regarding cervical cancer, the treatment will be all the easier and the chances of healing all the higher since the diagnosis will have been made early, "said Professor Olivier Graesslin.

Thank you to Pr Olivier Graesslin, head of gynecology-obstetrics at the CHU de Reims.

Definitiontransmission • Papillomavirus femalelocalization and symptomasMaladies associated • Cancerexamens of screeningVaccintraitations Definition: What is papillomavirus?...

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