What is HPV?
HPV (Human papillomavirus infection) virus, mostly sexually transmitted and can cause genital warts, cervical and vaginal cancer in women; It is a virus with more than 100 types. It can cause warts (condyloma) in different parts of the body, cell proliferation and cancer. HPV causes wart formation within 2-3 months after ingestion. Warts are most common in the genital area, but can occur anywhere on the body. 80-90% of HPV is destroyed by the body’s defense cells. The cancer formation process of the HPV virus is 10-15 years. 99% of oral cancers are HPV positive. HPV virus is also considered among the causes of penile, scrotum and anorectal cancers in men.
HPV (human papilloma virus, genital human papilloma virus, hpv virus) is a kind of virus that infects the genital area, skin and mucous membranes and causes the formation of wart-shaped masses called condyloma acuminatum (condyloma acuminatum, condyloma, condyloma, condyloma). As with many viral diseases, once the HPV virus enters the body, it settles in the cells and causes recurrent infections by causing exacerbations from time to time. Therefore, although HPV infection is accepted as a disease with no definite cure, it is thought that some types can be eliminated from the body in 4-5 years and disappear after infection.
There are nearly 100 subtypes of HPV currently known and classified. Some of these cause infection only in the reproductive system and these are called genital HPV. HPV types 6 and 11 most commonly cause genital warts. However, HPV types 16,18, 31,33, 35 and 52 cause cellular changes in the cervix. HPV virus is detected in 95% of women diagnosed with cervical cancer. The most important and perhaps the only cause of cervical cancer (cervical cancer), which is one of the leading female cancers, is HPV infection. For this reason, when the HPV virus and the genital warts it causes are detected, they should be treated and the patients should be followed closely, smear test and colposcopic examinations should be performed when necessary. It is also a fact that in the presence of genital warts (condyloma), which is a result of the HPV virus, the contagiousness of this virus is very high, and with the burning of these condylomas, the virus often goes into a convalescence period by decreasing its infectivity.
How are HPV virus and condyloma transmitted? How do genital warts occur?
HPV is the most common sexually transmitted disease. HPVs that infect the genital area are easily spread by contact. For HPV to be transmitted from one person to another, there does not necessarily have to be a full relationship. The disease can also be transmitted by contact of infected skin areas with each other. It can also be transmitted frequently in young people by “rubbing” from the outside without a full sexual intercourse.
The incubation period of the virus is variable. The incubation period varies according to the HPV type. While the incubation period for some HPV types is 1-2 months, it can take years for some HPV types. Symptoms may appear after a few months, sometimes several years after infection. In fact, sometimes the virus can remain in the body for years without any symptoms. Most of the patients show symptoms within 2-6 months. Infectiousness is highest in the presence of active genital lesions. After the warts appear and are treated, the longer the period before the wart reappears, the less contagious it is.
Condylomas can be transmitted by any sexual intercourse with an individual with genital HPV disease. The virus is transmitted through skin-to-skin contact through microscopic tears and abrasions that occur on the skin during intercourse. Detection of the virus in male semen suggests that it can also be transmitted through the contact of body fluids. Infection symptoms do not occur in everyone who comes into contact with the virus, but it has been determined that 60-90% of individuals with conduloma also have the virus in their partners. Once the virus enters the body, it can remain silent for many years. It can occur in anyone who is sexually active, and many sexually active people can be carriers of the HPV virus.
What are the symptoms of HPV- Genital Wart, Condyloma?
After contact and contamination with HPV, the disease does not necessarily occur. In fact, in most people, HPV is neutralized by the body’s own defense system. Another possibility is that the person who gets the virus does not show any symptoms for a long time. A person can live for years without any complaints. However, this does not prevent him from spreading the disease, and he can infect the people he is in contact with. This situation is called silent infection. People who carry the HPV virus that causes genital wart formation without any symptoms are also called “porters”.
Generally, small warts appear in the external genitalia. These can be seen or felt by the person himself. Warts are soft, slightly raised, pink-white, cauliflower-like formations. They can be alone or in groups. From time to time, they are not fluffed out and are found flat. Rarely, they can be seen in the vagina, around the breech. After anal or oral sex, warts may appear in the mouth and in the anus. In some cases, there may be warts in the vagina and on the cervix. Condyloma does not cause pain, but occasional itching and burning may occur. Sometimes the patient may not notice it with the eye, and itching, which is usually uncomfortable, can sometimes be the only symptom.
If left untreated, warts can remain unchanged for a long time, but these behaviors are extremely rare. They generally have a constant tendency to grow and spread. This growth is usually faster if there is another vaginal infection with the condyloma. It mostly spreads to moist and warm areas of the body. If abnormal color and shape changes and abnormal swellings that did not exist before are seen around the vagina and breech, if there is itching, burning and bleeding in the genital area, if the partner has condyloma or if he has had it before, a gynecological examination must be done.
Depending on the type of virus, HPV infections can cause some changes in the cells that make up the cervix, which can change into cancer called dysplasia. In the Pap smear, koilocytosis is detected in the cells. While low-risk types of viruses generally cause changes such as ASCUS, CIN (Cin 1, CIN 2, CIN 3) and SIL, which appear in the PAP smear, high-risk types can cause cervical cancer in the long term. Therefore, HPV typing is very important. HPV DNA typing is easily done in genetic laboratories today.
Cervical cancer is the second most common cancer among women worldwide and is a deadly cancer. However, it has a special importance in terms of being preventable among cancer types. The only and simplest way to prevent cervical cancer is regular pap – smear tests. When abnormalities defined as CIN or SIL are detected in the smear test, the diagnosis is confirmed by biopsy with colposcopy. Then, according to the degree of the disease, the changed area in the cervix is removed with simple operations called LEEP or conization, and then regular controls are started. If CIN or SIL is advanced, if the person has completed his/her family and does not want any other children, or if he/she is around the age of 40, removal of the uterus (hysterectomy) is another treatment method. These decisions are made according to the patient’s age, the patient’s familial-social status, and the degree and severity of abnormal changes in the cervix.