Human papillomavirus (HPV) infection is the most common sexually transmitted disease in both sexes. It is estimated that at least 80% of women will have been infected with some type of HPV in their lifetime. More than 150 different HPV types (genotypes) have been identified, which we classify as low or high oncogenic risk according to their probability of producing precancerous lesions and/or cancers.
Low oncogenic risk genotypes include genotypes 6 and 11, which are responsible for 90% of genital warts. Among the high-risk genotypes, 16, 18, 45, 31, 33 and 52 and 58 are responsible for more than 85% of cases of cervical cancer.
How is HPV detected?
There are direct and indirect methods to detect the presence of HPV. The most commonly used in consultation are:
- Cervical cytology: detects the presence of cells in the cervix affected by HPV.
- PCR: detects the presence of HPV and allows genotyping, that is, to establish whether it is a high-risk or low-risk virus and even the exact number.
- Colposcopy: Allows observation of the cervix with a magnifying camera and, through the application of a series of contrasts, detects lesions produced by HPV and takes biopsies of them.
- Biopsy of the cervix: This allows the degree of the lesion to be precisely established (mild, moderate or severe).
What are the health consequences of HPV?
Both men and women can be asymptomatic carriers and therefore not develop lesions, although they can spread the virus during sexual intercourse. In other cases, although the exact reason why some people are so predisposed is not known, the virus can cause lesions such as:
- Anogenital warts (condylomas)
- Precancerous cervical (CIN), vulvar (VIN), vaginal (VAIN), anal (AIN) and penile (PIN) lesions.
- Cancerous lesions: Þ 100% of cervical cancers Þ 90% of anal cancers Þ 70% of vaginal cancers Þ 40% of vulvar cancers Þ 40% of penile cancers Þ 5-70% of oropharyngeal cancers Þ 5%-70% of oropharyngeal cancers.
What steps should be taken to prevent this disease?
The use of a barrier method (condom) in all sexual relations reduces the transmission of HPV, but does not prevent it completely. At present, the only way to avoid HPV infection and, therefore, the lesions derived from this infection, is vaccination before the onset of sexual relations, included in our vaccination calendar at 12 years of age, for both girls and boys.
In each country there are programs for the early detection of cervical cancer and they are based, for the most part, on the periodic performance of cytology and/or PCR, but the objective of these programs is not to prevent infection by the virus, but to detect it in very early stages in order to establish the appropriate measures and follow-up to prevent it from progressing to high-grade lesions.
How does HPV affect men?
The prevalence of HPV infection among men is estimated to be between 30% and 50%. Most, as in women, are asymptomatic carriers, but may also develop lesions such as genital warts or anogenital or oropharyngeal cancers.