A "flu" in the cervix - HPV infection

Author: Xue Han Shenzhen People's Hospital

Reviewer: Wu Weiqing, Chief Physician, Shenzhen People's Hospital

"Oh my god, how did I get HPV? Do I have cervical cancer? What should I do?"

"Is HPV AIDS? I don't feel any discomfort. When did I get it?"

When interpreting physical examination reports, we often encounter such panicked female examinees.

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What kind of “demon” is HPV?

HPV (human papillomavirus) is a DNA virus. Although it is only one letter different from HIV (human immunodeficiency virus), it should not be confused with HIV. As of the end of 2020, a total of 228 types of HPV have been identified. According to the risk of causing tumors, it is divided into low-risk (non-carcinogenic) and high-risk (carcinogenic). Low-risk HPV (such as HPV6 and 11) usually causes genital warts (such as condyloma acuminatum); high-risk HPV (main types are HPV16, 18, 31, 33, 35, 45, 52, 58, 59, 39) can cause cervical cancer, vaginal cancer, vulvar cancer, anal cancer, penile cancer, head and neck cancer, etc. HPV16 and HPV18 can cause 70% of cervical cancer.

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HPV no longer wants to be the scapegoat

Many female patients are afraid to speak up after being infected with HPV, as family conflicts caused by it are common. Although sexual intercourse is the main route of HPV transmission, it is not the only route. HPV can also be transmitted through frictional contact, autologous implantation, etc. For example, if the hands touch HPV-contaminated objects, the virus may be introduced into the reproductive organs when using the toilet or bathing.

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Maintaining good immunity is important

HPV enters the human body with the intention of "feeding" but unexpectedly becomes someone else's delicacy. Most HPVs are detected and cleared by the human immune system in the early stages of infection, but a small number of HPV viruses evade the host's defenses and lurk in the human body for decades before they may cause cancer.

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The trilogy of love and hate between high-risk HPV and the cervix

Less than 10% of people develop from new infection to persistent infection to precancerous lesions to cancer

Establishment phase: HPV binds to cervical epithelial receptors and enters the cell nucleus.

Maintenance stage: A certain number of viral genomes are maintained in the cell nucleus, and the infection continues. Most people infected with HPV do not have any symptoms or signs.

Amplification stage: The virus is amplified and HPV DNA is integrated with the host DNA. The integration process can lead to genetic instability, which is also a common feature of tumor occurrence.

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Say “NO” to HPV

Primary prevention: Get HPV vaccine to enhance your own immunity.

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Secondary prevention: cervical cancer screening and treatment of precancerous lesions.

Women should undergo regular cervical cancer screening after having sexual intercourse, using a combined HPV and cervical cytology (TCT) test. If the initial screening results are abnormal, referral for colposcopy biopsy should be done, and any precancerous lesions found should be actively treated.

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Tertiary prevention: Standardized and individualized treatment of cervical cancer according to the stage, mainly including surgery, radiotherapy, chemotherapy, immunotherapy and targeted therapy.

Getting cervical cancer is not something that happens overnight. First, you need to be infected with high-risk HPV. Then, your immune system is not strong enough to clear the virus, which leads to persistent infection. At the same time, you do not have regular physical examinations, missing the best time to treat early infection and precancerous lesions, which will eventually develop into cervical cancer.

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Now that you know this, do you think HPV infection is not that scary? Pay attention, female friends must strengthen their immunity and have regular physical examinations.

References

[1] Li Mingzhu, Wei Lihui. Research progress on the tumorigenic mechanism of HPV and its prevention of HPV infection[J]. Chinese Journal of Obstetrics and Gynecology, 2022, 57(2): 152-155.

[2] Li Mingzhu, Shen Danhua, Li Jingran, et al. Research progress on HPV infection-related lesions in the female lower genital tract and anus[J]. Chinese Journal of Obstetrics and Gynecology, 2019, 54(5):358-360.