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Human Papillomavirus (HPV) Infection What is HPV Infection? HPV is one of the most common sexually transmitted infections (STIs). There are more than 100 types of HPV. HPV types 16 and 18 cause 70% of cancers of the cervix. They also cause a number of less common cancers such as cancers of the anus, penis, vagina and vulva. HPV types 6 and 11 cause 90 % of the cases of genital warts in women and men. How is HPV spread? HPV is spread by skin-to-skin contact from one person to another during oral, vaginal or anal sexual activity. Sexual intercourse is not necessary to get infected with HPV. HPV can infect all of the genital area and surrounding skin. This includes the vagina, cervix, rectum, penis, vulva, and anus. It is possible to have more than 1 type of HPV infection at the same time. What are the symptoms of HPV? Most people do not show any signs or symptoms of an HPV infection, and they can pass HPV to others without knowing it. How common is HPV infection? Three out of 4 sexually active people will get at least 1 HPV infection at some time in their lives. The more sexual partners you have, the higher your risk of spreading the virus and getting an HPV infection. What are the risks of HPV infection? Most women who have an infection of HPV in the cervix clear the infection within 2 years. But when it does not clear, cells in the cervix that are infected with HPV can become cancerous over a period of 10 years. Every year in BC: - 150 women will get cervical cancer and 40 will die from the disease. - 6,000 women will develop high-risk changes to the cervix, which are precancerous. - 10,000 invasive procedures will be done to stop cancer of the cervix from developing. - 90 people will get anal cancer and 20 will die from the disease - 5,500 people will develop genital warts Is there a vaccine for HPV? There are 2 HPV vaccines available in Canada: Cervarix™ and Gardasil™. Both vaccines protect against infection by HPV types 16 and 18 that cause most cases of cervical cancer and several less common cancers. Gardasil™ also protects against infection by HPV types 6 and 11 that cause most cases of genital warts. The vaccines prevent HPV infection but do not get rid of the infection once it has occurred. It is best to get the HPV vaccine before becoming sexually active and coming in contact with HPV, however people who are sexually active may still benefit from the vaccine. It is important for women to get regular Pap tests once they become sexually active because the HPV vaccines do not protect against all cancers of the cervix. Who should get the HPV vaccine? The HPV vaccine, Gardasil™, is provided free to girls in grade 6 in BC. Girls born in 1994 or later who missed getting the HPV vaccine, Gardasil™, may contact their local health unit to get immunized at no cost. Those not covered by the school-based program may purchase one of the HPV vaccines privately. Speak with your health care provider to decide which vaccine is best for you. How can I reduce the risk of HPV? - Get the HPV vaccine. - Always use a condom with sexual activity. - Delay the start of sexual activity. For more information For more information, see the following HealthLinkBC Files: #101b Human Papillomavirus (HPV) Vaccine #08o Condoms Help Prevent Sexually Transmitted Infections (STIs)
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Ozbiljnost infekcije HPV-om (Humani Papiloma Virus), koji je najčešći uzročnik raka maternice, ilustrira podatak da u Hrvatskoj od raka vrata maternice godišnje oboli oko 400 žena starijih od 25 godina, a 100 ih umre zbog prekasne dijagnoze i liječenja. U svijetu se godišnje otkrije 500.000 novih slučajeva karcinoma vrata maternice, i to ga stavlja na drugo mjesto po učestalosti raka kod žena, iza raka dojke. Smatra se da je u Hrvatskoj HPV-om zaraženo 15-45 posto mladih osoba od 18 do 30 godina. Postotak se u Americi penje čak na 60-70 posto, što prati i porast učestalosti karcinoma vrata maternice. Zbog toga je Svjetska zdravstvena organizacija preporučila cijepljenje protiv HPV-a na nacionalnoj razini, kao i programe ranog otkrivanja bolesti. - Postoji više od 100 različitih genotipova HPV-a. Većina se nalazi na koži, a njih 40-ak inficira genitalni sustav - pojašnjava dr. Nađa Aračić, ginekologinja u splitskoj poliklinici Cito. S obzirom na promjene koje uzrokuju, genitalni tipovi HPV-a svrstavaju se u visokorizične, među kojima su 16 i 18 na vrhu jer uzrokuju više od 70 posto slučajeva raka maternice i različitih predstadija raka, dok su dva niskorizična tipa virusa, točnije 6 i 11, uzročnici 90 posto genitalnih bradavica ili kondiloma. Nemar vodi u bolest Budući da je infekcija HPV-om spolno prenosiva bolest, važno je da se cijepljenje provede prije nego mladi stupe u prve spolne odnose. I spolno aktivne žene morale bi više voditi računa o svom zdravlju - dr. Aračić napominje kako je imala slučaj da joj žena u menopauzi kaže da je zadnji put bila na ginekološkom pregledu kad je rodila. S druge strane, kod mladih djevojaka na spolovilu se razviju bradavice veličine cvjetače. Takvim nemarnim odnosom kod mnogih se žena rak ne otkrije u ranoj fazi, a liječenje bradavica, koje inače rastu vrlo brzo, teže je i dugotrajnije. Virus živi na koži, pa upotreba kondoma nije dovoljna zaštita od infekcije HPV-om. Srećom, 90 posto infekcija nestane samo od sebe za 8-13 mjeseci, bez pojave simptoma bolesti i bilo kakvih posljedica. Kod manjeg broja žena, zaraženih visokorizičnim tipovima HPV-a, infekcija ostaje trajna i nakon 10 do 20 godina prelazi u rak vrata maternice. U Hrvatskoj je četverovalentno cjepivo (koje ujedno štiti i od raka i od kondiloma) odobreno prošle godine i zasad nije na listi HZZO. Jedna doza cjepiva stoji 1000 kuna, a kako se cijepljenje provodi u tri navrata - nulto cjepljenje, pa nakon dva mjeseca i nakon šest mjeseci, ta se cijena penje na 3000 kuna. Neki gradovi odlučili su investirati u zdravlje mladih, pa sami financiraju takvo cjepljenje. Na žalost, nijedan od njih nije u Dalmaciji. - Cijepljenje se u Splitu provodi samo u poliklinikama Cito i Sunce, a ja sam prošle godine cijepila samo 50-ak djevojaka koje su ili došle samoinicijativno ili su zdravstveno osviještene majke odlučile investirati u njihovo zdravlje - kaže dr. Aračić. Inače, najbolje bi bilo cijepiti djevojčice i žene od 9 do 26 godina. I one žene koje imaju prisutan HPV mogu se cijepiti, pod pretpostavkom da nisu inficirane sa sva četiri tipa virusa koja su zastupljena u cjepivu.