HPV Vaccine & HPV Test in Ankara
The Human Papilloma Virus (HPV) is among the most common sexually transmitted diseases today. According to a study conducted in the USA, approximately 80% of the population is at risk of encountering HPV at some point in their lives.
Due to its high prevalence, screening and prevention efforts for this virus have accelerated worldwide. Like many countries, HPV screening has become routine practice in Turkey. Also, many European countries have included the HPV vaccine in their routine vaccination programs.
What is HPV?
HPV (Human Papilloma Virus) is a DNA virus that settles in the anogenital epithelium at a rate of 40%. It is primarily a sexually transmitted infection.
The HPV virus is a virus that can most commonly cause Genital Warts (Condyloma) in women and men. There are more than 200 types of HPV. When high-risk types are not monitored and treated, they can lead to Cervical Cancer and Vaginal Cancer in women, and Penile Cancer in men. Although less frequently seen, the HPV virus is also considered responsible for a large part of Anal Cancers and Oropharyngeal (Throat) Cancers in both women and men.
How is HPV Transmitted?
HPV is transmitted through skin-to-skin contact. Although the main mode of transmission is known as sexual intercourse, transmission can occur during any kind of skin contact. Small scratches or irritation on the skin are necessary for transmission so that the virus can settle into the cell.
Also, full sexual intercourse is not required for transmission. Any contact, such as rubbing against the infected area, is sufficient for transmission. It can be transmitted to the mouth area via oral sex as well. Very rarely, it has been observed that it can be passed from mother to baby during birth or transmitted from contaminated items and public toilets, apart from the sexual route.
What are the Symptoms of HPV? (Genital Warts)
Wart formation begins 2-6 months after HPV transmission. In women, symptoms are more numerous and prominent than in men. Men may sometimes show no symptoms at all. In women, cauliflower-like bumps covering the anus or vagina are seen in the genital area. Warts are usually painless but occasionally itching and burning may occur. Bleeding may also be seen due to friction.
More important than warts in HPV infection are cell proliferations (Dysplasia) that are invisible to the naked eye. In this case, precancerous and cancerous lesions occur in the long term. Remember that it is possible to prevent cancer by going for regular gynecological examinations and having Cervical Screening (Pap Smear & HPV DNA).
HPV Types & Risk Classification
Highest Risk: Types 16, 18, 31, 45
High Risk: Types 33, 35, 39, 51, 52, 56, 58, 59, 68, 73, 82
Low Risk (Wart-Causing): Types 6, 11 (Responsible for 90% of warts)
High-risk types 16 and 18 are responsible for 75% of cervical cancers.
HPV Diagnosis: How is the Test Performed?
If there is a wart, a piece is taken from the wart (Biopsy); if there is no wart, a swab is taken from the vaginal discharge (like a Pap Smear). HPV DNA can also be detected in the smear test. When taking a sample, care should be taken to include the area called the Transformation Zone.
If the patient carries a High-Risk HPV virus, an advanced examination method called Colposcopy is applied.
What is Colposcopy?
Colposcopy is an advanced diagnostic method performed to determine the locations of possible cellular changes in the cervix. A special device called a “Colposcope” (a lighted microscope) is used for this procedure. During the examination, various solutions (Acetic acid / Lugol) are applied to the cervix to detect the locations of possible cell changes (Acetowhite areas). One or more biopsies are taken from these areas and sent for pathological examination.
HPV Treatment: Is there a cure?
There is no definitive cure (antiviral drug) to eradicate the virus from the body completely. In many patients, the immune system clears the virus from the body naturally. Viral clearance occurs in 90% of patients within 4-24 months after encountering the virus.
If warts develop, some treatments are applied to remove the lesions:
Creams: Creams aimed at boosting the immune system (Imiquimod) or destroying wart tissue.
Chemical Cautery: Trichloroacetic acid (TCA).
Cryotherapy: Freezing the warts with liquid nitrogen.
Electrocautery: Burning the warts with electric current.
Laser Treatment: Burning warts with laser energy.
Surgical Excision: Removing warts surgically.
HPV Vaccine (Gardasil)
The HPV vaccine is for prevention, not treatment. If the HPV vaccine is administered before encountering HPV, its protection is nearly 100%.
Who should get it? It can be administered to girls and boys between the ages of 9-45. However, every woman and man who has never had intercourse before can also get vaccinated. It can also be administered to patients with sexual activity, but its protection may decrease as they might have already been exposed to some types.
Safety: The HPV vaccine is approved by the World Health Organization (WHO). Since it does not contain live viruses, it does not cause the disease.
Dosage: It is administered intramuscularly (IM) in the arm. It is done in 3 doses (0, 2, and 6 months schedule).
Types of HPV Vaccines
There are quadrivalent (Gardasil 4) and nonavalent (Gardasil 9) vaccines available. The 9-valent vaccine, developed against nine types of HPV, provides the broadest protection.
Is the vaccine safe during pregnancy? It is not recommended to administer the HPV vaccine to pregnant women. If pregnancy occurs after starting the first dose, the subsequent doses should be postponed until after pregnancy.
Do screening tests continue after vaccination? Yes, continuing screening tests after the HPV vaccine is essential. Annual Pap Smear controls must be performed after active sexual life begins. The vaccine provides protection against approx. 70-90% of cervical cancers. Therefore, screening tests must continue for the remaining probability.