What is HPV (Human Papilloma Virus), What are its Symptoms and Why is HPV Vaccine Important?

Cervical cancer is the second most common type of cancer in women after breast cancer and causes the death of approximately 250,000 women every year. Almost all of this extremely serious type of cancer is caused by HPV viruses called Human Papilloma Virus. HPV virus, which belongs to the Papillomaviridae family, infects human epithelial cells to survive and uses the epithelial cell mechanism to multiply. This virus, which is directly related to cervical cancer, can also cause many other life-threatening diseases. Therefore, in order to fight against cervical cancer worldwide and to maintain personal health, it is important to recognize HPV correctly and to have information about its transmission methods and protection methods.

What is HPV (Human Papilloma Virus)?

HPV is a type of DNA virus that has approximately 200 different types and can only settle and multiply in human epithelial cells. This type of virus, which is 50-55 nanometers in diameter and contains a double-stranded circular DNA gene, settles in the epithelial tissues shortly after contact with the human body and causes wart-shaped lesions called “candyloma acuminatum” on these tissues. HPV, which frequently affects epithelial cells in the genital area, is the most common sexually transmitted disease agent worldwide. According to studies, it is possible to say that approximately 630 million people in the world are infected with this virus.

Each type of Human Papilloma Virus, which has a very large family, causes different health problems in the person, and accordingly, two different classifications are made: low risk (non-oncogenic viruses) and high risk (oncogenic viruses). Virus types called HPV 6 and HPV 11 are responsible for the majority of warts that appear in the genital area. These viruses, which are low-risk HPV types, do not cause cervical cancer, but they can cause intermittent genital tissue infection. Virus types called HPV 16, HPV 18, HPV 31, HPV 33, HPV 35, HPV 45, HPV 52 and HPV 58 are defined as high-risk viruses and increase the risk of cervical cancer in the person by affecting the uterine mucosa as well as the genital area. These high-risk virus types, which do not cause visible warts and similar lesions on the external genitalia, can persist for many years without causing any symptoms. Since this situation greatly delays the diagnosis of cervical cancer, regular gynecological examinations for certain age groups and vaccination planning at an appropriate frequency are extremely important to protect against cervical cancer.

HPV types, which are the most common sexually transmitted diseases and spread extremely quickly, can cause many serious health problems, from cancer to loss of fertility. However, as of today, there is no proven effective treatment option for HPV infection. In order to manage serious diseases that occur after infection, it is necessary to recognize the virus correctly and notice the symptoms of the disease at an early stage.

What Causes HPV? How Is It Transmitted?

HPV can settle not only in the epithelium of the woman’s uterus and vaginal tissue, but also in the epithelial cells of genital organs such as the penis, scrotum and vulva of both genders, and even in the tissues of the anus and bladder, causing growth lesions there. In order for the virus to multiply by carrying out DNA replication, it must reach the epithelial cell layer, which is the deepest epidermal layer. As a result of various injuries occurring in these tissues and irritations due to sexual intercourse, the virus passes through the upper layers of the skin and reaches the epithelial cell layer. In the later process, the α6ß4 integrin in the cells and the protein called L1 capsid on the HPV surface interact, and as a result, the virus settles into the cell group called keratinocytes. Since HPV is not a cytolytic virus, it only infects the cell it enters and does not cause a viral infection throughout the body.

Shortly after the virus enters the cells called keratinocytes, keratinocytes terminally differentiate and new virus formation occurs. Terminally differentiated keratinocyte cells cause shedding in the outermost layer of the epithelial tissue over time, and HPV is spread around with this event called natural desquamation.

Human Papilloma Virus is transmitted mostly through sexual contact, but transmission is also possible through perinatal transmission.

Transmission through sexual contact

HPV is transmitted from person to person mostly during vaginal and anal intercourse, but it is also possible to be transmitted through oral intercourse. In addition, there is also the possibility of transmission through sexual contact alone, without intercourse. Every sexually active adult individual is infected with Human Papilloma Virus at some point in his life, and he usually passes this infection, which is asymptomatic, on to his partner, without being aware of it. The risk of being infected with HPV after 3 years for a woman who has had intercourse with only one partner since the first sexual intercourse is approximately 46%. Viruses that cause genital warts are more contagious than other types of viruses. A person infected with HPV and treated for genital warts can transmit the virus to others, even if no warts are visible on the skin surface. Therefore, it is extremely difficult to determine how or when HPV is sexually transmitted. For this reason, one of the spouses being diagnosed with HPV should not be considered as an indicator of sexual infidelity.

Transmission through perinatal transmission

HPV can be transmitted from mother to baby during birth, and if the baby becomes infected with the virus, laryngeal and conjunctival papillomas are most likely to occur. There is also a risk of the fetus developing from an egg cell fertilized by a virus-infected sperm becoming HPV positive. In addition, infected secretions of the genital system can infect the unborn baby through the placenta.

What are the Symptoms of HPV?

In people with a fully functioning immune system, many types of viruses in the HPV family do not cause any health problems and are removed from the body within approximately 1-2 years with the intervention of the immune system. However, some virus subtypes can cause genital warts called condyloma acuminatum, precancerous skin lesions, and cancers in tissues such as the cervix, penis, anus, oropharynx, vulva, and vagina. Skin lesions caused by the virus can have four different appearances: acuminatum, papular, planar and flat.

Symptoms that occur in people with active HPV vary depending on the person’s immune status. For example, genital warts that occur in HIV-positive people or patients whose immune system is suppressed for any reason grow much faster than normal and can even reach giant sizes. This situation causes the benign lesion to turn into a malignant tumor structure.

Cervical cancer, which develops as a result of contact with high-risk HPV, does not cause any symptoms in the initial stage, but in the clinical stage of the disease, painless vaginal bleeding and vaginal discharge that resembles broth are often observed. Since abnormal vaginal bleeding and discharge due to infection will be symptoms of many other genital diseases, detailed examination with medical supervision is necessary.

Why is HPV Vaccine Important?

Cervical cancer is the second most common type of cancer in women after breast cancer. HPV vaccine increases the number of protective cells called neutralizing antibodies, especially in mucosal secretions, and prevents the virus from entering these mucosal tissues. Thanks to the HPV vaccine, which provides immunological protection and develops long-term immunity in the person, cervical cancer has become the only type of cancer that can be prevented by vaccination. It is possible to be protected by vaccination from Human Papilloma Virus, which is known to be associated with many serious health problems such as prostate cancer, Buschke Lowenstein tumor, bladder cancer and male infertility, as well as cervical cancer.