Cervical human papillomavirus infection

  Human papillomavirus has an important role in cervical cell abnormalities as well as in the pathology of cervical cancer, and high-risk HPV is an essential causative agent of cervical cancer.  HPV infection is a common sexually transmitted infection with a population prevalence of about 10%. Seventy to 80% of women have at least one HPV infection in their lifetime. The highest prevalence occurs in young women, where it can reach 20-25% of the population, with a decline in HPV infection after age 30 and a very small increase in HPV infection occurring in women over age 65. The prevalence of HPV infection is high among young women after first intercourse, while remaining high with the increase in the number of new sexual partners.  Detection techniques for HPV: karyotyping techniques-HC2, PCR; other detection techniques Opinions on the management of HPV infection: 1. HPV positive + cytology negative: for women over 30 years of age, repeated screening at 1-year intervals is an appropriate screening strategy; for adolescents high-risk HPV testing is not required.  2. ASC-US: For women over 30 years of age, HPV nucleic acid testing or repeated cytology can be used as a management strategy; for women under 30 years of age and adolescents, cytology every 6 months (even if HPV positive) is recommended.  3. Management during pregnancy: HPV nucleic acid testing, repeated cytology, and colposcopy can be used in the management of ASC-US women over 30 years of age. Unless infiltrating carcinoma is suspected, HPV nucleic acid testing and repeated cytology testing are applied in exactly the same way as in non-pregnancy, while colposcopy is recommended at 6 weeks postpartum. management of HSIL, AGC, and SCC is left to clinicians experienced in colposcopic evaluation of pregnant women. HPV vaccine is not recommended during pregnancy.  4. Management of postmenopausal women: HPV nucleic acid testing for ASC-US in this population would be highly effective.  5. Management of HIV-infected patients and immunosuppressed cases: HPV screening and management while balancing the effects of antiretroviral therapy requires further study.