HPV test as cervical cancer screening has been known to more and more women, but the significance of HPV test is not clear to many women. Often patients come with HPV positive reports for consultation, some will first baidu on the internet and become more panic after reading: Doctor, does HPV positive mean cervical cancer?
Now I am telling you, for women who are infected with HPV but have normal TCT, there is no need to worry, regular review is enough; for women who are preparing for pregnancy, they can go ahead and get pregnant with no worries, and wait for 6 weeks after giving birth to a child before reviewing.
In what cases does HPV positivity require attention and high priority?
HPV (Human papillomavirus), or human papilloma virus. It is a group of tiny, envelope-free, double-stranded DNA viruses, with more than 200 genotypes identified, of which about 40 infect the genital tract. Depending on their tumor-causing ability, they are divided into 2 categories: high-risk and low-risk types. The high-risk HPV types associated with cervical cancer are 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 66. The low-risk HPV types associated with condyloma include 6, 11.
Please read each of the following carefully.
1, HPV infection is very common, most of them are transient, 90% of immunocompetent women can naturally turn negative after 2 years of HPV infection.
After HPV infection, the body’s cellular immunity is mainly induced to clear the virus, once the body’s immunity clears a certain type of HPV, it is generally not easy to re-infect the same type of HPV, but there may be other types of HPV infection.
2. 99.8% of cervical cancer patients have high-risk HPV infection.
HPV16 and 18 are the most common HPV types in cervical cancer and precancerous lesions. Studies have shown that HPV16 infection persists for a longer period of time, 16-18 months on average, and the risk of progression to CIN3 and invasive cancer is significantly higher than other high-risk HPV types. the risk of progression to CIN3, especially adenocarcinoma and related precancerous lesions, is also higher when TCT is normal and HPV18 is positive.
It is important to emphasize that low-risk HPV causes genital warts, but does not cause cancer, its natural regression rate is high, the average infection time 7 to 8 months; only high-risk HPV persistent infection will cause cancer.
4, women preparing for pregnancy need to be screened for cervical cancer before delivery, if not in the first confirmed pregnancy must be screened, and exclude infection such as condyloma acuminata, bacterial vaginosis and Chlamydia trachomatis. If there are infections, they need to be cured before pregnancy.
5.Pregnancy will not accelerate the progression of cervical lesions, and cervical lesions will not affect the outcome of pregnancy.
If precancerous lesions are detected, colposcopic biopsy must be done and cervical intraepithelial neoplasia grade 2-3 (CIN grade 2-3) will require cervical conization (LEEP knife). Wait for a 3-month post-operative review to be normal before getting pregnant. Of course, if cervical cancer is detected, treat it actively first.
7. If HPV positive is found only during pregnancy check, pregnancy can be continued as long as TCT is normal. If it is a precancerous lesion, you can also continue to observe and continue pregnancy and wait for 6 weeks postpartum to review and do colposcopic biopsy if necessary.
8, HPV positive, cesarean delivery can not completely avoid neonatal infection, so it is still recommended to deliver by normal delivery, although the risk of normal delivery may be greater. And some data show that even if the newborn is infected with HPV, the HPV can be turned negative by 6 months after birth.
9, cesarean delivery can prevent infant whistling papillomatosis is not clear, so pregnancy combined with acromegaly is not an indication for cesarean delivery.
10.For the treatment of HPV positive, it should also be combined with the results of cervical cytology TCT.
(1) Direct referral for colposcopy for those positive for HPV types 16 and 18.
(2) For the other 12 HR-HPV positive, follow up after 12 months if the cytology result is negative and recommend colposcopy if HR-HPV is still positive.
(3) HR-HPV positive with cytology results of ASCUS and above referred for colposcopy.
(4) Referral for colposcopy if HR-HPV negative with cytologic findings of ASCUS and above.