I. What is HPVHPV (The human papilloma viruses human papilloma virus) is a small double-stranded DNA virus that has accompanied humans for a long time, and so far about 130 different genotypes have been found. The virus mainly infects the skin or mucous membranes, so it is also divided into three categories: 1. HPV that mainly infects the skin: there are genotypes 1, 4, 5, 8, 41, 48, 60, 63, 65, etc. This type of HPV can be detected in the skin, flat warts, and in the skin of some immunocompromised people who need long-term immunosuppressive drugs after organ transplantation or tumor patients, etc. 2. HPV that mainly infects mucous membranes: including 6, 11, 13, 44, 55, 16, 31, 33, 52, 58, 67, 18, 39, 45, 59, 68, 70, 26, 51, 69, 30, 53, 56, 66, 32, 42, 34, 64, 73, 54, etc. These viruses can be detected in benign and malignant tumors in male and female genital tracts and anus, and also in the oral cavity, pharynx, larynx, esophagus, etc. Currently, it is mainly these viruses that are found to be associated with malignant tumors. 3. HPV that can be found infected in both skin and mucosa: there are genotypes 2, 3, 7, 10, 27, 28, 29, 40, 43, 57, 61, 62 , and their relationship with malignancy is unknown. Ninety percent of the common clinical papillomas or genital warts are HPV type 6 and 11 infections. Overall, they are classified into low-risk and high-risk types based on their relationship with tumors. Precancerous lesions or invasive cancers of the reproductive tract are often associated with high-risk HPV such as types 16, 18, 31, 45, 53, etc. Currently, more than 35 such viruses are found to be associated with reproductive tumors; they are rarely associated with low-risk types such as types 6 and 11. HPV infection is mainly transmitted through “skin-skin” and “mucosa-mucosa” contact, therefore, sexual transmission is its main mode of transmission. Both men and women can be infected and become carriers, transmitters, and infected at the same time. It has been found that the risk of HPV infection is high for early sexual debut, multiple sexual partners, and sexual contact with high-risk groups, etc. Although the use of condoms by men cannot be completely avoided, it can significantly reduce the risk of infection. Most HPV infections are widespread and can be detected in the cervical, vaginal, and vulva of women and in the scrotum, foreskin, and skin of the penis of men. Foreign studies have found that up to 40% of sexually active women have subclinical HPV infection, and the infection rate is 5-10% for those older than 30 years of age. It is estimated that approximately 50% of women develop HPV infection within 4 years of first sexual intercourse. Vertical transmission from mother to child is uncommon, but respiratory papillomatosis has occurred in infants through mother-to-child transmission. The half survival period of high-risk HPV infection is 8-10 months, and the half survival period of low-risk HPV infection is about half of that of high-risk sex. After infection, there is some immunity to the same type of HPV virus, and a few have some degree of immune protection against other types. Third, the vast majority of patients with HPV infection have the virus cleared or suppressed by their own cell-mediated immune function within 1-2 years after HPV infection. A small proportion (10%) of high-risk HPV infections can persist for several years, which may be related to precancerous lesions, with HPV type 16 being the most common, and the longer the duration, the higher the risk of precancerous lesions. The longer the duration, the higher the risk of precancerous lesions. A 10-year follow-up from abroad shows that after the virus is cleared, the same type of HPV may reappear. Fourth, HPV and cervical cancer foreign epidemiological and clinical studies found that: 100% of certain cervical invasive cancers can be detected HPV DNA, with HPV 16, 18, 31, 45 types most common; in high-level precancerous lesions (CINII – CINIII) HPV DNA in 70-90%. The detection rate in CINI is 20-50%, and in atypical cells ASCUS, AGUS is close to 50%. It is generally believed that the time from HPV infection to precancerous lesions is several years or even more than 10 years, but recent studies have found that this time may be very short, within 5 years, and early detection of precancerous lesions may be possible through screening with HPV testing. HPV type 16 has the highest risk, with precancerous lesions found in 40% of women 3-5 years after infection. Combination of multiple types of HPV has a higher risk of precancerous lesions than single types of HPV infection. V. Prevention of HPV infection Because high-risk type PHV infection has been found to be closely related to cervical precancer and cervical invasive cancer, prevention of HPV infection may prevent or reduce the occurrence of cervical cancer. Virus-like particles of HPV L1, which does not contain viral DNA, are used as a vaccine, which can be injected to produce antibodies in the body and provide immune protection against the same type of HPV virus. However, it only protects uninfected people and has no significant therapeutic effect on infected people. There are two types of HPV vaccines available abroad, one is Merck’s “Gardasil”, which is a quadrivalent vaccine effective against HPV types 16, 18, 6 and 11; the other is GlaxoSmithKline’s “Cervarix”, which is a bivalent vaccine against HPV types 16 and 18. HPV 16 and 18 bivalent vaccine. The vaccine is usually given abroad to girls between the ages of 9 and 14 years old before their first sexual intercourse. Domestic research is underway, but it has not yet entered the clinic officially.