HPV is an abbreviation for Human Papillary Virus, which translates to Human Papilloma Virus. There are many types of HPV, and so far more than 100 subtypes have been identified, which are categorized into high-risk and low-risk types according to the threat they pose to human beings. There are 10 to 20 subtypes of HPV that are likely to cause cervical cancer, such as subtypes 16, 18, 31, 33, 35, 39, 45, 51, 52, and 58, and the most dangerous are subtypes 16 and 18, with subtype 16 causing 50 percent of cervical cancers and subtype 18 causing about 17 percent of cervical cancers. The low-risk subtypes include subtypes 6, 11, 40, 42, 43, 44, and 54. What is the threat of this virus to women’s health? High-risk and low-risk viruses have different roles. High-risk viruses in women are prone to cause tumors in the reproductive tract, mainly related to cervical cancer, German scientist Hausen discovered that HPV is the culprit leading to cervical cancer, for which he was awarded the Nobel Prize for Medicine in 2008. Of course, it is not true to say that HPV infections will definitely lead to cervical cancer, and only infections that last for more than 2 years will have a Other tumors associated with high-risk HPV include vaginal and vulvar cancers, and some cancers of the mouth and throat are also associated with HPV. Low-risk types of the virus cause genital warts, such as vulvovaginal condyloma acuminatum, which are characterized by raised warts and itching, and have a relatively low risk of causing cervical cancer. How is the virus transmitted? Can the virus be spread by oral sex? HPV is mainly spread through sexual intercourse, but sexual intercourse is not the only way to cause transmission; close contact is also a way of spreading HPV. Oral sex can also lead to the spread of the virus. So in addition to cervical cancer, can the HPV virus cause cancer of the digestive tract? As mentioned earlier, tumors in the oropharynx have been found to be associated with HPV infection as well. What kind of test can I do to find out if I have HPV? The most accurate test for HPV is the HC2 method. If the value is greater than 1, it means that you are infected. In addition to the HC2 test for cervical HPV infection, there is also a test for HPV virus subtypes to find out which subtype of the virus is present in the body. What should I do once I find out I’m infected? HPV infection is actually a common thing, according to foreign information, women have 80% chances of encountering HPV infection in their lifetime, but the focus is not on who will be infected, but on whose organism has the ability to get rid of the virus, most of the women will be able to get rid of the virus after being infected, if the same subtype of the HPV virus persists for more than 2 years of existence, it is called a persistent infection, and that is what needs vigilance. Ten years ago we did not have HPV screening, cervical smear was the main means of screening for cervical cancer, now with the understanding of the relationship between HPV and cervical cancer, more and more hospitals have carried out HPV and cervical cytology screening, but what brings is the fear of finding HPV infection, because it is related to tumors, and many women are overly worried about it. I have previously written a “HPV infection is not a big deal” popularization article, is to explain this situation, found that HPV infection, it is more important to carry out cervical cytology screening, this is to understand the cervix whether the cervix has occurred cervical cancer and pre-cancerous lesions of a technology, to understand the presence or absence of cervical lesions, for decision-making on how to deal with the next step is even more important. The presence or absence of cervical lesions is more important in making decisions about what to do next. If the test is only positive for HPV but the cervical cytology is normal, the test can be continued, or if the test is consistently positive for HPV 16 and 18, a colposcopy can be performed directly. In the case of HPV positivity and positive cervical cytology, further colposcopy should be considered to find out if there are any precancerous lesions. Is there an international treatment for HPV infection? Unfortunately, there are no specific drugs for the virus, so the international practice for HPV is to “treat the disease, not the virus”, which means that if there is only HPV infection and no cytologic abnormalities, then it is just an observation. There are many drugs on the domestic market that claim to be able to treat HPV, but they are often just advertisements by manufacturers, and there is a lack of randomized controlled studies with large samples. Many doctors are also influenced by the publicity of manufacturers, and prescribe treatments for HPV infections for their patients, but they often do not have the support of clinical evidence. As a result, our current response to just HPV infection alone is increased screening and no treatment. What should we do to prevent this dangerous viral infection? There is a preventive vaccine available for HPV, but it is not yet available in mainland China. The news just released today says that GSK’s vaccine has been approved, but it won’t be available until the beginning of 2017, so I’m afraid that we can only go to Hong Kong, Taiwan, and Macao for the vaccine before then, and it will take 3 injections to complete the whole course of treatment. After the injection, only can prevent HPV infection and HPV secondary cervical cancer and precancerous lesions, for the infection has occurred is not therapeutic, preventive vaccination is best before the start of sexual life, the most suitable crowd is 9 to 26 years old, after the start of sexual life inoculation of the preventive effect is reduced, but for the virus that has not been infected, there is still a certain preventive effect. The preventive effect of the HPV vaccine is not 100%, and cervical cancer caused by other non-major subtypes of HPV does not have a preventive effect. Therefore, it is not possible to rest easy after vaccination, and it is still necessary to undergo regular cervical cancer screening. Is it useful to get vaccinated if I am over 25 years old? As mentioned earlier, sexual intercourse and close contact are the main ways to get infected with HPV. It is generally recommended to get vaccinated before you start having sex, age is not the most important factor, sexual intercourse is an important factor, but after you start having sex, you do not have the opportunity to be exposed to all subtypes of HPV, so even if you are over the age of 25, the HPV vaccine will be effective if you have not been infected with HPV 16 and 18. The HPV vaccine is effective. Some patients also ask if the vaccination is still effective if they have already been found to be infected with hPV. I can only say that if you are not infected with subtypes 16/18, it may be effective, but due to the lack of data support, I can’t give a definite conclusion. From the results of large-scale clinical studies abroad, the efficiency of vaccination for women under the age of 34 is around 91%, and drops to 88% over the age of 35, so it’s not that it’s not effective at an older age, but that the efficiency decreases a bit. Are vaccinations dangerous? Vaccination is relatively safe, but the side effects of vaccines in Japan were magnified by the media and caused public panic. According to WHO statistics, HPV vaccination is a very safe thing to do. Most of the adverse events are pain at the site of vaccination, and other rare adverse events are similar to the chances of getting into a car accident on the street. Can men get the vaccine? Yes, in 2009, HPV was approved in the United States for vaccination in the male population, primarily also between the ages of 9 and 26 years old. Male vaccination has also helped to reduce the incidence of cervical cancer in the female population as well as the incidence of hPV-related tumors in males and the incidence of genital warts. What is the difference between the 2-valent vaccine and the 4-valent and 9-valent vaccines? The 2-valent vaccine approved in China is for HPV subtypes 16 and 18, which are the main subtypes leading to cervical cancer and can cover about 70% of cervical cancers. 4-valent vaccine can cover subtypes 6 and 11, which do not lead to cervical cancer, but lead to warts in the genital tract and other pathologies, so the 4-valent vaccine can reduce genital warts at the same time, and the 9-valent vaccine adds 5 new types of warts to the list. The 9-valent vaccine adds five new HPV virus types, including HPV31, 33, 45, 52 and 58, which can cover more HPV subtypes, but at present, both the 4-valent and 9-valent vaccines are not available in China, so you may need to wait for another 10 years. Will I be free from cervical cancer after HPV vaccination? It is not true that you will not get cervical cancer after HPV vaccination. As mentioned before, HPV is not 100% effective and cervical cancer may still occur, so regular cervical cancer screening is still needed. Can I get the HPV vaccine if I want to get pregnant? If you are planning to get pregnant, it is best to use contraception during the vaccination and try to get pregnant after completing the vaccination. If you find out that you are pregnant during the vaccination process, you do not have to have an abortion and just stop the later injections. The vaccine is relatively safe because it is a virus-like particle and no virus is used.