An in-depth analysis of how the HPV virus
it is treated in gynecology and proctology
HPV (Human Papillomavirus) is the most common sexually transmitted disease worldwide. It consists of a family of over a hundred different virus strains that, depending on the contracted type, can cause either benign or precancerous lesions affecting the mucous membranes of the anus, rectum, mouth, and throat. HPV is an opportunistic viral microorganism that replicates by exploiting the cells of the skin and mucous membranes, promoting excessive growth and causing the formation of growths such as condylomas and papillomas. The majority of HPV infections regress spontaneously, while a small percentage, if left untreated, can slowly evolve into a cancerous form.
Transmission and symptoms of Human Papillomavirus
The HPV virus is primarily transmitted through sexual contact, including oral sex, via contact with infected skin or mucous membranes. It is also believed that transmission can occur through physical contact if there are present lacerations, cuts, or abrasions. In the case of Human Papillomavirus, condoms greatly reduce the risk of transmission but do not eliminate it completely since condoms cannot cover all at-risk areas. People with a particularly vulnerable immune system are more exposed to the risk of infection. Symptoms of HPV vary depending on the type of infection. Generally, the most common signs are warts, which can be cutaneous, plantar, or genital (known as condylomas). The latter can be located on the external genitals, penis, inside the vagina, around or inside the anus, and on the perineum. Most HPV-related lesions are asymptomatic, but in some cases, they can cause discomfort, burning, and itching.
HPV Testing, Colposcopy and vaccination
The only way to diagnose HPV infection is through an HPV test. This screening test is primarily aimed at women and determines whether they have come into contact with the virus. It is a test that can be performed even in the absence of disease symptoms and is recommended from the age of thirty, every five years (while for women between the ages of 25 and 29, the Pap test is still recommended every three years). The test involves the painless collection of a small amount of cells from the uterine cervix, which is subsequently analyzed to verify the presence of the virus.
A positive HPV test does not mean that a tumor will develop because the majority of infections regress spontaneously. However, a positive patient will undergo further examinations. One investigative examination is colposcopy, which allows for an enlarged view of the cervix and any lesions detected during the screening test through the use of a special instrument and specific staining techniques. If the colposcopic examination reveals the presence of abnormal areas, small tissue samples (biopsies) will be taken for further analysis.
For males, there is currently no test available to detect HPV infection. Besides regular check-ups with specialists, the main weapon for protection and prevention is vaccination. For both sexes, the best time to get vaccinated is at a young age, before the onset of sexual activity. In Italy, HPV vaccination is recommended and offered free of charge to girls and boys from the age of 11, administered in two doses six months apart.
Anal HPV and proctology
The field of proctology also deals with Sexually Transmitted Infections. Anal HPV, or anal papilloma, is a virus that affects the anal area and can cause condylomas and, in more severe cases, tumors. Despite HPV being primarily associated with cervical cancer, it can also lead to anal neoplasia. The peak immune response to Human Papillomavirus infection is represented by condylomas (spots that primarily appear on the genitals, inside and around the anus) initially reddish, which over time transform into growths with a typical “cock’s comb” appearance. Condylomas then tend to spread rapidly and can cause burning and itching over time. It is essential to undergo a specialized proctological examination when the first symptoms appear to obtain an accurate diagnosis and identify the most appropriate treatment.
Anoscopia ad Alta Risoluzione per individuare le lesioni da HPV
High-resolution anoscopy (HRA) is used to detect anal HPV lesions. During this examination, a proctologist uses a high-resolution camera to magnify the anal region and identify intraepithelial neoplastic lesions that may not be visible to the naked eye during a traditional anoscopy. It should be noted that not all patients undergoing a proctological examination require HRA. High-resolution anoscopy is indicated for:
- Patients with potentially dangerous lesions;
- Patients with suspicious lesions for neoplasia;
- Patients who are at high risk, such as HIV-positive individuals.
The contents of this page are for informational use only and in no case should they replace the opinion, diagnosis or treatment prescribed by your doctor. The response to the same treatment can vary from one patient to another. Always consult with your doctor on any information relating to diagnosis and treatment and scrupulously follow his instructions.