Human Papillomavirus

The human papilloma virus (HPV, (或生殖器疣病毒)是一种非常常见的生殖器感染.

About HPV

人乳头瘤病毒通过身体接触在人与人之间传播. Because the most common contact in the genital area is sexual, HPV has been labeled a sexually-transmitted disease. 它也可以被看作是一种通过身体接触在人与人之间传播的细菌.

在大多数情况下,HPV感染没有症状,通常没有持久的影响. HPV感染可导致生殖器疣、宫颈癌前期,有时还会导致宫颈癌.

Types of HPV

More than 100 subtypes of HPV have been discovered. 其中许多亚型不会引起任何症状,而其他亚型则可能导致足部和手部疣.

Forty of these subtypes can affect the genital area. 这40种亚型已被编号,并分为低风险和高风险菌株. 一个人在50岁之前有80%的机会感染其中一种亚型. 对大多数人来说,病毒在两年内就处于检测不到的水平.

Low-risk subtypes

  • Less likely to cause cervical cancer than high-risk subtypes.
  • May cause genital warts. 两种常见的低风险亚型(6和11)导致90%的生殖器疣.

High-risk subtypes

  • 更常与宫颈癌前组织改变有关,可能导致宫颈癌, if left untreated over many years. 大约70%的宫颈癌前期和癌症是由HPV亚型16和18引起的.

Symptoms of HPV

Most people who contact HPV experience no symptoms. 感染通常会在患者不知道自己感染了HPV病毒的情况下传播.

某些亚型确实会引起生殖器疣和子宫颈癌前组织改变等症状, 也称为宫颈发育不良或CIN(宫颈上皮内瘤变). 如果不加以治疗,这些变化会导致女性患上宫颈癌. CIN is 100 percent curable with treatment.

About mild cervical dysplasia (mild precancer, or CIN I)

轻度宫颈发育不良通常是暂时的,特别是在青少年和年轻女性中. It is no longer considered a precancerous condition. It is now only viewed as HPV infection. 在大约70%的这种轻微病例中,病情无需任何治疗就会消失.

中度至重度宫颈病变或癌前病变(CIN II或CIN III)通常接受治疗以预防宫颈癌的发展.

How does my doctor tell if I have HPV

宫颈涂片异常可能提示宫颈有HPV或癌前组织改变. 你的医生或护理人员可能会建议你做阴道镜检查, 用显微镜仔细检查子宫颈的异常细胞模式.

宫颈活检常用于诊断HPV. A cervical biopsy is a simple office procedure. 大多数女性都能很好地忍受这个过程,只有轻微的抽筋.

Because HPV has been called a sexually-transmitted disease, 被诊断患有HPV的人往往会觉得自己被感染了, or are dirty. 我们试图鼓励我们的病人把它看作是另一种细菌,就像皮肤上的细菌一样. Such germs are considered a part of our normal biology.

If you have been diagnosed with a strain of HPV, 你的医生会想要确保你没有任何癌前病变.

生殖器疣可以通过身体检查诊断,通常不需要活检诊断.

Treatment

生殖器疣的治疗方法可以是用化学药物消灭疣,也可以是烧灼,或者激光. 有一些局部药物可以通过处方在家里使用来治疗疣.

中度或重度宫颈发育不良(宫颈癌前组织改变)最常用的治疗方法是环形电切手术(LEEP),该手术使用烧灼去除受影响的细胞. LEEP检查的开始方式与标准骨盆检查相同. 您将接受局部麻醉和温和的碘或醋溶液,以显示任何异常细胞. 你的医生或护士会通过一种叫做阴道镜的放大装置来观察细胞. 一个运行高频电流的think wire loop将允许你的医生非常精确地移除异常细胞. The tissue is then sent to the lab to look for cancerous cells.

Equally effective office treatment includes cyrotherapy, or freezing, which destroys the precancerous cells.

Preventing transmission

避孕套可以将HPV的传播减少50%以上. However, 它们不能提供完全的保护,因为病毒也存在于生殖器区域的外层皮肤上.

Smoking can affect a woman's ability to fight the virus, 因此,我们鼓励女性戒烟,帮助她们的免疫系统更好地清除体内的病毒.

The HPV vaccine

HPV (GARDASIL)是一种有效和安全的疫苗,可预防四种亚型:

  • The "low-risk" subtypes 6 and 11. These subtypes do not generally cause precancerous conditions. They are responsible for 90 percent of genital warts.
  • HPV subtypes 16 and 18. 这些高风险亚型导致70%的宫颈癌和子宫颈癌的癌前组织改变.

The vaccine does not protect against the other subtypes.

The vaccine is a series of three shots. 您将在第一次注射两个月后接受第二次注射. The third shot is given six months after the first shot. 该疫苗已被FDA批准用于治疗9至26岁的女孩和妇女. 许多保险计划将支付这些年龄组的疫苗费用.