Human papillomavirus (HPV) in women and men

The human papillomavirus (HPV) is one of the most common sexually transmitted infections in women and men. The peak of infection occurs at the beginning of an active sexual life. In addition to sexual transmission, the infection can occur through contact and domestic contact.

Today, more than 100 types of HPV are known, of which at least 14 have oncogenic potential and can cause cervical cancer. Furthermore, certain types of HPV are associated with the development of other cancers such as anal, oropharyngeal, vaginal, and penile cancers. This makes HPV an important target for research and prevention, not only in women but also in men. Types 16 and 18 of HPV are found in 7 out of 10 cases in the development of cervical cancer.

HPV and Pregnancy

HPV can affect the course of pregnancy, both in natural cycles and during in vitro fertilization (IVF). Depending on the type of virus and the level of immune response in the woman, the presence of HPV may increase the risk of complications such as premature birth, intrauterine growth retardation of the fetus, and newborn infection during delivery.

When planning a pregnancy or IVF, it is important to undergo a complete examination including an HPV-HR test, a Pap test, a colposcopy, oncogenic markers, and a general immune system test. In some cases, it may be necessary to consult an infectious diseases specialist or an immunologist to assess the risk level and the need for prior treatment.

Why is HPV Testing Necessary for Women?

Cervical cancer is the fourth most common cancer in women worldwide. Its development is closely linked to human papillomavirus, making prevention and early diagnosis key measures in the fight against this disease.

Prevention and control of papillomavirus include the following elements:

• Primary Prevention - vaccination against papillomavirus;
• Screening - testing for the presence of the virus in the body;
• HPV Treatment - elimination of the clinical manifestations of the infection;
• Diagnosis and therapy of oncological diseases caused by the virus;
• Secondary Prevention - regular check-ups with a gynecologist, cytological exams, maintaining the immune system through a healthy lifestyle, a balanced diet, and avoiding bad habits.

Risk Factors for Developing Cervical Cancer Against a Background of HPV

The risk of malignant degeneration of cells in the context of HPV depends on the following factors:

• the type of virus and its oncogenic power (particularly dangerous - 33, 31, 18, 16);
• the state of the immune system (weakened immunity increases the risk);
• the presence of concomitant STIs (herpes, chlamydia, gonorrhea);
• the number of births the woman has had (multiple births increase the risk);
• the presence of bad habits, such as smoking.

When Should HPV Screening Be Done?

WHO recommends that all women over 30 years old undergo regular screening for human papillomavirus at least once every three to five years. Women in risk groups (weakened immune system, high-risk oncogenic HPV, history of STIs) are advised to start screening earlier - from the age of 25 - and to be screened more frequently, according to their doctor's recommendations. Screening includes:

• DNA Test - detection of high-risk oncogenic virus (PCR method);
• Pap Test (Papanicolaou Test) - examination of cervical cells to detect precancerous changes;
• Colposcopy - Colposcopy is an examination that involves viewing the vagina and cervix using a speculum and a binocular magnifier.

External manifestations of HPV may include:

• genital warts (condylomata acuminata);
• cervical dysplasia;
• flat condylomas.

Treatment of Papillomavirus in Women

HPV is diagnosed and treated by a gynecologist, but depending on the clinical case, it may be necessary to consult other specialists such as an immunologist, a dermatovenerologist, and an oncologist. The immunologist helps assess the immune system and determine a maintenance strategy, while the dermatovenerologist treats the skin manifestations of the virus. In cases where precancerous or malignant changes are detected, the intervention of an oncologist is necessary for further observation and possible treatment.

HPV Treatment Methods

Therapy may include:

• antiviral medications;
• local and systemic immunotherapy;
• anti-inflammatory medications;
• removal of neoplasms (radio waves, laser, cryodestruction).

Additionally, women with oncogenic types of HPV identified should follow a screening program. This monitoring is necessary for the early detection of precancerous changes and timely initiation of therapy aimed at preventing the development of cervical cancer. This is especially important for women considering pregnancy, including IVF, IVF with egg donation, or IVF with double donation. In these cases, preliminary tests, including HPV testing, cytology, and colposcopy, are necessary, and appropriate treatment should be undertaken if needed to minimize risks for the mother and the unborn child.