what is HPV?
As HPV infection is a major cause of cervical cancer, vaccination offers
the hope of a reduction in the incidence of this cancer.
HUMAN papilloma virus (HPV) is a common sexually transmitted infection.
The HPV virus needs to infect cells in order to survive. Once inside a cell,
it directs the cell to make copies of it and to infect other healthy cells. The
infected cells eventually die and are shed from the body. When the virus is
shed, it can infect another person.
There are different types of HPV. The low risk types, such as HPV6 and HPV11
cause benign genital and respiratory warts, while persistent infection with
high-risk types such as HPV16 and HPV18 is associated with increased risk of
high grade cervical intraepithelial neoplasia (CIN), which is a precursor of
cervical cancer.
The genital warts (condylomas) may appear on the outside or inside the
reproductive tract. It can spread to nearby skin or to a sexual partner.
Genital warts are more likely to occur in people who have more than one
sexual partner or whose sexual partner has more than one partner. Other
reproductive tract infections are often associated with genital warts.
HPV is a major cause of cancer of the cervix. HPV infections by the high risk
types are common in young sexually active women. Most clear spontaneously
without ever causing cervical intraepithelial neoplasia while some develop a
persistent infection.
Hence, cervical cancer can be considered a rare consequence of persistent
infection with one or more high risk types, with other as yet undefined factors
playing a role.
Studies suggest that HPV may also cause cancer of the vulva, vagina, anus,
some cancers of the oropharynx (middle part of the throat that includes the base
of the tongue and tonsils).
The more sexual partners a person has, the more likely he or she will get HPV
infection. The vast majority of HPV infections go away without treatment.
Certain factors like smoking, multiple sexual partners, having many children,
oral contraceptive use and HIV infection are associated with an increase in the
risk of developing cervical cancer.
As HPV may have no symptoms, it may be more common than is thought.
Most genital warts may appear within a few weeks or months after sexual
contact with an infected person or they may not appear at all.
The warts are flat, abnormal growths in the genital area including the
cervix. Sometimes, the warts are extensive with a cauliflower-like
appearance.
There is no published data on the disease burden of HPV infection in our
country as HPV is not a notifiable infection.
However, cervical cancer is the second most common cancer in women here.
The National Cancer Register for 2003 shows the incidence in Peninsular
Malaysia as 13.4 and 62.9 per 100,000 women in the age groups 15 to 49 and 50 to
69 years respectively.
HPV vaccines
Women who had previously been infected by a particular HPV type are unlikely
to get re-infected by the same HPV type because of the antibodies produced.
There are two types of HPV vaccines: a bivalent (HPV16 and HPV18) and a
quadrivalent vaccine (HPV 6, 11, 16 and 18).
Both vaccines provide protection against 70% of the HPV types that cause
cervical cancer.
In addition, the quadrivalent vaccine provides protection against 90% of the
HPV types that cause genital warts.
The vaccines do not provide protection against HPV types that a person has
been exposed to.
However, a person who has had HPV may still benefit from the vaccine because
most people are not infected with all the types of HPV contained in the
vaccine.
The vaccines do not provide protection against other sexually transmitted
infections (STI).
Information about some aspects of HPV vaccines is yet to be clarified. This
includes the duration of protection although current data indicates that the
protection after vaccination lasts at least five years.
The vaccines are given by injection in the upper arm. The second and third
doses are given two and six months later.
The optimal age for HPV vaccination is between the age of nine and 26
years.
Effectiveness and safety
The HPV vaccines are effective. Studies of both vaccines, to-date, have
reported near 100% efficacy.
HPV vaccines are generally well tolerated and reactions are minimal. It is
usually limited to some pain, swelling, itching and redness at the injection
site, fever, nausea, vomiting, dizziness and fainting.
Other side effects reported include swollen glands in the neck, armpit, or
groin, headache, skin rashes, joint pain, aching muscles, unusual tiredness or
weakness, and a general feeling of being unwell.
Allergic reactions have been reported. They include difficulty in breathing,
wheezing and rashes. Some of these reactions are severe.
It is important to inform your doctor if you or your child has had an
allergic reaction to the vaccine; has a bleeding disorder; is immunocompromised,
such as with HIV infection; is pregnant or is planning to get pregnant, as the
vaccine is not recommended for use in pregnant women; has a fever more than
37.8°C; and is taking or intends to take any medicines including over the
counter medicines.
HPV vaccination is no substitute for Pap smear screening. Those who have
received HPV vaccines should continue Pap smear screening.
An abnormal Pap smear does not mean that a person has HPV infection or any
other condition, including cancer.
It does mean that you have to be examined with a procedure called colposcopy.
This involves using a magnifying instrument to look at the cervix, vagina, vulva
and anus.
If there are areas that appear suspicious, a biopsy, in which a small sample
of tissue is removed for microscopic examination, will be performed.
As HPV infection is a major cause of cervical cancer, vaccination offers the
hope of a reduction in the incidence of cervical cancer.
However, other measures are needed to eradicate cervical cancer. They include
widespread Pap smear screening and safe sexual practices.
One should also remember that HPV vaccines prevent HPV infections. It cannot
be extrapolated to the prevention of cervical cancer as there are, apart from
HPV infection, other as yet undefined factors playing a role in the genesis of
cervical cancer.
Dr Milton Lum is the chairperson of the Commonwealth Medical Trust. This
article is not intended to replace, dictate or define evaluation by a qualified
doctor. The views expressed do not represent that of any organisation the writer
is associated with
source :
http://thestar.com.my/health/story.asp
in Malaysia, these days school girls are so lucky because they are getting the vaccinations for free...how i wish that i also got the same chances last time...
to get it by myself now it costs about RM 1200 for all 3 doses
but of course the amount doesnt mean anything if it really prevents you from getting this fatal disease
moral of the story....
NO HARM TRYING
pray to Allah and do our own part, try our level best
insyaAllah....
hh
