Human Papillomavirus-Related Diseases and Prevention with Vaccination

Okužbe s humanimi virusi papiloma (HPV) so zelo pogoste spolno prenosljive bolezni, ki se značilno pojavijo kmalu po začetku spolne dejavnosti. Breme z njimi povezanih bolezni, rakavih in nerakavih, je veliko za ženske in moške. HPV, ki prinašajo veliko tveganje, visokotvegani ali onkogeni HPV pri ženskah povzročajo raka materničnega vratu, nožnice in zunanjega spolovila, pri moških pa raka penisa ter pomemben delež raka žrela in raka zadnjika pri ženskah in moških. Pred nekaj leti sta bili izdelani cepivi, ki preprečujeta okužbo z 2 genotipoma, ki povzročata raka (HPV 16 in 18). Pri neokuženih osebah v približno 95 % učinkovito preprečujeta bolezni, ki jih povzročata oba genotipa, ne zdravita pa okužbe. Profilaktični cepivi sta prvi, ki so ju naredili, da bi pri človeku preprečevali raka.Human papillomavirus (HPV) is an extremely prevalent sexually transmited infection that is typically acquired soon after the onset of sexual activity. The burden of HPV-related malignant and nonmalignant disease is high in women and men. High-risk or oncogenic types of HPV cause cervical, vaginal, and vulvar vancer in women. These types have also been shown to cause penile cancer in men and a substantial proportion of oropharingeal and anal cancer in women and men. Low-risk types of HPV cause anogenital warts. Virus-like particle-based vaccines have recently been developed to prevent the infection with two cancer-associated HPV genotypes (HPV 16, HPV 18) and have been ~ 95% effective in preventing HPV-associated disease caused by genotypes in virus-naive subjects. The prophylactic vaccines are not therapeutic for the already present infection. HPV prophylactic vaccines are the first vaccines designed to prevent a human cancer

Cepljenje proti HPV: poročilo vodilne skupine strokovnjakov za svetovanje o strategiji cepljenja pri Svetovni zdravstveni organizaciji, oktober 2008

No abstract.Ni abstrakta

Cervical Cancer Detection Using High-Risk Human Papillomavirus Testing

Since the development of cytology-based cervical cancer screening using PAP test in the mid-20th century, the PAP test has been accepted as a method for secondary prevention of cervical cancer. Screening for cervical cancer precursors by cytology has been very successful in the countries with high-quality programs and good coverage of the population at risk. Low-grade abnormalities are the most common type of cytologic abnormalities. In several countries, it is currently recommended to follow up these women by performing PAP smear tests in 6-month intervals. If the low-grade abnormalities do not normalize, colposcopy should be done, which every now and then leads to several unnecessary referrals, associated anxiety and costs. Human papillomavirus (HPV) infection is very common in young women after the onset of sexual activity and, when it persists, it may result in cervical intraepithelial neoplasia (CIN). The recognition of the strong causal relationship between the persistent infection of the genital tract with high-risk HPV types and the occurrence of cervical cancer has resulted in the development of a number of HPV DNA and HPV RNA detection systems. The detection of high-risk HPV DNA is considered to be potentially useful in three applications: (1) as a triage test to select the women with minor cytologic lesions in their PAP smears who need a referral for colposcopic diagnosis and treatment, (2) as a follow-up test for the treated high-grade intraepithelial lesion, and (3.) as a primary screening test alone or in combination with PAP test to detect cervical cancer precursors. There are clear benefits of the use of HPV DNA testing in the triage of atypical squamous cells, mild dyscaryotic cells in older women, and in the post-treatment surveillance of women after treatment for CIN. There is an increasing need for more information and educational programs about HPV