Papillomaviruses

The human papillomavirus (HPV) is one of the most common diseases that is predominantly sexually transmitted. Almost every adult sexually active person meets him during his life. According to statistics available for 2021, up to 660 million people are infected with HPV in the world.

Cancer risk

The most common type of HPV-associated cancer is cervical cancer (cervical cancer). Almost all cases of RSM (99%) are associated with genital infection with HPV infection. As of 2021, up to 70% of all cases of this disease and precancerous lesions of the cervix cause 16 and 18 types of virus. Papillomavirus also provokes the development of a number of other oncological pathologies in both sexes. These data were cited by the chief freelance specialist in infectious diseases in children of the Central and South-Eastern Districts of Moscow, Ph.D. Alexey Yuryevich Rtishchev.

How the virus is transmitted

The virus is transmitted not only genitally, but also by infection with the skin. "Contrary to a common misconception, it is completely impossible to protect against HPV with a condom," said Alexei Yuryevich Rtishchev, chief freelance specialist in infectious diseases in children of the Central and South-Eastern Districts of Moscow, Ph.D. in 2021, "the virus easily penetrates through skin contact. And if one of the partners is infected with papillomavirus, then the infectious agent will easily enter the body of another person. "

Symptoms

The human immune system does not recognize HPV as a threat, and the virus often does not manifest itself in any way for many years. However, despite the frequent asymptomatic course of the infectious process, the development of anogenital warts can indicate its presence. In the Russian Federation, the incidence of anogenital warts is quite high: in 2018, it was 18.8 cases per 100,000 population. This is an alarming symptom - there is evidence that the presence of anogenital warts may indicate an increased risk of anogenital malignancies.

2023: WHO: One in three men in the world infected with human papillomavirus

One in three men in the world over 15 years old is a carrier of genital human papillomavirus (HPV). This is stated in a study by the World Health Organization (WHO), the results of which were released in early September 2023.

A team of scientists led by Dr. Laia Bruni from the Cancer Institute of Catalonia combined data from 65 studies conducted from 1995 to 2022. This allowed for a comprehensive picture of HPV prevalence among men on a global scale. It turned out that about a third (31%) of men are carriers of the virus, and 21% are infected with one or more of the especially dangerous HPV serotypes that provoke the development of malignant formations.

Approximately a third (31%) of men are carriers of the virus

The highest rates were recorded in North America and Tropical Africa - 45% and 37% of HPV carriers, respectively. However, the minimum values ​ ​ are observed in East and Southeast Asia - approximately 15%.

It is also said that in women, almost all cases of cervical cancer are associated with infection with the human papillomavirus (99%). Despite the fact that most HPV infections go away themselves and do not cause any symptoms, persistent infection can lead to the development of tumors. Cervical cancer is the fourth most common type of malignancy among women. It is estimated that around 570,000 were diagnosed worldwide in 2018. cases of this disease and approximately 311 thousand. patients died.

Other serotypes of the virus can cause the formation of anogenital warts. A new initiative to intensify HPV vaccination, led by the GAVI (Global Alliance for Vaccines and Immunisation) alliance, is designed to improve the situation. It is aimed at strengthening existing programs and promoting the wider introduction of vaccination.^[1]

2022

Phase 3 clinical trial of the first domestic HPV vaccine starts

On June 27, 2022 biopharmaceutical , the company "" announced Nanolek that it had received Ministry of Health of the Russian federation permission from the third phase clinical trials in adult patients. HPV vaccines This will be the first domestic vaccine from HPV, which is planned to be brought to the market at the end of 2024. In 2 years, she should enter. National calendar of preventive vaccinations Read more. here

Nanolek plans to start production of a fully domestic vaccine against the human papillomavirus

The design of the building for the production of vaccines in a full cycle, including the development of substances, at the Nanolek plant Kirov region "" in will be completed by the summer of 2022, and in 3 years they plan to start producing the first completely domestic vaccine from virus human papilloma (HPV). This was announced on March 23, 2022 by Zdrav.Expert representatives of Nanolek. The project in the company was called "Our Tesla." More. here

2021

Nanolek attracted 2 billion rubles for the production of vaccines against the human papillomavirus

On October 21, 2021, it became known that the expert council of the Industrial Development Fund (FRP) approved the Nanolek company a loan in the amount of 2 billion rubles for the localization of pharmaceutical production. Read more here.

32 thousand girls vaccinated in Moscow in 9 months

Russia is implementing initiatives aimed at reducing the spread of HPV-associated diseases. A number of regions already have a program for HPV immunoprophylaxis. For example, in Moscow for 9 months of 2021, about 32,000 girls were vaccinated under the program. We have already accumulated extensive experience in the country and a significant number of studies on the safety of vaccine prophylaxis. HPV vaccination has been proven to play an important role in preventing cervical cancer and precancerous changes. It is especially important to undergo immunoprophylaxis for girls in adolescence and women under 26 years old: at this time, protection against papillomavirus is most fully manifested.

Today, vaccination has already been introduced into the national vaccination calendar in 111 countries around the world. It is planned that HPV vaccination will appear in the Russian national vaccination calendar in 2024.

Nanolek conducted phase 1 clinical trial of its HPV vaccine

The Russian biopharmaceutical The company Nanolek"" on November 22, 2021 reported the results of the 1st phase of a clinical trial, in which HPV vaccine its own development was compared with a vaccine of the same type manufactured in. USA Domestic drug showed a more favorable safety profile and better tolerability. Nanolek announced this on November 22, 2021. More. here

2020

WHO strategy to protect against cervical cancer adopted

In connection with the high medical and social significance, on November 17, 2020, the WHO strategy was adopted to eliminate the most common cancer caused by HPV - cervical cancer. The strategy includes three key components: HPV vaccination, screening and treatment.

It is assumed that the strategy will be implemented in several stages. In the medium term, until 2030, it is necessary to introduce vaccination of 90% of girls under 15 years of age, to ensure high-quality screening of women aged 35 years and again at the age of 45 years. It is also important to ensure that a minimum of 90% of women identified with cervical disease (invasive cancer and precancerous changes) are adequately treated. The successful implementation of all three components, according to experts, will help by 2050 to reduce by 40% the number of new cases of cervical cancer and prevent 5 million related deaths.

Experts: By vaccinating 40% of boys against HPV, we can prevent more than 600 cases of cancer per 100,000 women

43% of all types of genital cancer in men are caused by the human papillomavirus, primarily 11, 16 and 18 types, experts from the Interregional Forum of STI Specialists IUSTI noted in December 2020. At the same time, there is no state screening program that would identify these types of oncology in men at the initial stage.

At the same time, the number of men infected with the human papillomavirus is quite large. So, in the USA, a population study was conducted, covering 2,046 men. 42.2% of the study participants were found to have human papillomavirus, with high cancer risk in 23.4% of cases. In this case, the virus can be detected even when there are no visible neoplasms, and the person himself does not suspect that he is a carrier of this infection.

Importantly, men are more vulnerable to HPV than women. Thus, the immune response in the male population is significantly less than in women: only 10.4% of men have antibodies within 24 months after infection with HPV type 16, while in women this figure is 60%.

Reliable protection against human papillomavirus is vaccination. According to the study, the use of vaccination in men prevents high oncogenic risk HPV infection by 90% compared to the placebo group. It is important that the vaccination of 40% of boys will help prevent 687 cases of oncology per 100 thousand women in the future.

"The experience of foreign countries, in particular Australia, shows that a gender-neutral approach in human papillomavirus vaccination has a positive impact on the spread of infection, - notes the speaker of the forum, Mikhail Alexandrovich Gomberg, professor, doctor of medical sciences, chief researcher at the Moscow Scientific and Practical Center for Dermatovenerology and Cosmetology of the Ministry of Health of the Russian Federation, "And in the long term, it allows the elimination of HPV-associated types of oncology both in the male population and among women."

In Australia, girls aged 9-12 have been vaccinated since 2007, and since 2012, vaccination has been gender neutral - HPV immunization is received by adolescents of both sexes.

Tobacco smoke leads to transformation from papillomavirus to cancer

Research by Russian and international scientists suggests that smoking triggers the activation of carcinogens in organs such as cervical, genital, rectum, bladder and other organs not directly exposed to tobacco smoke. This is stated in an article by Doctor of Medical Sciences, oncologist Yulia Payanidi and Candidate of Sciences Svetlana Vinokurova, published in the medical journal Oncogynecology (October 2020).

The paper examines the impact of human papillomavirus (HPV) on the occurrence of reproductive cancer in women and the prospects for applying the harm reduction concept to possibly eliminate risks. In recent decades, oncologists have recorded the growing role of papillomas in the onset of malignant tumors.

"In itself, the presence of the human papillomavirus without concomitant risk factors does not lead to the emergence of malignant tumors," says an article by Yulia Payanidi and Svetlana Vinokurova.

Smoking, according to doctors, triggers the mechanism of oncogenic transformation of the infected epithelium, and also increases the expression of viral oncogenes. The reason is that of the more than 7,000 components of tobacco smoke, at least 69 substances are capable of causing cancer. As a result, derivatives of tobacco combustion products can be detected, for example, in the cervix, where it affects the mechanism of local immunity, as well as in the bladder.

"It has been established that the carcinogenic effect of smoking is not by increasing the risk of HPV infection, but by progressing from HPV infection to cancer," the study said.

Interestingly, the authors of the scientific article emphasize, nicotine itself is not a carcinogen. This is an alkaloid that is part of many plants, including potatoes and tomatoes.

"Quitting smoking should be an integral part of cancer therapy. Evidence-based smoking cessation intervention should be integrated into all cancer programs: from prevention and diagnosis to treatment and palliative care, "the authors of the article say.

According to them, over the years of abstinence from smoking in the body, the accumulated level of adducts, molecules of toxic substances that attach to DNA in cells, decreases. The process of DNA adduct accumulation can cause mutations in cells and initiate the occurrence of malignant tumors.

Papillomaviruses cause 750,000 new cases of cancer in the world every year

As of 2020, papillomaviruses annually cause 750 thousand new cases of cancer in the world. Cervical cancer ranks 2nd most common among all cancers of the reproductive system, second only to breast cancer. At the same time, from 50 to 80% of women with diagnosed cancer are infected with the human papillomavirus. This is one of the oldest viruses, more than 200 varieties of it are known.

The human papillomavirus bypasses the immune system and participates in the carcinogenesis of a number of organs of the female reproductive system. The highest susceptibility to papylomovirus infection in squamous epithelium-coated organs.

"The presence of human papillomavirus alone for high oncogenic risk is not enough. It is also necessary to have risk factors - a sedentary lifestyle, poor nutrition, bad habits, among which smoking is especially distinguished, "said Yulia Payanidi, professor at the Department of Obstetrics and Gynecology of the Russian National Medical University named after Pirogov of the Ministry of Health of Russia

Smoking, she said, is one of the key risk factors that can "push" papillomavirus to start expressing cells that cause malignancies. In addition, in 34% of observations in women who smoke, cervical cancer was combined with lung cancer.

"Smoking causes cancer not only in the respiratory system, tobacco smoke affects the metabolic activation of carcinogens throughout the body. Tobacco smoke contains benzapyrene, which accumulates in the colon. Smoking can also cause carcinogenesis in organs not exposed to tobacco smoke, so carcinogens can also be found in the cervix. At the same time, it is important to understand that nicotine, as a plant alkaloid, is not a carcinogen, "said Julia Payanidi.

According to the professor, patients who continue to smoke during the period of radiation therapy are 3 times more likely to have complications in the small intestine. Smoking also negatively affects the pharmacokinetics of chemotherapy, reducing its effectiveness. Smoke components can cause complications during operations. However, 80% of cancer patients continue to smoke even after diagnosis.

Since cervical cancer is one of the forms of neoplasms that can be detected in the early stages, one of the preventive measures may be population screening. The most effective was the screening of women from 25 to 65 years old annually. As well as vaccination against the human papillomavirus before the beginning of sexual life. In Iceland, for example, thanks to such measures for 40 years, the mortality rate from cancer of the reproductive system decreased by 80%, in Finland by 50%.

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