[Prevention of malignant tumors caused by human papilloma virus (HPV) by vaccination and with the methods of classical gynecologic diagnostics].
The "gold standard" of the gynecologic examinations is even today the classical clinical examination completed with the digital colposcopy, the Pap smears prepared from transport media and histological examination of biopsy material. Without these classical examinations one cannot evaluate the results of the molecular tests detecting papillomaviruses. The majority (70 to 90%) of the primary clinical symptoms caused by papillomaviruses recovers spontaneously. The recovery can be supported by, "imiquimod" (Aldara) which is an immunostimulant-inducing interferon gamma and the production of interleukins, since papillomavirus infection is able to prevent the production of these mediators through its blocking effect to the innate immunity. Prevention is the main aim of the contemporary public health facilitated by the modern gene technology. The tetravalent vaccine (types 6, 11, 16 and 18) is harmless, since no tumor inducing genes are included. The empty capsids are manufactured in yeast cells and purified to a high degree similar to that of hepatitis B vaccine. The tetravalent vaccine is a preventive vaccine. It will be useful for teenagers, who have not acquired yet the most common papillomavirus types. There is intensive research going on in order to create therapeutic vaccines, that might be effective also in people of older age who had acquired certain virus types before vaccination, and may possess clinical symptoms, too. Men are the source of papillomavirus infection of women. Therefore vaccination of both genders will be indicated. The importance of the classical diagnostic procedures will not be diminished even under the umbrella of vaccination, since the preventive efforts were shown to be fully effective, if the clinical examinations, colposcopy, pap smears and biopsies are regularly performed in the patients with clinical symptoms increasing the rate of recovery above 90%. About 13 to 15 subtypes of human papillomaviruses may induce malignant processes. These are also present and most frequent in Hungary both in sexually transmitted infections and in the cancers of head and neck.
Berencsi
György
G
Johan Béla Országos Epidemiológiai Központ, Budapest. berencsigy@oek.antsz.hu
Sziller
István
I
Melles
Márta
M
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000293:Adolescent; D000634:Aminoquinolines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D002471:Cell Transformation, Neoplastic; D003127:Colposcopy; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D000077271:Imiquimod; D008297:Male; D065006:Papanicolaou Test; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000276:immunology / Q000517:prevention & control*; D014412:Tumor Virus Infections / Q000276:immunology / Q000517:prevention & control*; D014626:Vaginal Smears; D014765:Viral Vaccines / Q000627:therapeutic use*
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000970:Antineoplastic Agents; D014765:Viral Vaccines; D000077271:Imiquimod