Monday , January 25 2021

35-year-old CIN3 female. Do you need HPV vaccine before and after pregnancy?



It is a good idea to periodically collect cell samples. Women who have been tested every three years at 25-69 years of age and who have tracked the recommended abnormalities can reduce the risk of cervical cancer by up to 80%. In Norway, one out of every 100 women with cervical cancer before the age of 75 years has not undergone a cell test for the past five years before diagnosis. Of the 10,000 women who underwent normal cytology, 3.5 to 2-3 women are suffering from cervical cancer.

HPV infection is common. 70-80% of all women and men were infected with HPV more than once. Approximately 25% of people who have received a positive HPV test have HPV type 16 alone. In general, 9 out of 10 people will get rid of the HPV infection for 2 years, but some people continue to have the infection for years. It takes an average of 10 years from HPV infection to detect coarse cell changes (CIN3).

Women who had previously undergone low-grade cell changes (ASC-US / LSIL) and benign HPV tests had to wait 6 to 12 months for new cell and HPV tests. Updated guidelines recommend low grade women to gynecologists with colposcopy and biopsy if HPV types 16 or 18 are available. However, low-grade women can wait 12 months before "new" HPV types for new management.

If the tissue sample (biopsy) indicates CIN2 or CIN3, it is recommended that the woman be treated with a configuration in which the cell change area is removed. This is a small procedure usually performed with local anesthesia, and the tissue removed is only 2 to 3 grams.

1. A gynecologist meant to get vaccinated after getting pregnant. Did you see what you recommended before? Can you make a mistake before taking the Constitution before? Do I need to take Gardasil 9 as an obstetrician?

In general, HPV vaccines should be taken as soon as possible. The only reason to delay the HPV vaccine is because of pregnancy. There is a widespread misconception that you should wait until you get pregnant before you get your HPV vaccine. There have been studies on HPV vaccines that are negative for HPV before vaccination. Ongoing HPV infection or established cell changes do not refer to the protective effect of the vaccine on subsequent infection and new cell changes, but do not affect ongoing HPV infection or cell changes.

Gardasil 9 is the latest HPV vaccine to deal with nine types of viruses (6, 11, 16, 18, 31, 33, 45, 52 and 58). It replaces the "old" Gardasil 4 vaccine covering 4 different virus types (6, 11, 16 and 18). Competitor Cervarix deals with two HPV types (16 and 18), but has a partial impact on three different HPV types (31, 33 and 45). Also, "old" Gardasil 4 partially affects HPV types 31, 33 and 45, but in studies comparing Gardasil 9 with gasoline 4, Gardasil 9 clearly has the best effect on HPV types 31, 33 and 45 And 58. There is no direct comparison of Cervarix with Gardasil 4 or Gardasil 9.

– Community catalog There is no effect on active HPV infection or established clinical disease.

It is not expected that the HPV infection will disappear because the HPV infection can not be expected to disappear due to the vaccination or because the vaccine can not cure the cell change. However, the vaccine always shows the same effect for new infections and new cell damage. You take it. Vaccines can reduce the risk of re-emergence in a relationship, and vaccines can reduce the risk of moving HPV from the mucosa to the mucosa or from the mucosa to another location on the same mucosa. Some studies show that the risk of recurrence of cellular changes after cessation of vaccination among women vaccinated decreases and risk is reduced regardless of whether the vaccine was given before or after pregnancy. If you take your first dose two weeks before pregnancy, depending on your constitution, many antibodies to HPV will be present at the wound site.

2. Should my husband get the same vaccine?

Since all three HPV vaccines have a positive effect on HPV types 16 and 18, it is not important whether they take any of the three vaccines or whether they have eaten the same vaccine, but most people who pay the vaccine cover most of the HPV types , That is, Gardasil 9.

– Should we not have sex to prevent infection?

You are less important in your constitution because you repeatedly infected each other. It is recommended that you use a condom until you have taken the HPV vaccine after pregnancy. The vaccine has a fairly good effect if you take it twice already after the first dose. The reason we recommend 3 doses is to ensure long-term immunity (life expectancy).

"We have recently received the flu vaccine. What would you say if you invited Gardasil 9 vaccine in the near future?

no. Although HPV and flu vaccines can be taken at the same time, some doctors recommend placing the vaccine in each arm.

3. Even if you are already infected with HPV16, can the vaccine prevent the HPV16 virus from spreading elsewhere in your body?

Yes. The vaccine allows the body to produce antibodies on the surface of the virus particles. This neutralizes the virus particles and prevents them from entering new cells. This reduces the risk of infection from the uterine cervix to the anus, mouth and throat. It also reduces the risk of resuming from relationships. However, the vaccine does not affect the viral particles already in the cell. Fortunately, in most cases, the immune system kills cells with viruses. In addition, the area of ​​the cervical cervix (cervix) will be removed by pregnancy.

4. I was worried about cancer elsewhere in my body because I am more vulnerable to HPV16. Can you tell us about the risk of cancer in HPV16?

There are several types that can cause cervical cancer (including HPV types 16, 18, 31, 33, 45, 52 and 58), but HPV type 16 mainly causes cancer elsewhere in the body. Genital, vulvar, Anus, mouth and throat). For women, this risk is much lower than the risk of cervical cancer. One out of every 100 women with cervical cancer in their lifetime suffers from ankle cancer before age 75 in one out of every 1,000 women and 75 out of 75 women who develop cancer due to oral and throat HPV. Compared to oral and throat HPV, 4 out of 1000 men will get cancer.

– What are the chances of an HPV infection elsewhere? Do I have any symptoms I should know?

Most HPV come from the genitals (cervix, vagina, vulva) and the anus. 6.5% of all women aged 34-69 years received a positive HPV test on cervical screening, but 1.0% of all women with HPV in the mouth and throat. Compared, HPV is 2-3% of all men in the mouth and throat. I do not think it helps too much to feel symptoms, but consult your doctor if you do not grow up, have bleeding, or if you have a wound that lasts longer than a month.

5. There may be fresh blood on paper that is dared to be dumped sometimes. During pregnancy, especially when the scaffolding was difficult, there was a problem. There may be blood in the bathroom. The problem is rare. Sometimes there is some fresh blood on the paper. Can this be an anal cancer?

Many people experience fresh blood on paper (especially the same). The most common causes are hemorrhoids or small mucous membranes. If this happens rarely, anal cancer is not likely to occur. If you often bleed, ask for an anoscopy check. Men with sex with men are at a higher risk of anal cancer than women with cervical cancer. The risk of anal cancer with the number of anal sex partners increases, but men who have never had anal sex can cause anal cancer due to HPV.


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