HPV: Why and how our body controls this virus

“Human papilloma virus (HPV)”  refers to a large family of 200 genotypes (subtypes) of viruses. The viruses of interest here are the ones that infect the skin and mucous membranes. There are about 40 genotypes which concentrate in the mouth and throat, on the skin and in the mucous membranes of the cervix, vagina, vulva, penis and anus.

In most cases, HPV manifests with temporary lesions which our immune system is able to control by triggering a response to neutralize transmission of the virus. However, our bodies cannot always prevent the development of cancers or the warts known condylomas, or anogenital or respiratory warts.

Of the 40 genotypes, 15 types are considered high risk of producing precancerous or cancerous lesions. Although almost all cervical cancers are due to HPV, that is not true for the other cancers associated with HPV, where other causes, such as skin diseases, smoking or alcohol use also play a role. However, most HPV infections, whether high or low risk, do not produce lesions and more than 90% of cases are cleared by our immune system in under 2 years [1].

The virus spreads easily by simple skin-to-skin contact, sometimes without penetration, which makes it by far the most common sexually transmitted or blood-born infection (STBBI). Three quarters of sexually active people of all sexes will have an HPV infection during their lifetime [2].

One person may be infected with one or more different HPVs, at the same time or successively. However, it is important to point out that, once infected, the large majority of people will neutralize the virus, but not eliminate it.

The high prevalence of HPV can be explained by its ability to become chronic and how easily it is spread and infects people.

Like with all infections caused by microorganisms (such as viruses, bacteria and fungi), our body activates a subgroup of white blood cells—T-cells or T-lymphocytes—in collaboration with other cell types to control HPV [3]. Even though human T-cells are generally very effective, their action is not infallible, as the appearance of condylomas and cervical cancers indicates. As well, HPV does not eliminate the cells it infects. As the body ages, a number of diseases, which had previously been controlled or undetected, may show up.

Another reason why our body does not defend itself at all or fully against some infections, including HPV infections, lies in the temporary or gradual weakening of our immune system as we age.

Our immune system may be weakened by various conditions, and every case is unique. For some people, the weakness may be inherited, even though it is often not detected until adulthood. Others may develop a weakened immune system because of chronic diseases such as diabetes and cancer, or because of medical treatments such as immunosuppressants (drugs that reduce the body’s immune response). Those treatments include the anti-rejection drugs used after a transplant, chemotherapy, cortisone and its derivatives or immunomodulatory biologics (drugs that treat diseases by altering the immune system). These treatments increase the risk of complications with previously controlled HPV [7].

Smoking doubles the risk of developing some types of uterine cancer. It can have many effects including the direct consequences related to the chemicals in smoke, as well as the recognized weakening of the immune system [8].

Stress is also associated with weakening the immune system. A study conducted in the early 2000’s on 333 19-year-old women who were monitored for 11 years showed an association between the persistence of HPV and participants’ stress levels. Even though it was not possible to determine whether the cause was stress itself or its negative effects (such as smoking and alcohol consumption) [9], French researchers recently found a direct interaction between stress hormones and immune system cells [10].

It is worth noting that diet also plays an important role in maintaining the health of our immune system. Many micronutrients (such as vitamins C and D, zinc, selenium, iron, and protein) are crucial for growth and immune system function. First of all, it is important to remember that food goes through our intestine, which hosts nearly 70% of our immune system, all on its own. Not to mention the increasingly complex and important role of the microbiota (microorganisms living in our intestine) which helps to protect our intestinal mucosa and produces some molecules like short-chain fatty acids which help with immune response [11].

Even though there is no one magic recipe for boosting our immune system, a healthy, balanced diet, following the recommendations of Canada’s Food Guide or a dietician, is an excellent way of supporting our defences every day. [12]

Even though our immune system generally protects us from HPV, the virus is still responsible for a number of conditions, including the development of cervical cancer and 8 other cancers. That is why health agencies, like Quebec’s, have established extremely safe and effective, free vaccination programs starting at age 9 and up to 45 years of age, depending on a few criteria [9].

At the same time, it is recommended that women aged 25-65 have a cervical cancer screening test. There has been a real revolution in screening: cytology, also called a Pap test, is now being replaced with the HPV test, which should be performed every 5 years. An even more innovative development is that women will soon be able to take the sample themselves at home, without a gynecological exam. NB: if there is a positive, high-risk HPV result with a self-collected test, a gynecological exam will be necessary.

Because there are no screening tests for the other HPV-related cancers, early recognition of the signs or symptoms of those cancers is important [10].

Moreover, it is essential to follow the other public health recommendations for a healthy diet, smoking cessation and stress management.

In short, HPV vaccination and screening are two powerful tools for eradicating cervical cancer and preventing most HPV-related cancers, through early immunization or screening when changes in immunity are anticipated or with a new sexual partner.

Choose simplicity with cervical cancer screening at Biron. Our staff can issue your medical prescription on-site and provide you with fast, confidential service all in a single appointment

• HPV testing with cytology triage

Book an appointment online or contact Biron Health Group Customer Service at 1 833 590-2712.