HPV: preguntas que no molestan Salud

Cuatro de cada cinco personas puede llegar a tener alguno de los cien tipos del Virus de Papiloma Humano (HPV) que existen. Por eso, es necesario hablar del tema. Para empezar hay que saber que es una enfermedad que se transmite por contacto sexual y se contagia fácilmente. Existen dos grandes grupos de virus: los de bajo riesgo oncogénico, que se asocian a las verrugas genitales; y los de alto riesgo, que también se producen por verrugas y que pueden derivar en un tumor. Más datos: según la Organización Mundial de la Salud, casi todos los casos de cáncer de cuello uterino pueden atribuirse a una infección por HPV. La buena noticia es que se puede prevenir si se detecta de manera temprana y se tratan las lesiones. Por eso, es fundamental tener claro cómo evitar el contagio. Estas son las respuestas a las preguntas que tal vez siempre nos hicimos.

1. ¿Puedo tener HPV y nunca saberlo?

Sí. La gran mayoría de las veces la infección se cura de manera espontánea sobre todo en las mujeres menores de 25 años, sin producir ningún síntoma ni manifestación en el cuerpo.

2. ¿Cómo se detecta?

Puede diagnosticarse con la aparición de verrugas en el área genital, aunque también suelen localizarse en la zona anal o incluso en la cavidad oral. Por lo general, se detectan en la vagina o en el cuello uterino durante el examen ginecológico, ya sea mediante el Papanicolaou o con el uso de pruebas moleculares específicas.

3. ¿Se puede contraer en cualquier momento?

Sí. El riesgo de infectarse está presente durante toda la vida sexual activa de la mujer. Es importante tener en cuenta que a mayor número de parejas sexuales, existen más posibilidades de contagio.

4. Si tuve una relación sexual sin penetración, ¿me puedo contagiar?

Sí. No es necesario que el pene ingrese a la vagina para que se produzca la transmisión. El contacto directo con la piel de la zona genital basta para contagiarse.

5. ¿Si uso preservativo, lo puedo contraer igual?

Sí. Si bien el uso de profilácticos disminuye el riesgo de contagio en una relación sexual, no es ciento por ciento efectivo porque el virus se encuentra en toda la piel ano-genital no cubierta por el condón. De todas formas, se indica su uso aún en una pareja estable hasta que la infección desaparezca.

6.En caso de embarazo, ¿puedo contagiar al bebé?

La transmisión vertical, es decir de madre a hijo, puede producirse especialmente en el momento del nacimiento durante el parto vaginal en aquellas pacientes que presentan lesiones importantes por HPV. En esos casos, se aconseja la cesárea como forma de prevenir el contagio.

7.Si se practica sexo oral, ¿también se corre riesgo de contagio?

Sí. Por eso es importantísima la utilización de métodos de barrera en cualquier modalidad de relación sexual.

Se calcula que la poblacion sexualmente activa por debajo de los 30 años ha tenido contacto con el virus en el 80% de los casos. El cancer de cuello uterino genera 3 mil nuevos casos por año y causa la muerte de mas de 2 mil mujeres anualmente.

8. Si tenía verrugas genitales y luego desaparecieron, ¿puedo volver a tenerlas?

Sí, porque se pueden tratar y volver a aparecer si el sistema inmunológico del cuerpo no ha eliminado totalmente el virus. De hecho, pueden permanecer en la piel sana, desde donde puede producir, aún muchos años después, nuevas lesiones y continuar contagiando.

9.¿Tener verrugas significa que voy a tener cáncer?

No. Se estima que sólo el 5 por ciento de las infecciones por HPV se tornan persistentes. Sólo si la infección continúa por muchos años (de 5 a 10), el virus puede considerarse de alto riesgo oncogénico y puede causar lesiones en el cuello del útero que pueden evolucionar al cáncer.

10. ¿Sólo afecta a las mujeres?

No. El HPV también se manifiesta en hombres. En ellos puede provocar verrugas genitales, cáncer de ano, orofaríngeo (cavidad nasal, glándulas salivales, amígdalas, lengua y boca) y raramente de pene. Tanto varones como mujeres pueden transmitir este virus, aunque no tengan ninguna lesión visible.

11.¿Qué vacunas existen?

Hay dos. Una que previene la infección por los dos tipos de HPV que causan la mayoría de los casos de cáncer de cuello uterino. La otra, además, previene los tipos de virus que causan verrugas genitales. No se aplican las dos. Se debe optar por una.

12.¿Para qué sirven las vacunas?

Ambas son muy eficaces, ya que son la mejor estrategia para evitar el cáncer de cuello uterino. Lo ideal es aplicarlas en mujeres que no se hayan contagiado anteriormente. Por eso es importante vacunar a las niñas antes del inicio de las relaciones sexuales, o lo más tempranamente posible si ya han tenido algún tipo de infección.

13.¿Me puedo dar la vacuna si ya tuve HPV?

Sí, ya que servirá como protección contra los tipos de virus con los que los pacientes no se hayan infectado hasta ese momento.

14.¿Se la pueden aplicar los hombres?

Sí. Es aconsejable también en varones ya que varios estudios han demostrado que protege contra lesiones precancerosas, contra el desarrollo de cáncer anal y la formación de verrugas genitales.

15.¿Se puede curar el HPV?

No. En la actualidad, no existe ningún tratamiento que cure el virus. Se pueden tratar las manifestaciones que provocan, como las verrugas o las lesiones.

UN PROBLEMA MUY FRECUENTE

Las verrugas genitales son formaciones de tamaño variable, de color blanco, rosado o grisáceo, que se encuentran en la zona de la vulva, el ano y la región perianal. Son consideradas como una de las infecciones de transmisión sexual más frecuentes. Se estima que por año se producen 30.000.000 de casos nuevos y se calcula que una de cada veinte personas tendrá verrugas genitales en algún momento de su vida.

A veces pueden producir picazón, ardor y muy raramente, olor. En personas con bajas defensas, las verrugas pueden crecer mucho, también infectarse y producir dolor y hedor muy desagradable, que puede ser percibido a distancia.

Suelen tratarse con tópicos, aunque, cuando son muchas o de gran tamaño, es preciso extraerlas con cirugía convencional, láser, radiofrecuencia o criocirugía.

Asesoraron: Dr. Daniel Stamboulian, pres. de FUNCEI; Dr. Diego Häbich, del Hospital Aleman; Dr. Mariano Luis Toziano, de la Fundacion Favaloro; Dr. Pablo Bonvehi, del CEMIC; Dra. Juana elida Mauro, del Hospital Durand; OMS, Ministerio de Salud de la Nacion..

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