Virus expert HPV reveals: Two "magic weapons" made me "unemployed"

Author: Zhao Qun, deputy chief physician of the Third Xiangya Hospital of Central South University

Reviewer: Xue Min, Professor of the Third Xiangya Hospital of Central South University

Hi! I am HPV, the Chinese name is human papillomavirus, known as the "culprit" of cervical cancer. I used to be unknown, but now I am a real "big shot" in the virus world. My virus friends envy me so much. However, they don't have my advantages, so don't try to copy my path to fame.

What? You don't believe it? Let me tell you.

First of all, I have a large family to back me up. My family has more than 100 members, 14 of whom are at high risk of cervical cancer. Type 16 and type 18 are even more powerful, and more than 70% of cervical cancers may be related to them [1-2].

Figure 1 Copyright image, no permission to reprint

Secondly, I work diligently and am very good at “scheming”. According to statistics[3], about 80% of women have been infected by me. Hahaha, am I super awesome! And I have super strong willpower. Once I get caught, even if you have strong immunity, it will take at least a year and a half to drive me out of your body; if you have poor immunity, hehehe, then I will “stay” in your body. Although it will take more than ten years or even longer, I will never give up until cervical cancer comes.

Figure 2 Copyright image, no permission to reprint

By the way, let me tell you in secret, who are my favorite people?

The first category is people who have high-risk sexual behaviors, such as having many sexual partners, having sex with the same sex, having sex with sex workers, etc.

The second category is people who like to have unclean sexual lives, such as not cleaning their reproductive organs in time, having sex during menstruation, anal sex, etc.

The third category is people with low immunity. For these people, I can easily set up camp in their bodies, and that life is so comfortable.

However, I now find that infection prevention is becoming increasingly difficult, because many people have received the HPV vaccine, which is the "magic sword" that our HPV family fears the most. This vaccine can stimulate the human immune system in advance and build a solid defense line that is difficult for us to break through.

Figure 3 Copyright image, no permission to reprint

1. The bivalent HPV vaccine is specifically designed to target the two most lethal “big guys” in our family – HPV16 and HPV18.

2. The quadrivalent HPV vaccine, in addition to the bivalent vaccine, can also protect against HPV6 and HPV11, which are the most effective in causing genital warts in our family. Moreover, the quadrivalent vaccine is also very suitable for men.

3. The most terrifying is the HPV 9-valent vaccine, which can deal with HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, covering almost all the strong members of our family.

Now women aged 9 and over can get the HPV vaccine. No matter how hard we try, it is always difficult to find a "breakthrough" for women who want to get the vaccine. A study of nearly 1.7 million Swedish women found that the HPV vaccine can reduce the incidence of cervical cancer by 53%. If the vaccination age is advanced to before the age of 17, the incidence of cervical cancer can be reduced by 88% [4]. This has a devastating impact on the work enthusiasm of the HPV family.

What's even more frightening is that there is a "magic sword" on one side to cut off our infection, and there is a "catcher" on the other side to destroy our "permanent" cause. This "catcher" is the liquid-based thin layer cytology test (TCT) + HPV combined screening, which is also called cervical cancer screening. Sometimes, we are discovered just after we enter; sometimes, we work hard and just do a little damage before being stopped by the doctor. We have to admit that for people who do regular cervical cancer screening, our cervical cancer cause is impossible to complete. Isn't it frustrating?

As a virus, I hate HPV vaccines and cervical cancer screening, but more and more people are getting vaccinated and undergoing regular screening. Therefore, we have to face the reality that we will soon be "outdated" or even completely unemployed. But now we will not give up. Humph! You in front of the screen, don't let us seize the opportunity to find you!

References

[1] Chinese Society of Eugenics, Colposcopy and Cervical Pathology, Chinese Medical Association, Gynecologic Oncology, Chinese Anti-Cancer Association, Gynecologic Oncology Committee, et al. Chinese Cervical Cancer Screening Guidelines (I)[J]. Chinese Journal of Clinical Obstetrics and Gynecology. 2023, 24(4): 437-442.

[2] Chinese Association of Preventive Medicine, Tumor Prevention and Control Committee, Chinese Medical Doctor Association, Colposcopy and Cervical Lesion Committee, Chinese Eugenics Association, Colposcopy and Cervical Pathology Committee, etc. Chinese Expert Consensus on Human Papillomavirus Nucleic Acid Testing for Cervical Cancer Screening (2022)[J]. Chinese Medical Journal, 2023, 103(16): 1184-1195.

[3] Chinese Society of Gynecologic Oncology, Chinese Society of Eugenics, Colposcopy and Cervical Pathology. Chinese expert consensus on the clinical application of human papillomavirus vaccine [J/CD]. Chinese Journal of Medical Frontiers (Electronic Edition), 2021, 13(2): 1-12.

[4] Lei J, Ploner A, Elfstrom KM, et al. HPV vaccination and the risk of invasive cervical cancer［J］． The New England Journal of Medicine,

2020, 383(14): 1340-1348．