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Vol. 37. Issue 5.
Pages 287-358 (May 2019)
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Vol. 37. Issue 5.
Pages 287-358 (May 2019)
CONTINUING MEDICAL EDUCATION: SEXUALLY TRANSMITTED INFECTIONS
DOI: 10.1016/j.eimce.2019.01.003
Genital infections due to the human papillomavirus
Infecciones genitales por el virus del papiloma humano
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Elena Sendagorta-Cudósa, Joaquín Burgos-Cibriánb, Manuel Rodríguez-Iglesiasc,
Corresponding author
manuel.rodrigueziglesias@uca.es

Corresponding author.
a Servicio de Dermatología, Hospital Universitario La Paz, Madrid, Spain
b Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d’Hebron, Barcelona, Spain
c Servicio de Microbiología, Hospital Universitario Puerta del Mar, Cádiz, Spain
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Table 1. Classification of HPV genotypes by oncogenic risk and associated diseases, as per the proposal of the International Agency for Research on Cancer.
Table 2. Description of some HPV detection assays available on the market.
Table 3. Marketed HPV vaccines.
Table 4. HPV vaccine recommendations.
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Abstract

The Human Papillomavirus (HPV) is a double-stranded DNA virus, with more than 200 different genotypes having been identified. This infection is considered the most common sexually transmitted infection (STI), and it is the cause of a significant number of diseases, both benign lesions (anogenital condylomas) and pre-malignant lesions and different cancers. The diagnosis of the infection is performed by molecular techniques based on the detection of viral DNA, the mRNA of oncogenic proteins and cellular alteration caused by the infection. Although there is no consensus regarding the best treatment, this should be individualised, and there are different options with ablative treatments being more effective but with greater recurrences, and immunomodulatory treatments being less effective in the short term but with fewer recurrences. Among the preventive strategies, vaccination against HPV is the best strategy against anogenital neoplasms and warts, its maximum effectiveness being when it is administered prior to exposure to HPV.

Keywords:
Papillomavirus
Condyloma
Vaccines
Resumen

El virus del papiloma humano (VPH) es un virus ADN bicatenario, habiéndose identificado más de 200 genotipos. Su infección es considerada la infección de transmisión sexual (ITS) más frecuente, siendo causa de gran cantidad de enfermedad, tanto lesiones benignas (condilomas anogenitales) como lesiones premalignas y diferentes cánceres. El diagnóstico de la infección se realiza por técnicas moleculares basadas en la detección del ADN vírico, el ARNm de las proteínas oncogénicas y la alteración celular provocada por la infección. Aunque no existe un consenso respecto al mejor tratamiento, debiendo este individualizarse, hay diferentes opciones, siendo los tratamientos ablativos más eficaces, pero con recidivas, y los tratamientos inmunomoduladores menos eficaces a corto plazo, pero con menos recidivas. Entre las estrategias preventivas, la vacunación contra el VPH constituye la mejor frente a las neoplasias y verrugas anogenitales, siendo su eficacia máxima cuando se administra antes de la exposición al VPH.

Palabras clave:
Papilomavirus
Condiloma
Vacunas

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