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- From: jsmith@unixg.ubc.ca (JR Smith)
- Newsgroups: sci.med
- Subject: Re: Cervical Dysplasia Questions
- Date: 25 Jan 93 04:59:39 GMT
- Organization: The University of British Columbia
- Lines: 77
- Message-ID: <jsmith.727937979@unixg.ubc.ca>
- References: <1993Jan22.193603.10478@ac.dal.ca> <1993Jan25.031443.28306@cs.rochester.edu>
- NNTP-Posting-Host: unixg.ubc.ca
-
- In <1993Jan25.031443.28306@cs.rochester.edu> fulk@cs.rochester.edu (Mark Fulk) writes:
-
- >In article <1993Jan22.193603.10478@ac.dal.ca> guruman@ac.dal.ca writes:
- >>I have a few questions about cervical dysplasia, any help would be appreciated.
-
- >I went through an experience with this with my SO several years ago;
- >take the following cum grano salis.
-
- >>1) Cervical dysplasia is a a)bacteria, b)virus c) a state of cells.
-
- >c) a state of cells. A pathologist makes the determination based on the
- >appearance of cervical epithelial cells under the microscope; the cells
- >come in the Pap smear.
-
- >>2) CD is a communicable disease ?
- >>
- >>3) Venereal Warts are a majour cause of CD ?
- >> if yes, must HPV be present in infected person, or is exposure to HPV
- >> enough?
- >>4) Cervical Dysplasia can be carried by men. ??
-
- >It is believed that human papilloma virus, which causes warts, is responsible
- >for most or all cases of CD. Virgin women never, or at least almost never,
- >get CD. Women whose (male) partners have genital warts get CD more often.
- >I don't believe that exclusively homosexual women get CD very often, so it
- >probably depends on the introduction of HPV into the vagina.
-
- >>5) It is totally treatable, and any re-occurrence is a new infection. ??
-
-
- >It is impossible to tell a new occurrence from a relapse, but generally,
- >this is thought to be true, at least if the CD is caught early enough.
-
- >>6) If antibiotics are used to treat CD, then mustn't it be a bacteria?
-
- >I'm not aware of antibiotics being used to treat CD. On the other hand,
- >I can imagine using antibiotics prophylactically if a surgical treatment
- >was fairly extensive (a "conization", say).
-
- HPV has been implicated as a possible cause of cervical cancer and is
- associated with upwards of 90% of cases of cervical dysplasia which is the
- cancer precursor looked for by Pap smears. HPV DNA is commonly found in
- the nuclei of these dysplastic or cancerous cells. There are at least 50
- subtypes of HPV and they are somewhat site specific. Types 6 and 11 cause
- genital warts and are often associated with mild dysplasia while types 16,
- 18, 31, 33 and 35 are likely to be found in moderate or sever dysplasia or
- cervical cancer itself. Other types of HPV cause common skin warts and other
- lesions. HPV subtypes associated with cervical dysplasia have also been
- implicated in vulvar, penile and perianal dysplasias and cancers. The
- evidence of a link is strong but be cautioned that 15 years or so ago HSV
- was implicated in a somewhat similar fashion.
-
- HPV is certainly common and the CDC suggests even more common than HSV.
- Transmission is primarily but not exclusively through sexual contact.
- Males certainly can be carriers of the virus without obvious evidence of
- carriage.
-
- Antibiotics are not used in the treatment of HPV infection. Flagyl is an
- antibiotic used against anaerobic bacteria. Diagnosis of cervical dysplasia
- and HPV infection can be made with Pap smears along with biopsys best directed
- by an instrument known as a colposcope. Treatments include chemical agents
- applied directly such as podophyllin or trichloroacetic acid, cryotherapy,
- laser therapy, local excision, conization all the way to hysterectomy.
- Relapse is not uncommon and follow-up is mandatory. It is very difficult to
- eliminate this virus and reinfection is also possible.
-
- Paps are essential for detection and early treatment but remember that an
- ounce of prevention... If celibacy isn't an option then we're back to you
- know what. CONDOMS!! These won't absolutely eliminate the risk obviously
- but they're a step in the right direction.
-
- As for counselling/treating partners who aren't. Some areas have mandatory
- reporting and partner tracing for some STD's but HPV commonly does not make
- these lists.
- JR
-
-
-