FATİH ŞAHİNER, Kenan ŞENER

Human Papilloma Virüs Enfeksiyonları, Risk Faktörleri ve Koruyucu Önlemler

Human papilloma virüsler (HPV) insanlarda siğil ve papillomlar gibi düşük malignite potansiyeli olan benign hiperplaziler başta olmak üzere çeşitli epitelyal lezyonlara neden olurlar. HPV'lerin kanseröz lezyonlarla ilişkili olduğu gösterilen bir alt grubu "yüksek-riskli" HPV'ler olarak adlandırılmaktadır. Yüksek riskli HPV'ler ile enfekte insanların küçük bir grubunda, enfeksiyonun başlangıcından genellikle 10-20 yıl sonra olmak üzere, başta servikal kanser olmak üzere çeşitli kanserler ortaya çıkmaktadır. Servikal kanser ülkemizde kadınlarda görülen kanserler arasında ilk on kanser içinde yer almaktadır. Dünya genelinde ise kadınlar arasında görülme sıklığı ve kansere bağlı ölüm nedenleri arasında ikinci sırada yer almaktadır. Yüksek-riskli HPV enfeksiyonlarında kanseröz dönüşüm uzun süren bir latentlik dönemini takiben meydana geldiği için servikal kanserler tarama programları ile erken evrelerde saptanabilmektedir. Gelişmiş ülkelerde tarama programları ve koruyucu önlemlerle servikal kanser insidansı ve servikal kansere bağlı ölüm oranları önemli ölçüde gerilemiştir. Bu makalede HPV enfeksiyonlarının patogenezi, epidemiyolojisi, bulaşma yolları ve risk faktörlerine kısaca değinildikten sonra, söz konusu enfeksiyonların ve ilişkili lezyonların önlenmesine yönelik tarama ve aşılama programları ve diğer koruyucu yaklaşımların güncel bir değerlendirmesi sunulmuştur.

[Human Papillomavirus Infections, Risk Factors, and Preventive Measures]

Human papillomaviruses (HPVs) cause of many epithelial lesions especially benign hyperplasia with low malignant potential such as warts and papillomas in humans. A sub-group of HPVs, which associated with cancerous lesions, has been called as "high-risk" HPV. Mainly cervical cancer and other various types of cancer arise a small percentage of persons infected with high-risk HPV, usually 10-20 years later onset of infection. Cervical cancer is one of the ten most common cancer types among women in our country and it is the second most frequently occurring cancer and second most common cause of death from cancer worldwide among women. Cervical cancers are detected in the early stages by screening programs owing to malignant transformation occurs after a long latency period in high-risk HPV infections. Screening programs and preventive strategies have significantly decreased the incidence of cervical cancer and cervical cancer mortality rates in developed countries. Pathogenesis, epidemiology, transmission routes and risk factors of HPV infections have been explained briefly in this paper. In addition, the article presents a current overview of screening and vaccination programs and other strategies for the prevention of HPV infection and associated lesions.

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