
Course aimed at health professionals specialized in Gynecology
COORDINATOR:
Dr. Javier Cortés
Former president of the Spanish Association of Colposcopy and Cervical Pathology
AUTHORS:
Dr. Damian Dexeus. Women’s Health Institute
Dr. Andrés Carlos López. Hospital Quirón Salud Málaga
Dra. María Kyrgiou. Imperial Collge London
Dr. Luis Serrano. Polinclínico HM Gabinete Velázquez
INTRODUCTION:
Since Harald Zur Hausen identified the human papillomavirus (HPV) and some time later a multidisciplinary and international group clarified its necessary causal relationship with cervical cancer, the evidence for the oncogenic power of HPV has continued to grow.
HPV is etiologically necessary for all squamous and glandular cervical cancers, for nine out of ten anal cancers, for four out of ten vulvar cancers, for seven out of ten vaginal cancers and for three out of ten oropharyngeal cancers. This burden makes HPV the second leading cause of cancer identified – after tobacco – and therefore preventable.
Consequently, it is essential to provide the physician with the knowledge and skills necessary to manage HPV-dependent pathology. The main objective of this course is to do so in a comfortable, interactive and quality manner.
1. NATURAL HISTORY OF HPV
Dr. Serrano & Dr. López Díaz
1.1 EPIDEMIOLOGY
1.2 TRANSMISSION
1.3 INFECTION
1.4 CONCLUSIONS
2. THE ROLE OF THE MICROBIOME AND IMMUNITY IN HPV
Dra. Kyrgiou
2.1 HPV AND CERVICAL CARCINOGENESIS
2.2 THE HUMAN MICROBIOME
2.3 THE VAGINAL MICROBIOTA
2.4 FACTORS INFLUENCING THE COMPOSITION OF THE VAGINAL MICROBIOTA
2.5 THE VAGINAL MICROBIOTA AND ITS RELATIONSHIP TO HPV, CIN AND CERVICAL CANCER
2.6 POSSIBLE MECHANISMS WITH EFFECTS ON CERVICAL HEALTH AND PATHOLOGIES MEDIATED BY THE VM
2.7 PROBIOTICS, PREBIOTICS AND VPH
2.8 FUTURE STUDIES
2.9 CONCLUSIONS
3. PRIMARY PREVENTION OF HPV: VACCINES
Dr. Cortés & Dr. Dexeus
3.1 CERVARIX
3.2 GARDASIL 9®.
3.3 ADDITIONAL INFORMATION
3.4 STATUS OF VACCINATION AGAINST HPV IN SPAIN
3.5 CONCLUSIONS. THE FUTURE OF VACCINATION AGAINST HPV
4. DIAGNOSIS OF HPV
Dr. Dexeus & Dr. Cortés
4.1. DETERMINATION OF HPV DNA/MRNA
4.2. COMPLEMENTARY METHODS
4.3. CONCLUSIONS
5. MANAGEMENT OF THE PRESENCE OF HPV AND THE LESIONS CAUSED BY IT
Dr. López Díaz & Dr. Serrano