María Silva/Agency Reforma
Monterrey, NL 22-Dec .- The existence of the vaccine against the human papillomavirus (HPV) is no longer a novelty in the population and prevention campaigns between 9 and 45 years old has been exhaustive.
however, the men , who also suffer and are virus transmitters, do not have a scheme of vaccination and littleHe knows about his prevention, although in the health sector specifies the same age range as female sex for his application.
"" It is still not contemplated as a health strategy for male sex for the cost it represents, both in Mexico and in other countries, "says José Tusán, infectologist gynecologist. Since 2006, the cofepris approved for mexico the tetravalent vaccine called Gardasil, which is applied in both sexes, and the cervarix, which is only for women. < / p >.
The NOM (Official Mexican Standard) establishes that vaccination in Mexico is at least contemplated only for women of 9 years of age, and maximum 12, and approved schemes are that after the first dose, we have to wait two months To apply the next and six months the third and last.
For Cervarix, after the first vaccine, the second is the next month and the third and last at six months, coincide Tiran and Jorge Arratia make-up, urologist.
"So that a single female vaccination scheme can be justified in any country, it is required above 80 percent of vaccinated women, without this condition is considered necessary immunization in men; it is expected that soon there is a change for They ", explain Tiran.
In the United States, he adds the infectologist gynecologist, a high-risk men's oriented vaccination was performed, for example, men who have sex with men, and those populations were an important goal to prevent, or groups that are susceptible to another Type of factors, but there has been no open vaccination, as performed with women.
"Both sexes, preferably, the vaccine should be applied before initiating sexual intercourse, to avoid cancer and / or warts or condylomas caused by this virus in cervix or matrix neck, vulva, vagina, anus, penis and Orofainge ", point to sputter and arroy.
"When applying this tetravalent vaccine, four types of viruses are covered, from among the 100 that exist: 6, 11, 16 and 18," ARRATIA says.
"The biggest problem in men is when populations are divided," adds Tiran. "Heterosexuals are those who have the greatest problem of suffering type 16, and it is logical, because women also have a high rate of it, which is the main cause of cancer, compared to those who have sex with men, their greatest risk It's type 6 ".
Within four types, adds Arratia, 70 percent of cervical cancers and about 90 percent of genital warts or warts are covered, but the vaccine has a cross-reaction and also protects from other viruses that cause HPV.
The cervarix only covers types 16 and 18 of this virus in women from 10 to 55 years.
"Between 50 to 80 percent of the sexually active population suffers HPV, and of this percentage around 15 percent expresses it in the form of condilomas, and the rest does not manifest it," says Arratia. "There are a lot of men and women who never knew they suffered, because the immune system can eliminate it after 18 to 24 months in many cases."
In a less privileged scenario, some viruses are very resistant and after 10 years can be expressed as cervical cancer, in women, and anus and penis, in men, manifest the urologist.
"In the United States and Europe there is a well described pyramid on the incidence of head and neck cancer by HPV, which is also associated with more than 95 percent of cervical cancers; 50 percent, vulva and Vagina; 88 percent of anus cancers; 80, penis, 20 percent, laryngeals, and 90 skin of non-melanomatous origin.
"Here we prefer to establish advanced vaccination strategies, and we suggest that it is both women and men, because it is the only way to break the cycle of disease transmission. Therefore, the recommendation is to receive the vaccine before Start sexual life to get the greatest protection, but it is important to note that the vaccine is also useful already initiated sexual life, with a very high rate of effectiveness, so if a person wants to practice the true concept of safe sex, It recommends that it be protected against the human papillomavirus, "says Tiran.
How is it transmitted?
La única forma de transmisión del vph es a través de las relaciones sexuales, y aunque parezca que a los 9 años es aún muy temprano para que sucedan, está comprobado que en esa etapa el sistema inmunológico es más fuerte y si se cumplen las tres dosis requeridas, se logra la protección total contra este padecimiento, indica Arratia.
"The virus is infected by sexual contact in 97 percent of the cases and it is required to be friction in tissues so that it is transmitted; oral sex is by friction; penis-vagina and penis-anus as well. Genital area can contribute to the friction of sexual contact there is contagion, "he says Tiran.
The urologist clarifies that although condylomas increase the possibility of the transmission of human papilloma, its presence in genitals is not synonymous with cancer, or sometimes it is presented without any visible injury.
"The CDC (Centers for Disease Control and Prevention) launched some particular guidelines for the application of the vaccine in men, which is indicated for prevention of condomomas, anal intraepithelial neoplasia and year-old cancer," adds Arratia. "Fortunately, it is already clinical studies that support it, and it was demonstrated that they can also prevent oropharyngeal cancer, which appears by oral sex, penis and cervicuterine in women."
How is it detected in men?
Most of the time it happens when the woman goes to the gynecologist for the papanicolau or by injuries in the genital area and the doctor concerns the couple to the urologist.
"Many times in them the condylomas are not visible, but there are some tools to detect the virus. One of them is the Penoscopy in which a liquid with acetic acid is applied that causes the flat condylomas more whitish. This change is due to breaking the injuries, and an 80 percent sensitivity is achieved.
"There is another proof that is the most sensitive, the PCR, recommended for men and women. It is a brushing of the genital area, where cells are obtained, to study the viral DNA, and with this there is detected the Specific presence of the human papillomavirus or absence ", explains Arratia.
The form
In both sexes, the application of the vaccine is intramuscular and in Mexico is distributed both in the private and institutional medium, but changes the presentation, both specialists coincide.
Costs fluctuate around 2 thousand 500 to 4 thousand pesos in prellatened syringe.In the health sector it only applies in women.
|
