VIRUS HPV NGUYÊN NHÂN HÀNG ĐẦU GÂY LOẠN SẢN CỔ TỬ CUNG

DANH MỤC CHIA SẼ
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hpv

I. Virus HPV

  Virus HPV phổ biến lây truyền qua đường tình dục và có 200 chủng virus HPV liên quan chặt chẽ với nhau.

  Virus HPV lây truyền qua đường tình dục có hai loại khác nhau:

 • Các chủng virus HPV nguy cơ thấp gây ra mụn cóc sinh dục trên dương vật hay âm đạo.

 • Các chủng virus HPV nguy cơ cao gây ung thư ở cả nam và nữ.

Virus HPV liên quan đến các bệnh ung thư: hậu môn, cổ họng, cổ tử cung, dương vật, âm đạo.

Mặc dù hầu hết trường hợp nhiễm HPV đều có thể tự khỏi và các tổn thương tiền ung thư cũng có thể tự khỏi, nhưng vẫn có nguy cơ đối với phụ nữ nhiễm HPV gây tổn thương mãn tính và tiền ung thư sẽ xâm lấn và phát triển thành ung thư cổ tử cung. Ở phụ nữ có hệ miễn dịch bình thường thì mất khoảng 15-20 năm để ung thư cổ tử cung phát triển. Nhưng ở những phụ nữ có hệ miễn dịch kém chẳng hạn như những người nhiễm HIV thì chỉ mất 5-10 năm phát triển ung thư cổ tử cung.

II. Virus gây u nhú ở người là gì?

  Virus gây u nhú ở người (human papillomavirus – HPV) là một loại DNA virus không có vỏ thuộc họ Papillomaviridae. Virus HPV có hơn 200 loại khác nhau, nhưng phần lớn là vô hại. Trong số 200 loại này có khoảng 40 loại tác động lên cơ quan sinh dục.

  Virus HPV lan truyền rất mạnh qua tiếp xúc trực tiếp (tiếp xúc da – da). Các loại virus gây u nhú ở người được phân thành loại nguy cơ thấp và loại nguy cơ cao, dựa vào khả năng phát triển ung thư của chúng. Đa số các loại virus HPV thuộc nguy cơ thấp, chỉ có khoảng 12 loại thuộc nguy cơ cao. Trong 12 loại này, virus HPV type 16 và HPV type 18 thuộc loại nguy cơ cao nhất, là nguyên nhân của khoảng 70% tổng số ca ung thư cổ tử cung.

  Hầu như bất kỳ ai trong độ tuổi sinh hoạt tình dục đều nhiễm virus gây u nhú ở người ít nhất một lần trong đời, và một nửa số trường hợp là virus nguy cơ cao. Khi nhiễm virus HPV, hệ miễn dịch của cơ thể sẽ hoạt động để chống lại sự lây nhiễm, và đa số trường hợp sẽ đào thải virus trong vòng hai năm. Những người không thể đào thải sẽ mang virus gây u nhú ở người mạn tính.

hpv1

III.Nguyên nhân nào dẫn tới loạn sản cổ tử cung

  Loạn sản cổ tử cung là một tình trạng tiền ung thư xảy ra khi xuất hiện các tế bào bất thường phát triển tại niêm mạc của cổ tử cung hoặc ống cổ tử cung. Loạn sản cổ tử cung có nguy cơ tiến triển thành ung thư cổ tử cung?

  Các tế bào cổ tử cung có thể bị biến đổi theo thời gian, do đó loạn sản cổ tử cung có thể xuất hiện ở bất kỳ lứa tuổi nào, và có rất nhiều yếu tố nguy cơ có thể dẫn tới loạn sảncổ tử cung, bao gồm:

Nhiễm virus gây u nhú ở người (human papillomavirus – HPV).

• Bắt đầu quan hệ tình dục quá sớm; sinh nở trước tuổi 16.

• Quan hệ tình dục với nhiều người, hoặc quan hệ tình dục với người có quan hệ tình dục với nhiều người; quan hệ tình dục không an toàn.

• Mắc bệnh lí gây suy giảm miễn dịch hoặc sử dụng các thuốc gây ức chế miễn dịch.

• Hút thuốc lá.

  Trong các yếu tố nêu trên, nhiễm virus gây u nhú ở người – virus HPV là nguyên nhân chính gây ra loạn sản cổ tử cung. Cần lưu ý rằng sự tồn tại của loạn sản cổ tử cung và/hoặc nhiễm virus HPV không có nghĩa rằng đã bị ung thư cổ tử cung, bởi loạn sản cổ tử cung là một tình trạng tiền ung thư (có thể diễn tiến thành ung thư sau này), và nhiễm virus HPV là nguyên nhân hàng đầu gây loạn sản cổ tử cung cũng như làm tăng nguy cơ xuất hiện ung thư cổ tử cung.

IV. Làm thế nào để phòng tránh loạn sản cổ tử cung?

  Phụ nữ có thể làm giảm tối đa nguy cơ mắc loạn sản cổ tử cung bằng cách tránh những hoạt động tình dục có nguy cơ cao lây nhiễm virus HPV và sử dụng vắc – xin ngừa HPV. Các phương pháp phòng tránh khác có thể áp dụng là không hút thuốc lá (hoặc bỏ hút thuốc lá) và thực hiện theo khuyến cáo của Hiệp hội Ung thư Hoa Kỳ về tầm soát để phát hiện sớm ung thư cổ tử cung, trong đó bao gồm nội dung phụ nữ từ 21 tuổi trở lên nên bắt đầu xét nghiệm tế bào cổ tử cung tầm soát ung thư cổ tử cung.

  Để tránh những hoạt động tình dục có nguy cơ cao lây nhiễm virus HPV, phụ nữ nên chú ý:

• Không nên bắt đầu quan hệ tình dục quá sớm.

• Không nên quan hệ với nhiều người.

• Quan hệ chung thủy với một bạn tình không bị nhiễm virus gây u nhú ở người.

• Quan hệ tình dục an toàn: Lưu ý rằng sử dụng bao cao su khi quan hệ tình dục không ngăn chặn hoàn toàn được việc lây nhiễm virus HPV, bởi đường lây truyền là qua tiếp xúc trực tiếp da – da, nhưng sử dụng bao cao su vẫn mang lại hiệu quả giảm tới 70% nguy cơ lây nhiễm virus HPV.

  Quan hệ tình dục an toàn tránh mắc loạn sản cổ tử cung

  Phương pháp phòng ngừa virus HPV hiệu quả nhất là sử dụng vắc – xin. Theo khuyến cáo của Trung tâm Kiểm soát và Phòng ngừa dịch bệnh (Centers for Disease Control and Prevention – CDC) Hoa Kỳ và Cao đẳng Sản phụ khoa Hoa Kỳ (American College of Obstetricians and Gynecologists), trẻ em nam và nữ nên được sử dụng vắc – xin ngừa virus HPV ở độ tuổi giữa 11 và 12 tuổi, đồng thời những người trong độ tuổi từ 13 tới 26 tuổi cũng nên được sử dụng vắc – xin nếu trước đó chưa từng được sử dụng.

  Với phụ nữ có hoạt động tình dục nên được kiểm các các tế bào cổ tử cung bất thường và các tổn thương tiền ung thư bắt đầu từ 30 tuổi.

  Nếu cần điều trị tiền ung thư để cắt bỏ các tế bào hoặc tổn thương bất thường, nên áp dụng liệu pháp đông lạnh (phá huỷ các mô bất thường trên cổ tử cung bằng cách đóng băng).

Nếu có dấu hiệu ung thư cổ tử cung thì các lựa chọn điều trị bao gồm phẫu thuật, xạ trị và hoá trị.

hpv2

Tiêm phòng vắc-xin HPV giảm nguy cơ ung thư cổ tử cung

V. Vai trò của vắc-xin trong dự phòng HPV

  Virus HPV chủ yếu lây truyền qua đường tình dục do da tiếp xúc trực tiếp với da, niêm mạc miệng, hầu họng hoặc tiếp xúc với dương vật, tử cung, âm đạo, hậu môn của người bị nhiễm bệnh. Hôn hay chạm vào bộ phận sinh dục của đối tác bằng miệng sẽ có nguy cơ cao bị lây truyền virus HPV. Tiêm vắc xin phòng HPV là vắc-xin giúp phòng bệnh sùi mào gà và các bệnh như ung thư cổ tử cung, u nhú bộ phận sinh dục do Human Papillomavirus (HPV) gây ra.

Bs. ĐỖ THỊ TÚ VÂN

Nguồn tham khảo: webmd.com, who.int.
familydoctor.org; webmd.com; mayoclinic.org

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