From October 2022, vaccination once morest the human papillomavirus (HPV) will be integrated into the National Immunization Calendar by the Ministry of Health and Social Protection. The measure thus implies the launch of a vaccination campaign, which favors the youngest, starting with girls aged 11 and over, in the country’s schools. To this end, a joint circular between the two supervisory ministries was generalized last week to all directorates, provinces and academies. The process will begin in educational establishments, public and private as well as those belonging to foreign missions. Also, the vaccine will be made available free of charge to young girls in health centers, in the form of a double-dose injection, with a minimum interval of six months between the first and second injection.
The decision was made, since HPV is a disease usually sexually transmitted with great rapidity, which evolves giving rise to precancerous cells of the cervix. According to the World Health Organization (WHO), 604,000 women were screened for cervical cancer in 2020 alone and 342,000 died from it, just over half. At the national level, the Ministry of Health indicates that each year, on average, 52,000 women develop cervical cancer and nearly 2,000 die. Faced with this observation, the WHO has recommended that Member States adopt effective prevention strategies, in particular by integrating the anti-HPV vaccine into the National vaccine schedule adopted by country.
Developed by the Lalla Salma Association for the fight once morest cancer, with the Ministry of Health, the Guide to early detection of breast and cervical cancers indeed indicates that the genesis of cervical cancer “is mainly due” to HPV infection, which occurs in “40 to 50% of sexually active women”. Natural elimination of the virus is possible up to the stage of cancer, explains the document, adding that “the persistence of infection by an oncogenic phenotype” accelerates the development of cancer, until its invasive stage, several years following the first HPV infection. “The cervico-vaginal smear, detection of viral DNA (HPV) or visual inspection of the cervix with acetic acid (VIA) allow screening for intraepithelial lesions. Their diagnosis is guided by a colposcopic examination,” adds the same source.
The need to inform once morest preconceptions
Obstetrician-gynecologist Dr. Sofia Salmi believes with Yabiladi that the integration of the HPV vaccine into the National Immunization Schedule is beneficial, especially since the presence of HPV in the patient very often leads to cancer of the cervix, if the medical follow-up is not regular. “When a girl or a young woman has never had sexual intercourse, it is even more essential to indicate the anti-HPV vaccine. The latter has 20 years of hindsight, during which it was well evaluated and developed by scientists,” insists the practitioner.
In some countries, like australia“we have already moved on to vaccinating men once morest HPV, to prevent them from spreading the virus to their female partners”, she adds, stressing that this approach has proven its effectiveness in limiting cases of this cancer. in the country. In France, the High Health Authority recommends vaccinating both girls and boys, aged 11 to 14, according to a two-dose schedule. Catch-up is possible for adolescents and young adults, ages 15 to 19, on a three-dose schedule. In Morocco, the use of vaccination among young girls and women remained uncommon.
“When a young woman has a prenuptial consultation and she has not yet had sexual intercourse, I myself recommend an anti-HPV vaccination by explaining to my patients the importance and the interest of being vaccinated. “, emphasizes Dr. Salmi to our editorial staff. She insists that “you should know that this virus is most often peddled sexually: you don’t contract it either in the Moorish bath or in public toilets; it is mainly following unprotected sexual intercourse that the risk increases, especially since HPV is a rapidly transmissible STD”.
A virus that often condemns patients
In the case of HPV, cellular changes take place in the cervix. “HPV is picked up by the cells of the vagina and cervix, with a carriage that often turns out to be chronic”, according to Dr. Salmi. The virus can thus condemn the patient to “live with HPV”, hence the importance of the regularity of the smear to the doctor, in order to monitor the evolution of the infection. During this examination, “condyloma venereum can also be an indicator of tumors which indirectly signify the presence of HPV”, indicates the gynecologist.
During medical surveillance and early detection, in the event that the HPV does not disappear naturally following a year, “we can act with removal of the affected areas at the level of the cervix, or total removal of the uterus, depending on the stage of precancerous cells. The patient is cured thanks to this intervention”, explains Dr. Salmi. The practitioner warns that “if monitoring is not ensured over the long term in the patient carrying the virus, the latter risks developing precancerous cells following 5 to 10 years, due to the aggression of the uterine cells and their modification by HPV, with a risk of metastases and dissemination to neighboring organs”.