Human papillomavirus

Human papillomavirus is the most common infection in the world.

According to researchers, more than 90% of people around the world are infected with one type or another of HPV.Currently, there are more than 70 varieties of human papillomavirus.

The virus affects the skin and mucous membranes: various warts, papillomas and condylomas form on them.The human papillomavirus lives in human blood and does not manifest itself until a certain time.But as soon as the immune system weakens, growths appear on the skin and/or mucous membranes.This explains the rather long incubation period: from several weeks to tens of years.

What is it?

The human papillomavirus (HPV) causes changes in tissue growth patterns.It causes various skin diseases and mucosal lesions.Modern medicine identifies more than a hundred types of viruses.

Papilloma is a benign tumor that grows on the surface of the skin and looks like a small nipple.The size of papillomas can be one to two cm.Places of occurrence: oral cavity, nose, pharynx, vocal cords;it can form in the bladder and other places.

Depending on the type of virus, the diseases also differ: warts are caused by human papillomaviruses types 2 and 4, flat warts are caused by viruses types 3 and 10, and genital warts are caused by types 6 and 11. Some types of viruses (16, 18, 31, 33, 35) cause cervical dysplasia or a favorable context for the development of cervical cancer.The human papillomavirus is transmitted by contact and in the household, remaining on the skin and mucous membranes.

Human papillomavirus is divided into two groups −high and low risk.The low-risk group includes virus types (mainly 6 and 11) that cause genital warts.The high-risk group includes types 16, 18, 31, 33, 35 of the virus, which cause cervical dysplasia and increase the risk of cervical cancer.

How can you get infected?

The source of infection is a sick person or a carrier of the virus, that is, HPV is transmitted only from person to person.

There are three known ways of transmitting this infection:

• contact and domicile (through touch);
• sexual (genital, anal, oral-genital);
• in childbirth from mother to child.

HPV affects the skin and mucous membranes: various warts, papillomas and condylomas form on them.

Risk factors

An interesting fact is that different types of HPV can manifest themselves in different ways, causing a person to develop benign or malignant tumors.Furthermore, human papilloma is a virus that can affect the skin and mucous membranes, or may not be detected until the infection carrier's immunity decreases.

According to world statistics, the probability of developing this disease increases several times in the following categories of citizens:

• pregnant women;
• patients who often suffer from various diseases;
• people with a non-traditional orientation;
• male or female representatives who have suffered from sexually transmitted diseases;
• excessively sexually active people;
• people with immune system disorders;
• sexual partners of people who carry HPV or have an active form of the disease;
• women suffering from various cervical diseases.

All representatives of these categories must undergo examinations to detect papillomatosis.It is also recommended to take the test for those people who are fans of free sexual relations, have many sexual partners or change them frequently.Even an unprotected act can cause infection, which is why experts advise following preventive measures for this disease.

Human papillomavirus: incubation period

Typically, when infected with human papillomavirus, the incubation period is long: from half a month to several years.Human papillomavirus infection is characterized by a latent (latent) course.A person can be infected with several types of papillomavirus at the same time.Under the influence of various factors, the virus is activated, its reproduction increases and the disease enters the phase of clinical manifestations.

In most cases (up to 90%), self-healing occurs within 6 to 12 months;in other cases, there is a long-term chronic relapsing course with possible malignancy of the process (depending on the type of virus).

HPV classification and symptoms

The clinical symptoms of human papillomavirus are quite variable - for some types they are practically absent and many are manifested by the growth of papillomas in different parts of the body.

There are several types of skin growths - they serve as the basis for the classification of HPV.

Simple papillomas

Its growth is caused by human papillomavirus type 2;the growths themselves are distinguished by roughness, the presence of a keratinized layer and a size of 1 mm or more.Often, such growths are not isolated, but represent a localized “blended” zone.Simple papillomas (also called vulgar) can be located on the palms of the hands and between the fingers;in children, they are detected in the knees.

Flat papillomas

Caused by human papillomavirus types 3 and 10, they are identical in color to the skin and, therefore, are less noticeable.But, in addition to the appearance of neoplasms, flat papillomas are characterized by itching, hyperemia (redness) of the skin and pain.

Plantar papillomas

At the beginning of their development, plantar papillomas look like a shiny, whitish spot.Then it “rises” slightly above the level of the skin surface.Multiple mosaic neoplasms may appear around the main papilloma.These neoplasms complicate the patient's life - he has difficulty walking and it is almost impossible to find comfortable shoes.

Filiform papillomas

This type of neoplasm in question is characteristic of women over 50 years of age;they first appear in the form of small lumps of a yellowish hue.Over time, these protrusions grow and turn into a cluster of numerous “threads”.

Condylomata acuminata

The appearance of the formations resembles cauliflower or a rooster's comb.Most often, condylomas are located on the foreskin, on the head of the penis, near the urethra, around the anus, on the labia minora, on the vaginal mucosa, on the cervix, in the corners of the mouth, at the mouth of the urethra.

Bowen's disease

It looks like a single formation exclusively in the upper layer of the epidermis (usually on the head).A 5 to 50 mm lesion looks like a growing stratum corneum of the skin, sometimes covered with crusts.Caused by HPV type 16. The formations are prone to degeneration into squamous cell carcinoma.

Formations in the oropharynx

Blooming papillomatosis in the oral cavity also looks like cauliflower: white plaques on the oral mucosa.It occurs in elderly people.Laryngeal papillomatosis can descend to the trachea, bronchi and lung tissue, and occurs in children and adults.Signs of laryngeal papillomatosis are dysphonia (speech disorder) and aphonia (inability to speak), hoarseness and difficulty breathing.When HPV infects the oropharynx, cancer can occur.

Human papillomavirus in men

Human papillomavirus infection in men can occur without any symptoms.It is also important to note that, in the main risk group, men who frequently change sexual partners have unprotected sex.

Pathological formations are located in the following places:

• on the head and shaft of the penis;
• on the skin of the scrotum;
• in the perineal region;
• on the mucous membrane.

A virus of this type in men can take the form of high oncogenicity.This leads to cancer of the genital organs.But, if treatment is started on time, the risk of oncogenic diseases is minimized.Warts caused by the HPV virus are removed surgically or with special chemical solutions.At the same time, antiviral medications are prescribed.Therefore, in the early stages of the development of this type of disease in men, it can be completely eliminated.

Human papillomavirus in women

As already mentioned, women between the ages of 20 and 45 are more susceptible to the virus.But here it is worth mentioning that the main risk group are those who frequently change sexual partners and have unprotected sex.

This type of infection in women is divided into the following groups:

• high oncogenicity;
• low oncogenicity;
• non-oncogenic type.

The most dangerous infection for women's health is a high type of oncogenic infection.It almost always leads to an oncological disease - a malignant tumor, cervical cancer.The risk of developing this pathology is 90%.The situation is further aggravated by the fact that in the early stages of development the disease does not present symptoms.Occasionally, small warts may appear on the palms of the hands and soles of the feet.

With a type of infection with high oncogenicity, condylomas are formed.These are wart-like formations, but with irregular edges.These formations can appear in the vagina, anus and perineum.Sometimes condylomas can take the form of fluid-filled blisters, which eventually burst and give off an unpleasant odor.

High-type HPV infection can also cause cancer of the vagina and vulva.In rarer clinical cases, nasopharyngeal cancer is possible.It is important to note that it is almost impossible to completely cure the highly oncogenic form of HPV.

The danger of human papillomavirus infection

The properties of the papillomatosis virus are such that it settles on the skin or mucous membrane of various organs: reproductive (male and female), esophagus, bronchi, oral cavity, rectum.It can also be located in the conjunctiva of the eyes.

Each strain of the virus has its “favorite” location.Thus, the most dangerous types 16 and 18, when ingested, are immediately “directed” to the genitals, and the low-oncogenic viruses 6 and 11 infect the vulva and perineum region, causing the development of genital warts there.These same strains can cause papillomatosis in a child's respiratory tract if they are born naturally to a mother with genital warts.

After infection, a disease with pronounced symptoms does not always develop.On the contrary, the disease often goes unnoticed and does not lead to serious consequences.

The most dangerous complications of human papillomavirus infection are:

1. Cervical cancer.It occurs in women as a result of infection with human papillomavirus type 16 or 18. It has been proven that this disease does not occur in the absence of the papillomavirus.And if previously there was talk of the development of cervical carcinoma due to erosion or ectropion, now this has been revised and denied;
2. Rectal carcinoma.Unlike the first disease, it can have other causes;
3. Throat cancer.It is also caused by virus type 16;
4. Lung cancer, which can occur when infected with types 16, 18, 11, 2, 6, 30;
5. Respiratory failure, which develops with the growth of malignant papillomas in the respiratory tract (larynx, trachea);
6. Contact bleeding from condylomas.If they are on the external genitalia, perineum or vagina, they are caused by sex.In other places (in the nose, mouth), bleeding can be caused by mechanical injuries with other objects.

Every year, according to official sources, just under half a million (470 thousand) new cases of cervical cancer caused by this virus are registered worldwide.233 thousand women die from this disease every year.This places this cancer in 2nd place in frequency among all oncological pathologies in gynecology (first place in breast cancer) and in 5th place among all causes of mortality in women.Most often, women under 40 die from cervical carcinoma.

HPV and pregnancy

The human papillomavirus does not affect reproductive function, that is, the virus does not prevent a woman from having a child.

If a human papillomavirus infection is detected during pregnancy:

• The first thing is to look for a good gynecologist and be observed by him until birth,
• the most important thing is what manifestations of infection a woman has, the doctor's tactics will depend on this,
• The virus has no effect on the fetus!
• warts and papillomas can be removed after childbirth,
• minimal medications (only when necessary) during pregnancy,
• during childbirth, the child can become infected when passing through the birth canal,
• if there are pronounced changes in the pregnant woman's cervix, she may be offered a cesarean section,
• in the absence of manifestations - natural childbirth.

In general, cesarean section for HPV infection is rarely performed.And subsequent manifestations of infection in children are also extremely rare or insignificant.

Diagnosis

In recent years, medicine has made significant progress in diagnosing PVI.This became possible thanks to the systematization of data on HPV and the diseases associated with it, the study of all existing routes of infection, the various mechanisms of pathogenesis of the infectious process and the state of the immune system, as well as possible morphological changes.

There are several ways to diagnose human papillomavirus infection, and in this case, experts adhere to generally accepted algorithms:

• Sexually active women and men should be tested for HPV.
• HIV-infected patients and those with symptoms of sexually transmitted diseases should also be screened.
• People who have proven risk factors for PVI.
• Patients with sharp papillomas in the oral cavity and anogenital region.
• Patients suffering from various pathologies of the cervix.
• Couples planning pregnancy.

Basic PVI diagnostic methods:

1. Visual inspection of injuries.
2. Using a magnifying glass and colposcope.
3. Cytological research methods.
4. Molecular biological techniques.
5. Histological (pathomorphological) examination.

All patients examined for the presence of PVI are simultaneously tested for syphilis, hepatitis and HIV, smears are taken for bacterioscopic examination of secretions from the urethra, vagina and cervix, and PCR and bacteriological examination are prescribed for the presence of urogenital infections.

As a rule, the detection of papillomavirus does not cause difficulties: the infection is detected during standard examinations by a gynecologist or dermatologist.If appropriate symptoms occur, a targeted biopsy is performed.In the case when the patient is diagnosed with flat condylomas located in the anogenital region, to prevent the development of malignant diseases, testing for human papillomavirus serotypes with an oncogenic marker is carried out.

How to treat human papillomavirus?

At the moment, no methods have been developed for the radical treatment of human papillomavirus infection in men or women.All existing schemes are aimed at inactivating the pathogen and strengthening antiviral immunity;Warts, condylomas and dysplasia are removed using minimally invasive methods.Surgical excision, conization and removal of the cervix are rarely practiced and mainly in cases of reasonable suspicion of oncological pathology.

Destructive methods: surgical excision, curettage, electrosurgery, cryodestruction, laser surgery.

• Surgical treatment is performed if malignancy is suspected.It is not used as often because when a wart is removed heavy bleeding can occur.During this manipulation, the excised wart is sent for biopsy and the wound is sutured.
• Curettage is the removal of a wart with a curette, that is, by curettage.Then, electrocoagulation is performed and a dry dressing is placed on the wound.
• Electrosurgery is used to remove small warts.But even in this case, relapses are possible.This method can also be used for large warts, but before starting they must be soaked or an electrode must be inserted into the thickness of the wart, so that the separation between the cells becomes less strong.
• Cryodestruction is carried out using liquid nitrogen.
• Laser surgery currently occupies a prominent position in surgical treatment, that is, in addition to destruction, hemostasis is carried out in parallel.In addition to the laser vaporizing the wart, it also has a direct toxic effect on HPV, therefore this treatment method comes first in the choice of treatment for cervical intraepithelial neoplasia, and is also dominant in the treatment of genital warts in pregnant women (even in the last stages of development).

Cytostatic drugs and chemicals with a cauterizing effect are also used.

Immunotherapy - this method of treatment is used only in combination with other methods, as it does not have any specific effect, but only activates components of the immune system.

Combination treatments include a combination of the above methods.

Top 10 myths about human papillomavirus

There are more than enough myths about HPV.We want to talk about the most common of them.So, what do people say about papillomaviruses:

1. There is no reliable data on whether HPV vaccination helps, so it is not necessary to get vaccinated.Answer: Yes, in fact, there are more than 100 papillomaviruses and there is really no data that the vaccine protects against all of them.However, vaccination will protect you from the most aggressive strains for 5 years.The vast majority of recipients did not experience any side effects from the vaccine, so in our opinion it is still better to be vaccinated.
2. If you have genital warts, it will cause cervical cancer.Answer: It is not known how many sleepless nights this myth caused.In fact, things are not so bleak.Both warts and cervical cancer are caused by the human papillomavirus.But with completely different strains.Therefore, problems with the genitals may have nothing to do with cancer.
3. It is more effective to have a swab test than to get the HPV vaccine.Answer: A smear test is a screening test to see if you have mutated precancerous cells in your cervix.And vaccination aims precisely to ensure the formation of antibodies in the body, protecting cells from mutation when the virus enters.Therefore, it is definitely better not to skimp on vaccination than to wait until the cells start to become malignant.
4. Older women do not need to be tested for HPV.Answer: One in four cases of cervical cancer and 41% of all cervical cancer deaths occur in women aged 65 and over.Regular screening is extremely important because HPV can reappear after years of silence.It is advisable to carry out the analysis every three years for women aged 21 to 29, and every 3-5 years between 30 and 65 years old.
5. If there are no condylomas, but the smear reveals viruses, then I have cervical cancer.”Answer: Don't jump to conclusions.Viruses can remain in the human body for a long time, but this does not mean a precancerous condition.The appearance of these viruses in tests indicates that their number has increased, and this occurs as a result of a decrease in the body's general immunity.Therefore, the main thing you should pay attention to based on the results of this analysis is the state of immunity, and it is best to carry out treatment aimed at maintaining it.
6. All papillomaviruses cause cancer.Answer: Many types of HPV do not cause problems.HPV infections usually go away on their own, without any intervention, within a few months of being acquired, and about 90% go away within 2 years.And only a small proportion of infections with certain types of HPV can persist and develop into cancer.
7. If you always use a condom, you won't catch papillomavirus.Answer: Condoms certainly reduce the likelihood of contracting HPV and sexually transmitted diseases.However, protected sex is not 100% guaranteed, as the papillomavirus is transmitted through any contact with mucous membranes.HPV can also be transmitted through touch, using the same bathroom and hygiene items.If papillomas are located on the mucous membrane of the lips, transmission of the papillomavirus through a kiss is possible.All of the above do not eliminate the need to use condoms.
8. HPV can be completely cured.Answer: It is not the virus itself that can be treated, but the diseases it caused.You can get rid of genital warts, remove warts, and even cure a precancerous condition of the cervix.But the virus itself, unfortunately, remains in the human body.
9. Once you get HPV, it will come back again and again.Truth: Not necessary at all.Yes, the doctor will likely see the presence of strains in the swabs.But if you lead a healthy lifestyle, eat well and therefore have good immunity, viruses will not manifest themselves.No way!
10. In a relationship, an HPV diagnosis means that one partner cheated on the other.Answer: It is this myth that has led many people to tragically incorrect conclusions and caused many couples to break up because they did not take into account one of the most mysterious aspects of genital HPV - the ability of the virus to remain latent.Even if you and your man have been together since high school, an HPV diagnosis just means that one of you has contracted a human papillomavirus infection at some point in your life.

Prevention

HPV prevention is based on the following three methods:

1. Primary, which helps identify risk factors, prevent the spread of infections, as well as develop special vaccines;
2. Secondary, which is based on examining the patient, helping to identify the disease at an early stage;
3. Tertiary, which is based on preventing the development of relapses in individuals treated for this infection.

At the state level, a series of preventative measures are also being taken to prevent the spread of HPV.It is the desire to improve the well-being of the population by limiting videos and advertising, which are based on the hidden propaganda of promiscuity, and introducing programs to support young families.

At a medical level, preventive measures are based on carrying out sanitary and educational work among the population with familiarity with the routes of transmission of various sexually transmitted infections, their symptoms, treatment methods and, most importantly, barrier contraception methods against their infection.

Individual preventive measures include the following:

• refusal of promiscuous sexual relations;
• mandatory use of condoms during sexual intercourse, although it has been established that HPV can also be transmitted through close contact with the skin;
• periodically visit a doctor for examination;
• maintaining a healthy lifestyle, active sports;
• promptly treat identified diseases of the reproductive system.

Nowadays, 2 types of vaccines have been invented and introduced into medical practice.These drugs are completely harmless to humans, since the viruses they contain are not alive.It is recommended to prescribe them to women and men aged 9 to 17;They can also be administered for preventive purposes to women under the age of 26.