Human papillomavirus

Human papillomavirus is the most common infection worldwide.

According to researchers, more than 90% of people worldwide are infected with some type of HPV.There are currently more than 70 varieties of human papilloma virus.

The virus affects the skin and mucous membranes: various warts, papillomas and condyloma form there.The human papilloma virus lives in human blood and only manifests itself at a certain time.But as soon as the immune system weakens, growths appear on the skin and/or mucous membranes.This explains the fairly long incubation period: from a few weeks to several decades.

What is this?

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

Papilloma is a tumor, considered benign, which develops on the surface of the skin and resembles a small nipple.The size of papillomas can range from one to two cm.Places of occurrence: oral cavity, nose, pharynx, vocal cords;can form on the bladder and other places.

Depending on the type of virus, the diseases also differ: warts are caused by human papilloma viruses 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 background for the development of cancerof the cervix.The human papillomavirus is transmitted by contact and domestically, remaining in the skin and mucous membranes.

The 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 modes of transmission of this infection:

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

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

Risk factors

An interesting fact is that different types of HPV can manifest themselves differently, causing the development of benign or malignant tumors.In addition, human papilloma is a virus that can affect the skin and mucous membranes, or may not be detected at all until the immunity of the infection carrier wanes.

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

• pregnant women;
• patients who often suffer from various conditions;
• people with a non-traditional orientation;
• male or female representatives suffering from sexually transmitted diseases;
• people who are too sexually active;
• people with immune system disorders;
• sexual partners of people deemed to carry HPV or present an active form of this disease;
• women suffering from various cervical diseases.

All representatives of these categories must undergo examination for papillomatosis.It is also recommended to be tested for people who adhere to free sexual relations, who have many sexual partners or who change them frequently.Even an unprotected act can cause infection, so experts advise you to follow preventive measures against this disease.

Human papillomavirus: incubation period

Generally, in case of infection with the human papilloma virus, the incubation period is long: from half a month to several years.Human papillomavirus infection is characterized by a hidden (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 increased, and the disease enters the phase of clinical manifestations.

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

HPV Classification and Symptoms

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 such skin growths - they serve as the basis for the classification of HPV.

Simple papillomas

Their 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.Very often, these growths are not isolated, but represent a localized “fused” area.Simple papillomas (also called common) can be located on the palms and between the fingers;in children they are detected on the knees.

Flat papillomas

Caused by human papillomaviruses types 3 and 10, they are identical in color to the skin and are therefore the least visible.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 very beginning of their development, plantar papillomas look like a whitish, shiny spot.Then it “rises” slightly above the level of the skin surface.Multiple mosaic neoplasms may appear around the main papilloma.Such neoplasms complicate the patient's life – it is difficult for him to walk and it is almost impossible to find comfortable shoes.

Filiform papillomas

This type of neoplasm in question is characteristic of women over 50 years old;they first appear as small bumps with a yellowish tint.Over time, these bumps grow larger and turn into a group of many “threads.”

Condyloma acuminatum

The appearance of the formations resembles cauliflower or a cockscomb.Most often, warts are localized on the foreskin, 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 scabs.Caused by HPV type 16. Formations are prone to degeneration into squamous cell carcinoma.

Formations in the oropharynx

Flowering papillomatosis in the oral cavity also resembles cauliflower: white plaques on the oral mucosa.Occurs in older people.Laryngeal papillomatosis can extend down to the trachea, bronchi and lung tissues 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 papilloma virus in men

Human papillomavirus infection in men can occur without any symptoms.It should also be noted that in the main risk group, men who often change sexual partners have unprotected sex.

Pathological formations are localized 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 humans can take the form of strong oncogenicity.This leads to cancer of the genital organs.But if you start treatment on time, the risk of oncogenic diseases is minimized.Warts caused by the HPV virus are removed surgically or using special chemical solutions.At the same time, antiviral drugs are prescribed.Therefore, in the early stages of the development of this type of disease in humans, it can be completely eliminated.

Human papillomavirus in women

As already mentioned, women aged 20 to 45 are most susceptible to the virus.But here it should be noted that the main risk group is those who often 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.This almost always leads to an oncological disease - a malignant tumor, cervical cancer.The risk of developing such a pathology is 90%.The situation is further aggravated by the fact that in the early stages of development the disease does not have any symptoms.Sometimes small warts may appear on the palms and soles.

With a type of infection with high oncogenicity, condyloma is formed.These are formations similar to warts, but with irregular edges.Such formations can appear in the vagina, anus and perineum.Sometimes warts can appear as bubbles containing fluid, which over time burst and emit 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 should be noted 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 either in the skin or in the mucous membranes of various organs: reproductive (male and female), esophagus, bronchi, oral cavity, rectum.It can also be localized in the conjunctiva of the eyes.

Each strain of the virus has its own “preferred” location.So, 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 region of the vulva and perineum, causing the development of genital warts.These same strains can cause papillomatosis of a child's respiratory tract if he or she was born naturally to a mother with genital warts.

After infection, a disease with pronounced symptoms does not always develop.On the contrary, the disease most 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 papilloma virus type 16 or 18. It has been proven that this disease does not occur in the absence of papilloma virus.And if earlier they talked about the development of carcinoma of the cervix 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 a type 16 virus;
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 condyloma.If they are found on the external genitalia, perineum or in the vagina, then they are caused by sex.In other places (nose, mouth), bleeding can be caused by mechanically injuring them with other objects.

Every year, according to official sources, just under half a million (470,000) new cases of cervical cancer caused by this virus are recorded worldwide.233,000 women die each year from this disease.This places this cancer in 2nd place in frequency among all cancer pathologies in gynecology (first place in breast cancer) and in 5th place among all causes of mortality in women.Most often, women under the age of 40 die from cervical carcinoma.

HPV and pregnancy

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

If human papillomavirus infection is detected during pregnancy:

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

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 advances in the diagnosis of PVI.This became possible due to the systematization of data on HPV and diseases associated with it, the study of all existing routes of infection, numerous 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 cervical pathologies.
• Couples planning a pregnancy.

Basic diagnostic methods of PVI:

1. Visual inspection of lesions.
2. Using a magnifying glass and a colposcope.
3. Cytological research methods.
4. Molecular biology 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 discharge 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 carried out by a gynecologist or dermatologist.If appropriate symptoms appear, a targeted biopsy is performed.In the case when a patient is diagnosed with flat condylomas localized in the anogenital region, to prevent the development of malignant diseases, a test for human papillomavirus serotypes with an oncogenic marker is carried out.

How to treat human papillomavirus?

Currently, no methods of radical treatment of human papillomavirus infection in men or women have been developed.All existing programs aim to inactivate the pathogen and strengthen antiviral immunity;warts, condyloma and dysplasia are removed using minimally invasive methods.Surgical excision, conization and ablation of the cervix are rarely performed and mainly in cases of reasonable suspicion of oncological pathology.

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

• Surgical treatment is carried out if a malignant tumor is suspected.It is not used so often, because when a wart is removed, serious 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 using a curette, that is to say by curettage.After that, electrocoagulation is performed and a dry bandage is placed on the wound.
• Electrosurgery is used to remove small warts.But even then, relapses are possible.This method can also be used for large warts, but before starting, they must be soaked or an electrode inserted into the thickness of the wart, so that the separation between the cells becomes less strong.
• Cryodestruction is carried out with liquid nitrogen.
• Laser surgery currently occupies a leading position in surgical treatment, that is, in addition to destruction, hemostasis is carried out in parallel.In addition to the fact that the laser vaporizes the wart, it also has a direct toxic effect on HPV, therefore this treatment method takes the first place in the choice of treatment of cervical intraepithelial neoplasia, and is also dominant in the treatment of genital warts in pregnant women (even in the later 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, since it does not have any specific effects, but only activates components of the immune system.

Combination treatments include a combination of the above methods.

TOP 10 myths about the human papilloma virus

There are 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 you are not required to get vaccinated.Answer: Yes, indeed, there are over 100 papillomaviruses, and there is really no data indicating that the vaccine will protect against all of them.However, vaccination will protect you from the most aggressive strains for 5 years.The vast majority of recipients experienced no side effects from the vaccine, so it is best, in our opinion, to get vaccinated anyway.
2. If you have genital warts, it will lead to cervical cancer.Answer: We don't know how many sleepless nights this myth has caused.In fact, things are not so bleak.Warts and cervical cancer are caused by the human papilloma virus.But with completely different strains.So genital disorders may have nothing to do with cancer.
3. It is more effective to take a smear than to get vaccinated against HPV.Answer: A Pap smear is a screening test to determine if you have mutated and precancerous cells on your cervix.And vaccination aims precisely to guarantee the formation of antibodies in the body, protecting cells from mutations when the virus enters.It is therefore better not to skimp on vaccination rather than waiting 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 deaths from cervical cancer occur in women aged 65 or older.Regular screening is extremely important because HPV can reappear after years of silence.It is recommended to carry out the analysis every three years for women aged 21 to 29, and every 3 to 5 years between 30 and 65 years old.
5. If there are no warts but the smear shows viruses, then I have cervical cancer.Answer: Don’t rush to conclusions.Viruses can stay in the human body for a long time, but this does not mean that it is a precancerous condition.The appearance of these viruses in the tests indicates that their number has increased, which is the result of a decrease in the overall immunity of the body.Therefore, the main thing that you need to pay attention to, based on the result of this analysis, is the state of immunity, and it is better 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 acquisition, and about 90% of them 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 will not catch papillomavirus.Answer: A condom certainly reduces the risk of contracting HPV and sexually transmitted diseases.However, protected sex is not a 100% guarantee, since the papillomavirus is transmitted through any contact of mucous membranes.HPV can also be transmitted through contact, using the same toiletries and hygiene items.If the papillomas are located on the mucous membrane of the lips, then transmission of papillomavirus through kissing is possible.All of the above does 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 causes.You can get rid of genital warts, you can remove them, you can 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 most likely see the presence of strains on the smears.But if you lead a healthy lifestyle, eat right and, accordingly, have good immunity, viruses will not manifest themselves.No way!
10. In a relationship, an HPV diagnosis means that one partner has cheated on the other.Answer: It is this myth that has led many people to tragically erroneous conclusions and caused many couples to break up because they failed to take into account one of the most mysterious aspects of genital HPV: the virus's ability to remain latent.Even if you and your man have been together since school, an HPV diagnosis simply 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 allows you to identify risk factors, prevent the spread of infection, as well as develop special vaccines;
2. Secondary, which is based on the examination of the patient, allowing the disease to be identified at the initial stage;
3. Tertiary, which is based on preventing the development of relapses in individuals treated for this infection.

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

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

Individual preventive measures include the following:

• refusal of promiscuous sex;
• mandatory use of a condom during sex, although it has been established that HPV can also be transmitted through close skin contact;
• periodically visit a doctor for examination;
• maintain 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 both women and men aged 9 to 17;they can also be given for preventive purposes to women under 26 years of age.