Human papilloma virus

Human papillomavirus is the most common infection in the world.

According to researchers, more than 90% of people worldwide are infected with one type of HPV or another.There are currently more than 70 types 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 that

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.

A papilloma is a tumor, considered benign, that grows on the surface of the skin and looks like a small wart.The size of the papilloma can be from one to two cm.Places of appearance: oral cavity, nose, pharynx, vocal cords;they can form in the bladder and other places.

Depending on the type of virus, the diseases also differ: warts are caused by human papillomavirus 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 the background for the development of cervical cancer or cervical cancer.The human papillomavirus is transmitted through contact and household contact, remaining in the skin and mucous membranes.

Human papilloma virus is divided into two groups -high and low risk.The low-risk group includes the types of viruses (primarily 6 and 11) that cause genital warts.The high-risk group includes types 16, 18, 31, 33, 35 viruses, 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 household (by 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

It is an interesting fact that different types of HPV can manifest themselves differently, causing a person to develop benign or malignant tumors.Also, human papilloma is a virus that can affect the skin and mucous membranes, or it cannot be detected at all until the immunity of the carrier of the infection decreases.

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

• women who are pregnant;
• patients who often suffer from various diseases;
• persons of non-traditional orientation;
• representatives of men or women who suffered from sexually transmitted diseases;
• people who are excessively sexually active;
• people with disorders of the immune system;
• sexual partners of persons who are found to be carriers of HPV or have an active form of this disease;
• women suffering from various cervical diseases.

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

Human papillomavirus: incubation period

Usually, when infected with the human papilloma virus, the incubation period is long: from half a month to several years.Human papillomavirus infection is characterized by a 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 stage 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 relapsing course with possible malignancy of the process (depending on the type of virus).

Classification and symptoms of HPV

Clinical symptoms of human papillomavirus are quite variable - in 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 their roughness, the presence of a keratinized layer and the size of 1 mm or more.Very often, such growths are not isolated, but represent a localized "joined" zone.Simple (also called vulgar) papillomas can be found on the palms and between the fingers;in children, they are revealed on the knees.

Flat papillomas

Caused by human papillomavirus types 3 and 10, they are identical in color to the skin and are therefore the least noticeable.However, apart from 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" a little 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 in the form of small nodules of a yellowish hue.Over time, these protrusions grow and turn into a set of numerous "threads".

Condylomas acuminata

In appearance, the formations resemble cauliflower or a rooster's comb.Most often, condylomas are found on the foreskin, head of the penis, near the urethra, around the anus, on the labia minora, on the mucous membrane of the vagina, 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 appears as a growing stratum corneum of the skin, sometimes covered with a crust.It is caused by HPV type 16. Formations tend to degenerate 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 the elderly.Papillomatosis of the larynx can descend into the trachea, bronchi and lung tissue, and occurs in children and adults.Signs of laryngeal papillomatosis are dysphonia (speech disorder) and aphonia (impossibility of speech), 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 is also worth noting 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 area;
• on the mucous membrane.

The virus of this type in men can have a form of high oncogenicity.This leads to cancer of the genital organs.But, if the treatment is started on time, the risk of oncogenic diseases is minimized.Warts caused by the HPV virus are removed surgically or using special chemical solutions.Antiviral drugs are also prescribed at the same time.Therefore, in the early stages of the development of this type of disease in men, it can be completely eliminated.

Human papilloma virus in women

As already mentioned, women between the ages of 20 and 45 are most susceptible to the virus.But here it is worth noting the fact 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.It 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 complicated by the fact that in the first stages of development the disease shows no symptoms.Occasionally, small warts may appear on the palms and soles.

Condylomas are formed in highly oncogenic types of infection.These are formations similar to warts, but with jagged edges.Such formations can appear in the vagina, anus and perineum.Sometimes condylomas can take the form of bubbles with liquid, which burst over time and emit an unpleasant smell.

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

Risk of infection with human papilloma virus

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

Each virus strain has its own "favorite" localization.Thus, the most dangerous types 16 and 18, when swallowed, are immediately "directed" to the genitals, and low-oncogenic viruses 6 and 11 infect the area of the vulva and perineum, causing the development of genital warts there.The same strains can cause papillomatosis in the respiratory tract of a child if he 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 occurs unnoticed and does not lead to serious consequences.

The most dangerous complications of human papilloma virus 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 papillomavirus.And if earlier they talked about the development of cervical cancer from erosion or ectropion, now it has been revised and denied;
2. Rectal cancer.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 condyloma.If they are on the external genitalia, perineum or in the vagina, then they are caused by sex.In other places (in the nose, mouth) bleeding can be caused by mechanical injury by other objects.

Every year, according to official sources, slightly less than half a million (470 thousand) new cases of cervical cancer caused by this virus are registered in the world.233 thousand women die from this disease every year.Thus, this cancer ranks 2nd in frequency among all cancer pathologies in gynecology (first place after breast cancer) and 5th among all causes of female mortality.Women under the age of 40 most often die from cervical cancer.

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 human papillomavirus infection is detected during pregnancy:

• the first thing is to find a good gynecologist and be under supervision until delivery,
• the most important thing is what manifestations of the infection the woman has, the doctor's tactics will depend on that,
• The virus has no effect on the fetus!
• warts and papillomas can be removed after childbirth,
• minimal intake of drugs (only if necessary) during pregnancy,
• during childbirth, the child can become infected passing through the birth canal,
• if there are pronounced changes on the cervix, pregnant women can offer a caesarean section,
• in the absence of manifestations - natural birth.

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

Diagnostics

In recent years, medicine has made significant progress in the diagnosis of PVI.This became possible thanks to the systematization of data on HPV and diseases associated with it, the study of all existing infection routes, many mechanisms of the 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 must be tested for HPV.
• Patients infected with HIV and those with symptoms of sexually transmitted diseases should also be screened.
• People who have proven risk factors for PVI.
• Patients with spiky papillomas in the oral cavity and anogenital area.
• Patients suffering from various pathologies of the cervix.
• Couples planning 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 biological techniques.
5. Histological (pathomorphological) examination.

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

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 localized in the anogenital region, in order to prevent the development of malignant diseases, testing of human papillomavirus serotypes with an oncogenic marker is carried out.

How to treat human papilloma virus?

Currently, no methods have been developed for the radical treatment of human papillomavirus infection in men and women.All existing schemes aim to inactivate pathogens and strengthen antiviral immunity;warts, condylomas and dysplasias are removed by minimally invasive methods.Surgical excision, conization and removal of the cervix are rarely practiced, mostly in cases of well-founded 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 so often, because heavy bleeding can occur when removing the wart.During this manipulation, the excised nipple is sent for biopsy, and the wound is sutured.
• Curettage is the removal of a wart with a curette, i.e. curettage.After that, electrocoagulation is performed, and a dry bandage 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 inserted into the thickness of the wart, so that the separation between the cells becomes less strong.
• Cryodestruction is performed with liquid nitrogen.
• Laser surgery currently occupies a leading position in surgical treatment, i.e., in addition to destruction, hemostasis is also carried out in parallel.In addition to vaporizing warts, the laser also has a direct toxic effect on HPV, so this method of treatment is in first place in the treatment of cervical intraepithelial neoplasia, and it is also dominant in the treatment of genital warts in pregnant women (even in the last stages of development).

Cytostatics and chemicals with a cauterizing effect are also used.

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

Combined treatments include a combination of the above methods.

TOP 10 myths about the human papillomavirus

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

1. There is no reliable data on whether the HPV vaccination helps, so you do not need to get vaccinated.Answer: Yes, indeed, there are more than 100 papillomaviruses and there is really no evidence 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 did not experience any side effects from the vaccine, so in our opinion, it is better that they get vaccinated anyway.
2. If you have genital warts, it will lead to cervical cancer.Answer: It is not known how many sleepless nights this myth has caused.Actually, things are not so bleak.Both warts and cervical cancer are caused by the human papillomavirus.But with completely different strains.So, genital problems may not have anything to do with cancer.
3. It is more effective to have a smear than to get the HPV vaccine.Answer: A Pap test is a screening test to see if you have mutated precancerous cells on your cervix.And the vaccination is precisely intended to ensure the formation of antibodies in the body, protecting the cells from mutation when the virus enters.Therefore, it is definitely better not to save 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 over the age of 65.Regular screening is extremely important because HPV can reappear after years of silence.The analysis should be done every three years for women aged 21 to 29, and every 3-5 years between 30 and 65.
5. If there are no condylomas, and the swab shows 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 the tests indicates that their number has increased, and this happens as a result of a decrease in the overall immunity of the organism.Therefore, the main thing you should pay attention to based on this analysis result is the state of immunity, and it is better to carry out treatment in order to maintain it.
6. All papillomaviruses cause cancer.Answer: Many types of HPV do not cause problems.HPV infections usually clear up on their own, without any intervention, within a few months of getting it, and about 90% clear up within 2 years.And only a small part of infections with certain types of HPV can survive and develop into cancer.
7. If you always use a condom, you will not get the papillomavirus.Answer: A condom certainly reduces the likelihood of contracting HPV and sexually transmitted diseases.However, protected sex is not a 100% guarantee, because the papilloma virus is transmitted through any contact with the mucous membrane.HPV can also be transmitted by touching, using the same toilets and hygiene items.If the papillomas are located on the mucous membrane of the lips, then it is possible to transmit the papilloma virus through a kiss.All of the above does not eliminate the need to use condoms.
8. HPV can be completely cured.Answer: The virus itself cannot be treated, but the diseases it has caused.You can get rid of genital warts, you can remove warts, 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: It's not necessary at all.Yes, the doctor will most likely notice the presence of strain on the swabs.But if you lead a healthy lifestyle, eat right and as a result have good immunity, viruses will not manifest themselves.No way!
10. In a relationship, an HPV diagnosis means one partner has been cheating on the other.Answer: It is this myth that has led many people to tragically wrong conclusions and led to the breakup of many couples because they failed to consider 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 school, an HPV diagnosis just means that one of you has been infected with human papillomavirus 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 infection, and develop special vaccines;
2. Secondary, which is based on the examination of the patient, helps to identify the disease in the very initial stage;
3. Tertiary, which is based on preventing the development of recurrence in people treated for this infection.

A number of preventive measures are also being taken at the state level to prevent the spread of HPV.It is the desire to improve the well-being of the population, limit videos and advertisements, which are based on hidden propaganda of promiscuity, and introduce support programs for young families.

At the medical level, preventive measures are based on the implementation of sanitary and educational work among the population along with familiarization with the ways of transmission of various sexually transmitted infections, their symptoms, treatment methods and, most importantly, methods of barrier contraception 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 skin contact;
• periodically visit a doctor for check-ups;
• maintaining a healthy lifestyle, active sports;
• timely treat identified diseases of the reproductive system.

Today, 2 types of vaccines have been invented and introduced into medical practice.These drugs are completely harmless to humans, because the viruses they contain are not alive.Prescribing is recommended for both women and men aged 9-17;it is also allowed to be given for preventive purposes to women under the age of 26.