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 or another of HPV.There are currently more than 70 varieties of human papillomavirus.

The virus affects the skin and mucous membranes: various warts, papillomas and warts form on them.The human papillomavirus lives in human blood and does not manifest itself until a certain time.But 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 tumor, considered benign, that grows on the surface of the skin and resembles a small nipple.The size of papillomas can vary from one to two cm.Places of occurrence: oral cavity, nose, pharynx, vocal cords;it can form on 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 viruses 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 domestically, remaining in 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 virus types 16, 18, 31, 33, 35, 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 virus carrier, that is, HPV is transmitted only from person to person.

There are three known ways to transmit this infection:

• contact and family unit (through touch);
• sexual (genital, anal, oro-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 differently, causing the development of benign or malignant tumors in a person.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 carrier of the infection 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 ailments;
• people with non-traditional orientation;
• male or female representatives suffering from sexually transmitted diseases;
• excessively sexually active people;
• people with immune system disorders;
• sexual partners of people found to be carriers of HPV or affected by an active form of this disease;
• women suffering from various cervical diseases.

All representatives of these categories must undergo examination to detect papillomatosis.It is also advisable to undergo the test for those people who support free sexual intercourse, who have many sexual partners or who change them frequently.Even an unprotected act can cause an infection, so experts recommend following preventive measures for this disease.

Human papillomavirus: incubation period

Usually, when infected with human papillomavirus, 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 papillomaviruses at once.Under the influence of various factors, the virus becomes 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 a long-term chronic relapsing course is observed 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 manifest themselves with 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 their size of 1 mm or more.Very often, these growths are not isolated, but represent a localized “fused” area.Simple papillomas (also called vulgar) can be located on the palms of the hands and between the fingers;in children they are found on the knees.

Flat papillomas

Caused by human papillomaviruses types 3 and 10, they have an identical color to that of the skin and are therefore 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 whitish, shiny spot.It then “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 the age of 50;they initially appear in the form of small yellowish bumps.Over time, these bumps grow and turn into a mass of numerous “threads.”

Condylomata acuminata

The appearance of the formations resembles cauliflower or cockscomb.Most often, warts are found 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, at 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 subject to degeneration into squamous cell carcinoma.

Formations in the oropharynx

Blooming papillomatosis in the oral cavity also resembles cauliflower: white plaques on the oral mucosa.It occurs in older 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 worth noting that in the main risk group men who often change sexual partners have unprotected sexual intercourse.

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 mucosa.

A virus of this type in humans can take the form of high 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 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 the most susceptible to the virus.But here it is worth noting 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 this pathology is 90%.The situation is further aggravated by the fact that in the early stages of development the disease has no symptoms.Small warts may occasionally appear on the palms of the hands and soles of the feet.

With a type of infection with high oncogenicity, warts are formed.These are formations similar to warts, but with jagged edges.Such formations can appear in the vagina, anus and perineum.Sometimes warts can take the form of blisters containing liquid, 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, cancer of the nasopharynx is possible.It is worth noting 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 is deposited in the skin or mucosa of various organs: reproductive (both 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 "preferred" location.Therefore, the more dangerous types 16 and 18, when ingested, are immediately "directed" to the genitals, while viruses with low oncogenic effect 6 and 11 infect the vulva and the perineal area, causing the development of genital warts there.These same strains can cause papillomatosis in the airways of a child if he is 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 papillomavirus infection are:

1. Cervical cancer.It occurs in women following infection with human papillomavirus type 16 or 18. This disease has been shown to not occur in the absence of papillomavirus.And if previously there was talk of the development of cervical carcinoma due to erosion or ectropion, this has now been revised and refuted;
2. Rectal cancer.Unlike the first disease, it can have other causes;
3. Throat cancer.It is also caused by the type 16 virus;
4. Lung cancer, which can occur if 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 warts.If they are found on the external genitalia, perineum or vagina, they are caused by sex.In other locations (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 thousand) new cases of cervical cancer caused by this virus are recorded worldwide.Every year 233 thousand women die from this disease.This places this tumor in 2nd place in terms of frequency among all tumor pathologies in gynecology (in first place among breast tumors) and in 5th place among all causes of mortality in women.Most often, women under 40 die from cervical cancer.

HPV and pregnancy

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 find a good gynecologist and have him observe you until the 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 if necessary) during pregnancy,
• during childbirth, the baby may become infected while passing through the birth canal,
• if there are pronounced changes in the cervix of the pregnant woman, they can offer 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.

Diagnostics

In recent years, medicine has made significant progress 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 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 should undergo HPV testing.
• 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 sharp papillomas in the oral cavity and anogenital area.
• 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 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 the discharge of the urethra, vagina and cervix, and PCR and bacteriological examination for the presence of urogenital infections are prescribed.

As a rule, 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 event that a patient is diagnosed with flat warts localized in the anogenital region, to prevent the development of malignant diseases, testing of human papillomavirus serotypes with an oncogenic marker is carried out.

How to treat human papillomavirus?

At present, 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, warts and dysplasias are removed using minimally invasive methods.Surgical excision, conization and removal of the cervix are performed rarely and especially in cases of reasonable suspicion of oncological pathology.

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

• Surgical treatment is performed if a malignant neoplasm is suspected.It is not used as often because severe bleeding can occur when a wart is removed.During this manipulation, the excised wart is sent for a biopsy and the wound is sutured.
• Curettage is the removal of a wart by curette, that is, 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 in this case repercussions are possible.This method can also be used for large warts, but before starting it is necessary to immerse them or insert an electrode into the thickness of the wart, so the separation between the cells becomes less strong.
• Cryodestruction is performed with liquid nitrogen.
• Laser surgery currently occupies a leading position in surgical treatment, that is, in addition to destruction, hemostasis is performed in parallel.In addition to the fact that the laser vaporizes the wart, it also has a direct toxic effect on HPV, so this treatment method takes 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 last stages of development).

Cytostatic drugs and chemicals with 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 effect, but only activates the components of the immune system.

Combined 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 ones.So, what do people say about papillomaviruses:

1. There is no reliable data on the effectiveness of HPV vaccination, so it is not necessary to get vaccinated.Answer: Yes, in fact, there are more than 100 papillomaviruses and there is actually no data that the vaccine protects against all of them.However, vaccination will protect you from the more 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 get vaccinated.
2. If you have genital warts, this will lead to cervical cancer.Answer: It is unknown how many sleepless nights this myth has caused.In reality, things aren't entirely that bleak.Both warts and cervical cancer are caused by the human papillomavirus.But with completely different strains.So genital problems may have nothing to do with cancer.
3. It is more effective to get a pap smear than the HPV vaccine.Answer: A pap smear is a screening test to check for mutated, pre-cancerous cells on the cervix.And vaccination has the precise purpose of ensuring that antibodies are formed in the body, protecting the cells from mutation when the virus enters.So it's definitely better not to skimp on vaccination than to wait until the cells start to turn malignant.
4. Older women do not need to undergo HPV testing.Answer: One in four cases of cervical cancer and 41% of all cervical cancer deaths occur in women age 65 and older.Regular screening is extremely important because HPV can reappear after years of silence.It is recommended to perform the analysis every three years for women aged 21 to 29, and every 3-5 years between 30 and 65 years.
5. If there are no warts, but the swab reveals viruses, then I have cervical cancer". Answer: Do not make hasty 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 its number has increased, and this occurs due to a decrease in the general immunity of the body. Therefore, the main thing you should 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 clear up on their own, without any intervention, within a few months of acquisition, and about 90% clear up within 2 years.And only a small percentage of infections with some types of HPV can persist and turn into cancer.
7. If you always use a condom, you will not get papillomavirus.Answer: Condoms definitely reduce the chance of contracting HPV and sexually transmitted diseases.However, safe sex is not a 100% guarantee, since the papillomavirus is transmitted through any contact of the mucous membranes.HPV can also be transmitted through contact, using the same toilet and hygiene items.If papillomas are located on the mucosa of the lips, transmission of the papillomavirus through kissing is possible.All of the above does not eliminate the need to use a condom.
8. HPV can be completely cured.Answer: It is not the virus itself that can be cured, 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 contract 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 strains on the smears.But if you lead a healthy lifestyle, eat well and, accordingly, have good immunity, viruses will not manifest themselves.At all!
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 incorrect 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 just means that one of you has contracted a human papillomavirus infection at some point in his 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 examination of the patient, helping to identify the disease at the initial stage;
3. Tertiary, which is based on the prevention of the development of relapses in individuals treated for this infection.

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

At the medical level, preventive measures are based on carrying out sanitary and educational work among the population, familiarizing themselves 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 is established that HPV can also be transmitted through close contact with the skin;
• periodically visit a doctor for examination;
• maintain a healthy lifestyle, active sports;
• timely 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 between 9 and 17;they can also be administered for preventive purposes to women under the age of 26.