Human papilloma viruses

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

The virus affects the skin and mucous membranes: various warts, papillomas and condylomas form on them.The human papilloma virus lives in human blood and only manifests itself after a certain period of time.But as soon as the immune system becomes weaker, 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?

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

A 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, throat, 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 of types 2 and 4, flat warts are caused by viruses of types 3 and 10, and genital warts are caused by types 6 and 11.Some virus types (16, 18, 31, 33, 35) cause cervical dysplasia or a favorable background for the development of cervical cancer.The human papillomavirus is transmitted through contact and household routes and remains in the skin and mucous membranes.

The human papillomavirus is divided into two groups:high and low risk.The low-risk group includes the 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, i.e.h.HPV is only transmitted from person to person.

There are three known routes of transmission of this infection:

• contact and household (through touch);
• sexual (genital, anal, oral-genital);
• at birth 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 and lead to 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 recognize itself at all until the immunity of the carrier of the infection weakens.

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

• pregnant women;
• Patients who often suffer from various ailments;
• people with a non-traditional orientation;
• male or female representatives suffering from sexually transmitted diseases;
• people who are excessively sexually active;
• People with immune system disorders;
• sexual partners of people who have been found to be carriers of HPV or have an active form of this disease;
• Women suffering from various diseases of the cervix.

All representatives of these categories must undergo an examination for papillomatosis.It is also recommended that people who are supporters of free sexual intercourse, have many sexual partners or change them frequently, get tested.Even one unprotected action can lead to an infection.Therefore, experts advise you to take preventive measures against this disease.

Human papillomavirus: incubation period

When infected with the human papillomavirus, the incubation period is typically long: from half a month to several years.Infection with the human papillomavirus is characterized by a hidden (latent) course.A person can become 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

The clinical symptoms of human papillomavirus are very diverse - 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 characterized by their roughness, the presence of a keratinized layer and their size from 1 mm.Very often, such growths are not isolated, but represent a localized “fused” zone. Simple (including vulgar) papillomas can be localized on the palms of the hands and between the fingers;in children they are found on the knees.

Flat papillomas

They are caused by human papillomavirus types 3 and 10, are the same color as the skin and are therefore the least noticeable.However, in addition to the appearance of neoplasms, flat papillomas are also 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 occur 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 is characteristic of women over 50 years old;They initially appear as small, yellowish bumps.Over time, these bumps grow and turn into a collection of numerous “threads”.

Condylomas acuminata

The appearance of the formations resembles cauliflower or cockscomb.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 and at the opening of the urethra.

Bowen disease

It looks like a single formation exclusively in the upper layer of the epidermis (usually on the head).A lesion of 5 to 50 mm looks like a growing layer of cornea, sometimes covered with crusts.Caused by HPV type 16. The 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.Occurs in older people.Laryngeal papillomatosis can invade the trachea, bronchi and lung tissue and occurs in children and adults.Signs of laryngeal papillomatosis include dysphonia (speech disorder) and aphonia (inability to speak), hoarseness and difficulty breathing.When HPV infects the oropharynx, cancer can develop.

Human papillomavirus in men

Infection with the human papilloma virus can occur without symptoms in men.It is also worth mentioning that the main risk group includes men who frequently change sexual partners and 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 dam area;
• on the mucous membrane.

A virus of this type can have high oncogenicity in men.This leads to cancer of the sexual organs.However, if you start treatment 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 drugs are prescribed.Therefore, this type of disease can be completely eliminated in the early stages of development in men.

Human papillomavirus in women

As mentioned earlier, women aged 20-45 are most vulnerable to the virus.However, it should be noted here that the main risk group is 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 severe oncogenic infection.Almost always it leads to an oncological disease – a malignant tumor, cervical cancer.The risk of developing such pathology is 90%.What makes matters worse is that the disease does not show any symptoms in the first stages of development.Occasionally, small warts may appear on the palms of the hands and soles of the feet.

In a type of infection with high oncogenicity, condylomas form.These are wart-like structures, but with jagged edges.Such formations can appear in the vagina, anus and perineum.Sometimes condylomas can take the form of fluid bubbles that burst over time and give off an unpleasant odor.

Infection with a high type of HPV can also cause vaginal and vulvar cancer.In rarer clinical cases, nasopharyngeal cancer is possible.It is worth noting that it is almost impossible to completely cure the highly oncogenic form of HPV.

The risk of infection with human papilloma viruses

The properties of the papillomatosis virus are such that it settles either in the skin or in the mucous membrane of various organs: reproductive organs (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”.When ingested, the most dangerous types 16 and 18 are immediately “directed” to the genitals, and the weakly oncogenic viruses 6 and 11 infect the vulva and perineal area and cause genital warts to develop there.These same strains can cause papillomatosis in the respiratory tract of a child if he or she is born naturally to a mother with genital warts.

After an infection, an illness with pronounced symptoms does not always develop.On the contrary, the disease usually goes unnoticed and has no 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 types 16 or 18.It has been proven that this disease does not occur in the absence of the papilloma virus.And if previously there was talk of cervical carcinoma developing through erosion or ectropion, this has now 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 with infection 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 genitals, perineum or in the vagina, they are provoked by sex.In other places (in the nose, in the mouth) bleeding can be caused by mechanical injury with other objects.

According to official sources, almost half a million (470,000) new cases of cervical cancer caused by this virus are recorded worldwide every year.233,000 women die from this disease every year.In terms of frequency, this type of cancer ranks second among all cancers in gynecology (first place for breast cancer) and fifth among all causes of death in women.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 you need to do is find a good gynecologist and have him observe you until birth.
• The most important thing is what signs of infection a woman has.The doctor's tactics depend on this.
• The virus has no effect on the fetus!
• Warts and papillomas can be removed after birth,
• minimal medication intake (only if necessary) during pregnancy,
• During birth, the child can become infected while passing through the birth canal.
• If there are significant changes to the pregnant woman's cervix, a cesarean section can be offered,
• in the absence of manifestations - natural childbirth.

In general, a cesarean section is rarely performed for HPV infection.And later symptoms of infection in children are extremely rare or insignificant.

diagnosis

In recent years, medicine has made significant progress in diagnosing PVI.This became possible due to the systematization of data on HPV and associated diseases, the study of all existing routes of infection, 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.In this case, experts adhere to generally accepted algorithms:

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

Basic diagnostic methods of PVI:

1. Visual inspection of lesions.
2. With magnifying glass and 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, swabs are taken for bacterioscopic examination of discharge from the urethra, vagina and cervix, and PCR and bacteriological examination for the presence of urogenital infections are prescribed.

Detecting the papilloma virus usually does not cause any difficulties: the infection is detected during standard examinations by a gynecologist or dermatologist.If there are corresponding symptoms, a targeted biopsy is carried out.If a patient is diagnosed with flat condylomas 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 have been developed for radical treatment of human papillomavirus infection in men or women.All existing programs are aimed at inactivating the pathogen and strengthening antiviral immunity;Warts, condylomas and dysplasias are removed minimally invasively.Surgical excision, conization and removal of the cervix are practiced rarely and mainly when there is reasonable suspicion of oncological pathology.

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

• If malignant disease is suspected, surgical treatment is carried out.It is not used as often because severe bleeding can occur when removing a wart.During this manipulation, the excised wart is subjected to a biopsy and the wound is stitched.
• Curettage is the removal of a wart using a curette, i.e. curettage.Electrocoagulation is then 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 on large warts, but they must first 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, i.e.h.In addition to the destruction, hemostasis is also carried out at the same time.In addition to the fact that the laser vaporizes the wart, it also has a direct toxic effect on HPV, so this method of treatment comes first in the choice of treatment for cervical intraepithelial neoplasia, and also dominates in the treatment of genital warts in pregnant women (even in the last stages of development).

Cytostatics and chemicals with caustic effects are also used.

Immunotherapy – this treatment method is used only in combination with other methods, as it does not have a specific effect, 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 more than enough myths about HPV.We want to talk about the most common of them.So what do people say about papilloma viruses:

1. There is no reliable data on whether vaccination against HPV helps, so you do not need 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 protects you against the most aggressive strains for 5 years.The vast majority of recipients had no side effects from the vaccination, so in our opinion it is better to get vaccinated anyway.
2. If you have genital warts, it can lead to cervical cancer.Answer: It is unknown how many sleepless nights this myth has caused.In fact, the situation is not quite so bleak.Both warts and cervical cancer are caused by the human papillomavirus.However, with completely different burdens.So problems in the genital area may have nothing to do with cancer.
3. A smear test is more effective than an HPV vaccination.Answer: A smear test is a screening test to determine if there are mutated, precancerous cells on your cervix.And the vaccination is intended to ensure that antibodies are formed in the body that protect the cells from mutations if the virus invades.So 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 checkups are extremely important because HPV can reappear after years of silence.For women aged 21 to 29, it is recommended to carry out the analysis every three years, and between 30 and 65 years old - every 3-5 years.
5. If there are no condylomas but the smear 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 that it is a precancerous condition.The appearance of these viruses in tests indicates that their number has increased, which is due to a decrease in the body's general immunity.Therefore, based on this analysis result, you should first of all pay attention to the state of immunity and it is better to carry out treatment aimed at maintaining it.
6. All papilloma viruses cause cancer.Answer: Many types of HPV do not cause problems.HPV infections usually clear up on their own without intervention within a few months of infection and about 90% clear up within two 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 be able to contract papilloma viruses.Answer: A condom certainly reduces the chances of contracting HPV and sexually transmitted diseases.However, protected sex is not a 100% guarantee, as the papilloma virus is transmitted through any contact with mucous membranes.HPV can also be transmitted through touch when using the same toiletries and hygiene products.If there are papillomas on the mucous membrane of the lips, transmission of the papilloma virus through a kiss is possible.None of this excludes the use of condoms.
8. HPV can be completely cured.Answer: It is not the virus itself that can be treated, but rather the diseases it causes.You can get rid of genital warts, you can remove warts and even cure a precancerous lesion of the cervix.But the virus itself, unfortunately, remains in the human body.
9. Once you get HPV, it keeps coming back.Truth: Not necessary at all.Yes, the doctor will most likely detect the presence of strains in the smears.However, if you lead a healthy lifestyle, eat right and therefore have good immunity, viruses will not appear.Not at all!
10. In a relationship, a diagnosis of HPV means that one partner has cheated on the other.Answer: It is this myth that has led many people to tragically wrong 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 virus's ability to remain latent.Even if you and your husband have been together since school, an HPV diagnosis only means that one of you has had 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 and develop specific vaccines;
2. Secondary, which is based on the examination of the patient and helps to detect the disease at the very first stage;
3. Tertiary, which is based on preventing the development of relapses in people being treated for this infection.

A number of preventative measures are also being 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 restricting videos and advertising based on hidden promiscuity propaganda and introducing programs to support young families.

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

Individual preventive measures include:

• Refusal of promiscuous sexual intercourse;
• mandatory use of a condom during sexual intercourse, although it has been proven that HPV can also be transmitted through close skin-to-skin contact;
• Visit a doctor regularly for examinations;
• maintaining a healthy lifestyle, active sports;
• Immediately treat identified diseases of the reproductive system.

Nowadays, two 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.It is recommended to prescribe them to both women and men aged 9 to 17 years;They may also be given to women under 26 years of age for prevention.