Human papillomavirus

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.Currently, there are more than 70 types of human papillomavirus.

The virus affects the skin and mucous membranes: various warts, papillomas and condylomas form on them.Human papillomavirus lives in human blood and does not manifest itself for a certain period of 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 ten years.

What is this?

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

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 from one to two cm.Places of occurrence: oral cavity, nose, pharynx, vocal cords;it can form in the bladder and other places.

Diseases also differ depending on the type of virus: warts are caused by human papillomavirus 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 types of viruses (16, 18, 31, 33, 35) cause favorable development of cervical lacerations.cancer.Human papillomavirus remains on the skin and mucous membranes and is transmitted through contact and domestic routes.

Human papillomavirus 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 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 virus carrier, which means that HPV is transmitted only from person to person.

Three ways of transmission of this infection are known:

• communication and domesticity (through touch);
• sexual (genital, anal, oral-genital);
• from mother to child during birth.

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, which causes benign or malignant tumors in a person.Also, human papilloma is a virus that can affect the skin and mucous membranes or may not reveal itself until the immunity of the carrier of the infection is reduced.

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 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 who are carriers of HPV or have an active form of this disease;
• women suffering from various cervical diseases.

All representatives of these categories should be examined for the detection of papillomatosis.Testing is also recommended for promiscuous people who have many sexual partners or who change them frequently.Even an unprotected act can cause infection, so experts advise to follow 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 (hidden) 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 - 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 provoked 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.Often, such growths are not isolated, but represent a localized "combined" zone.Simple (also called vulgar) papillomas can be located between the palms and fingers;in children they are found in the knees.

Flat papillomas

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

Plantar papillomas

At the very beginning of their development, plantar papillomas appear as a whitish, shiny spot.Then it "rises" slightly above the level of the skin surface.Multiple mosaic neoplasms can be seen around the primary papilloma.Such neoplasms make life difficult for the patient - it is difficult for him to walk and it is almost impossible to find comfortable shoes.

Filiform papillomas

This type of neoplasm is typical for women over 50 years old;they first appear as small yellowish bumps.Over time, these bumps grow and turn into a large collection of "threads".

Condylomas acuminata

The formations look like cauliflower or rooster.Most often, condylomas are located on the foreskin, on the head of the genital organ, 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 appears as a single formation only in the upper layer of the epidermis (usually on the head).Between 5 and 50 mm, a lesion looks like a growing layer of skin, sometimes covered with crusts.The cause is HPV type 16. Formations tend to turn into squamous cell carcinoma.

Formations in the oropharynx

Blooming papillomatosis in the oral cavity is also similar to cauliflower: white plaques on the oral mucosa.It occurs in elderly people.Laryngeal papillomatosis can descend on the trachea, bronchi and lung tissue and occurs in children and adults.Symptoms of laryngeal papillomatosis are dysphonia (speech disorder) and aphonia (inability to speak), hoarseness and breathing difficulties.Cancer can develop when HPV infects the oropharynx.

Human papillomavirus in men

In men, human papillomavirus infection 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;
• in the mucous membrane.

In men, this type of virus can take the form of high oncogenicity.It causes genital cancer.But if you start treatment in 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, it can be completely eliminated in the initial stages of the development of this type of disease in men.

Human papillomavirus in women

As already mentioned, women between the ages of 20 and 45 are most susceptible 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 high type of oncogenic infection.It almost always causes oncological disease - malignant tumor, cervical cancer.The risk of developing such a pathology is 90%.The condition is aggravated by the fact that the disease does not show symptoms in the early stages of development.Sometimes small warts can appear on the palms and feet.

Condylomas are formed with high oncogenic type of infection.These are wart-like formations, but with curved edges.Such formations can be seen in the vagina, anus and perineum.Sometimes condylomas can be in the form of bubbles with liquid, burst over time and emit an unpleasant smell.

High-type HPV infection can also cause vaginal and vulvar cancer.In more rare clinical cases, nasopharyngeal cancer is possible.It should be noted that it is almost impossible to completely treat the highly oncogenic form of HPV.

The threat of human papillomavirus infection

The characteristics of the papillomatosis virus are that it is located either on 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 strain of the virus has its own "favorite" localization.Thus, the most dangerous types 16 and 18 are immediately "directed" to the genitals when ingested, and low oncogenic viruses 6 and 11 infect the vulva and perineum region, causing the development of genital warts there.These same strains can cause respiratory papillomatosis in a child if born to a mother who naturally has genital warts.

A disease with obvious symptoms does not always develop after infection.On the contrary, the disease often occurs imperceptibly and does not cause serious consequences.

The most dangerous complications of human papillomavirus infection are:

1. Cervical cancer.In women, it occurs 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.If they used to talk about the development of cervical carcinoma from erosion or ectropion, now this has been revised and refuted;
2. Rectal carcinoma.Unlike the first disease, there may be other causes;
3. Throat cancer.It is also caused by virus type 16;
4. Lung cancer that can occur when infected with types 16, 18, 11, 2, 6, 30;
5. Respiratory failure that develops with the growth of malignant papillomas in the respiratory tract (larynx, trachea);
6. Contact bleeding from condyloma.If they are in the external genitalia, perineum or vagina, they are sexually aroused.Bleeding in other places (nose, mouth) can cause mechanical damage with other objects.

According to official sources, less than half a million (470 thousand) new cases of cervical cancer caused by this virus are registered in the world every year.Every year 233 thousand women die from this disease.This makes this cancer the 2nd most frequent among all cancer pathologies in gynecology (the first place is breast cancer) and the 5th among all causes of death in women.Women under the age of 40 often die from cervical carcinoma.

HPV and pregnancy

Human papillomavirus does not affect reproductive function, that is, the virus does not prevent a woman from having children.

If human papillomavirus infection is detected during pregnancy:

• the first thing is to find a good gynecologist and be under his supervision until birth,
• the main 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 medication during pregnancy (only when necessary),
• during birth, the child can be infected while passing through the birth canal;
• If a pregnant woman has obvious changes in her cervix, they may suggest a caesarean section,
• in the absence of manifestations - natural birth.

In general, cesarean section for HPV infection is rarely performed.Further 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 was possible thanks to the systematization of information about HPV and related diseases, the study of all available 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 follow 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 tested.
• People with proven risk factors for PVI.
• Patients with pointed papilloma in the oral cavity and anogenital area.
• Patients suffering from various pathologies of the cervix.
• Couples planning pregnancy.

The main diagnostic methods of PVI:

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

All patients examined for the presence of PVI are simultaneously examined for syphilis, hepatitis and HIV, smears are taken for bacterioscopic examination of urethral, vaginal and cervical secretions, PCR and bacteriological examination are prescribed for the presence of infections of the genitourinary organs.

As a rule, detection of papillomavirus is not difficult: the infection is detected during standard examinations by a gynecologist or dermatologist.If appropriate symptoms occur, a targeted biopsy is performed.When the patient is diagnosed with flat condylomas localized in the anogenital region, a test of human papillomavirus serotypes with an oncogenic marker is performed to prevent the development of malignant diseases.

How to treat human papillomavirus?

Currently, no radical treatment methods have been developed for human papillomavirus infection in men or women.All existing schemes are aimed at neutralizing the pathogen and strengthening antiviral immunity;warts, condylomas and dysplasias are removed by minimally invasive methods.Surgical excision, conization and removal of the cervix are rarely used and mainly in cases of reasonable suspicion of oncological pathology.

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

• When a malignant tumor is suspected, surgical treatment is performed.It is not used very often, because severe bleeding can occur when the wart is removed.During this manipulation, the cut wart is sent for biopsy and the wound is sutured.
• Curettage is the removal of a wart using 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.However, relapses are also possible in this case.This method can also be used for large warts, but before starting, they must be soaked or the electrode inserted into the thickness of the wart, so that the separation between the cells is 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 performed in parallel.In addition to vaporizing warts, the laser has a direct toxic effect on HPV, so this treatment method is in the first place in the treatment of cervical intraepithelial neoplasia and is preferred in the treatment of genital warts (even in the last stages of development) in pregnant women.

Cytostatic drugs 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 the components of the immune system.

Combined treatments include a combination of the above methods.

TOP 10 myths about human papillomavirus

There are quite a few myths about HPV.We want to talk about the most common of them.So, what people say about papillomaviruses:

1. There is no reliable information on whether the HPV vaccine helps, so there is no need to get vaccinated.Answer: Yes, there are actually over 100 papillomaviruses and there is no evidence that the vaccine will protect against all of them.However, the vaccine will protect you against the most aggressive strains for 5 years.The vast majority of recipients have not experienced any side effects from the vaccine, so in our opinion it is still better to get vaccinated.
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.Thus, genital problems may have nothing to do with cancer.
3. Getting a Pap smear is more effective than getting the HPV vaccine.Cavab: Yaxma testi uşaqlıq boynunuzda mutasiyaya uğramış, xərçəng öncəsi hüceyrələrin olub-olmadığını yoxlamaq üçün aparılan müayinədir.Peyvənd, virusun daxil olduğu zaman hüceyrələri mutasiyadan qoruyan antikorların bədəndə əmələ gəlməsini təmin etmək üçün dəqiq nəzərdə tutulub.Thus, it is better not to avoid 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 cervical cancer cases and 41% of cervical cancer deaths occur in women age 65 and older.Regular screening is extremely important because HPV can reappear after years of silence.For women between the ages of 21-29, it is advisable to perform the analysis every three years, and between the ages of 30-65, every 3-5 years.
5. If there are no condylomas, but the virus is detected in the smear, I have cervical cancer". Answer: do not rush to draw conclusions. Viruses can remain in the human body for a long time, but this does not mean a pre-cancerous condition. The appearance of these viruses in tests indicates an increase in its number, 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 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.A: Many types of HPV do not cause problems.HPV infections usually clear up on their own within a few months without intervention, and about 90% clear up within 2 years.Only a small percentage of infections with certain types of HPV can persist and turn into cancer.
7. If you always use a condom, you will not get papillomaviruses.Answer: Condoms certainly reduce the chance of contracting HPV and sexually transmitted diseases.However, protected sex is not a 100% guarantee, because the papillomavirus is transmitted through any contact with mucous membranes.HPV can also be transmitted by touching, using the same toilet and hygiene products.If the papillomas are located on the mucous membrane of the lips, it is possible to transmit the papillomavirus through kissing.All of the above does not eliminate the need to use condoms.
8. HPV is completely treatable.Answer: Not the virus itself, but the diseases caused by it can be treated.You can get rid of genital warts, remove warts, even treat pre-cancerous conditions 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: You don't have to.Yes, the doctor will most likely see the presence of strains in the smears.But if you lead a healthy lifestyle, eat right, and as a result have good immunity, viruses will not manifest themselves.Not at all!
10. An HPV diagnosis in a relationship means one partner is cheating 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 consider one of the most mysterious aspects of HPV - the virus's ability to remain hidden.Even if you and your man have been together since school, an HPV diagnosis means that only one of you has had human papillomavirus infection at some point in your life.

Prevention

HPV prevention is based on three methods:

1. Primary, which helps to identify risk factors, prevent the spread of infection, as well as to develop special vaccines;
2. Secondary, based on the examination of the patient, which helps to identify the disease at the initial stage;
3. The third is based on the prevention of relapses in persons treated for this infection.

In order to prevent the spread of IPV, a number of preventive measures are implemented at the state level.This is a desire to increase the welfare of the population, limit the videos and advertisements based on the hidden propaganda of immorality, and introduce support programs for young families.

Preventive measures at the medical level are based on carrying out sanitary and educational work among the population, familiarizing them with the ways of transmission of various sexually transmitted infections, their symptoms, treatment methods and, most importantly, contraceptive methods to prevent their infection.

Individual preventive measures include:

• abstinence from promiscuous sex;
• mandatory use of a condom during sexual intercourse, although it has been determined that HPV can also be transmitted through close skin contact;
• visiting a doctor for periodic examination;
• healthy lifestyle, active sports;
• timely treat identified diseases of the reproductive system.

Currently, 2 types of vaccines have been invented and used in medical practice.These drugs are completely harmless to humans, because the viruses in them are not alive.It is recommended to prescribe them to both women and men aged 9-17;it is also allowed to use them for preventive purposes in women under 26 years of age.