human papilloma virus

Human papillomavirus is the most common infection worldwide.

According to researchers, more than 90 percent of people worldwide are infected with one or another type of HPV.Currently, there are more than 70 variants of human papillomavirus.

The virus affects the skin and mucous membranes: various warts, papillomas and genital warts form on them.Human papillomavirus exists in human blood and does not become apparent until a certain time.But once the immune system is weakened, growths can appear on the skin and/or mucous membranes.This explains the rather long incubation period: from weeks to decades.

what is it?

Human papillomavirus (HPV) causes changes in tissue growth patterns.It causes various skin diseases and mucosal lesions.Modern medicine has identified more than a hundred viruses.

A papilloma is a benign tumor that grows on the surface of the skin and looks like a small nipple.Papillomas can be one to two centimeters in size.Site of occurrence: oral cavity, nose, pharynx, vocal cords; can form in the bladder and other places.

Diseases vary depending on the type of virus: warts are caused by human papillomavirus types 2 and 4, flat warts are caused by types 3 and 10, and genital warts are caused by types 6 and 11.Certain types of viruses (16, 18, 31, 33, 35) can cause cervical dysplasia or serve as a favorable background for the development of cervical cancer.Human papillomavirus is transmitted through contact and household routes and remains in the skin and mucous membranes.

Human papillomavirus is divided into two groups -high risk and low risk.The low-risk group includes the types of viruses that cause genital warts (mainly types 6 and 11).High-risk groups include viruses 16, 18, 31, 33, and 35, which can cause cervical dysplasia and increase the risk of cervical cancer.

How did you get infected?

The source of infection is a patient or virus carrier, that is, HPV can only be transmitted from person to person.

This infection has three known ways of spreading:

• contact and family (through touch);
• Sexual (genital, anal, orogenital);
• During childbirth from mother to child.

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

risk factors

An interesting fact is that different types of HPV behave differently, causing a person to develop benign or malignant tumors.Additionally, human papilloma is a virus that can affect the skin and mucous membranes, or may not detect itself at all until the infection carrier's immunity weakens.

According to world statistics, the following categories of citizens are several times more likely to suffer from this disease:

• pregnant women;
• Patients who often suffer from various diseases;
• People with unconventional tendencies;
• Male or female representatives suffering from sexually transmitted diseases;
• People with a hyperactive sex life;
• People with immune system diseases;
• have been found to be a carrier of HPV or the sexual partner of someone active with the disease;
• Women with various cervical spondylosis.

All representatives of these categories must undergo examination to detect papillomatosis.Testing is also recommended for people who engage in liberal sexual relationships, have multiple sex partners, or frequently change sex partners.Even an unprotected behavior can lead to infection, so experts recommend taking precautions to prevent this disease.

Human papillomavirus: incubation period

Usually, after infection with human papillomavirus, the incubation period is very long: from half a month to several years.Human papillomavirus infection is characterized by an insidious (latent) course.A person can be infected with multiple types of papillomavirus at the same time.Under the influence of various factors, the virus is activated, multiplies, and the disease enters the clinical manifestation stage.

In most cases (up to 90%), spontaneous recovery occurs within 6-12 months, in other cases there is a long-term chronic relapsing process, and this process can become malignant (depending on the type of virus).

HPV classification and symptoms

Clinical symptoms of human papillomavirus vary widely, with some types showing few symptoms and many presenting with papillomas in different parts of the body.

There are many types of these skin growths - they are the basis for HPV classification.

simple papilloma

Their growths are caused by human papillomavirus type 2; the growths themselves are characterized by their roughness, the presence of cornified layers and their size of 1 mm or more.Often, this growth is not isolated but represents a localized "merging" area.Simple (also called vulgar) papillomas can be located on the palms of the hands and between the fingers; in children, they appear on the knees.

flat papilloma

They are caused by human papillomavirus types 3 and 10 and are the same color as the skin, making them least noticeable.But in addition to the appearance of tumors, flat papillomas are also characterized by itching, skin congestion (redness), and pain.

plantar papilloma

At the beginning of development, a plantar papilloma looks like a white, shiny spot.It then "rises" to a level just above the skin's surface.Multiple mosaic tumors may appear around the main papilloma.The tumor complicated the patient's life - he had difficulty walking and finding comfortable shoes was almost impossible.

filiform papilloma

This type of tumor is characteristic of women over 50; they first appear as small, yellowish bumps.Over time, these bumps will grow in size and turn into clusters of large "threads."

genital warts

The formations have an appearance similar to cauliflower or cockscombs.Most commonly, genital warts are located on the foreskin, glans penis, near the urethra, around the anus, labia minora, vaginal mucosa, cervix, corners of the mouth, and urethral opening.

Bowen's disease

It looks like a single structure just in the upper layers of the epidermis (usually on the head).Lesions 5 to 50 mm look like growths in the stratum corneum of the skin, sometimes covered with scabs.Caused by HPV type 16.These structures are susceptible to degeneration into squamous cell carcinoma.

structure of oropharynx

Papillomatosis that blooms in the mouth also looks like cauliflower: white patches on the oral mucosa.Occurs in older adults.Laryngeal papillomatosis can descend into the trachea, bronchi, and lung tissue and is more common in children and adults.Symptoms of laryngeal papillomatosis are dysphonia (speech disorder) and aphonia (inability to speak), hoarseness, and difficulty breathing.When HPV infects the oropharynx, cancer may occur.

male human papillomavirus

Men infected with human papillomavirus may not have any symptoms.It is also noteworthy that among the main risk groups, men who frequently change sexual partners engage in unprotected sex.

Pathological structures are located at:

• on the head and shaft of the penis;
• on the skin of the scrotum;
• in the perineal area;
• on mucous membranes.

Such viruses in men may be highly carcinogenic.This can lead to cancer of the reproductive organs.However, if you start treatment on time, the risk of cancer-causing diseases is minimized.Warts caused by the HPV virus can be removed surgically or with a special chemical solution.At the same time, antiviral drugs are prescribed.Therefore, in the early stages of such diseases in men, they can be completely eliminated.

female human papillomavirus

As already mentioned, women aged 20-45 are most susceptible to the virus.But it is worth noting here that the main risk groups are those who frequently change sexual partners and have unprotected sex.

Such infections in women are divided into the following groups:

• Highly carcinogenic;
• Low carcinogenicity;
• Non-carcinogenic.

The most dangerous infections for women's health are highly cancer-causing infections.It almost always leads to neoplastic diseases - malignant tumors, cervical cancer.The risk of developing such lesions is 90%.This is further aggravated by the fact that the disease does not show symptoms during the first stages of its development.Sometimes, small warts appear on the palms of the hands and soles of the feet.

Genital warts form due to a highly carcinogenic infection.These structures resemble warts but have jagged edges.This structure can appear in the vagina, anus, and perineum.Sometimes genital warts take the form of bubbles of fluid that burst over time and emit an unpleasant odor.

High-type HPV infection can also cause vaginal cancer and vulvar cancer.In rarer clinical cases, nasopharyngeal carcinoma is possible.It is important to note that complete cure of highly carcinogenic HPV is nearly impossible.

Risks of Human Papillomavirus Infection

The peculiarity of the papillomavirus is that it settles in the skin or in the mucous membranes of various organs: reproductive organs (male and female), esophagus, bronchi, mouth, rectum.It can also be located in the conjunctiva of the eye.

Each virus strain has its own “favorite” niche.Therefore, the most dangerous types 16 and 18 are "directed" to the genitals immediately after ingestion, while the less carcinogenic types 6 and 11 infect the vulva and perineal areas, causing genital warts to appear there.If a child is born naturally to a mother with genital warts, these same strains may cause respiratory papillomatosis in the child.

After infection, symptoms of the disease do not always appear.Instead, the disease usually occurs unnoticed and does not lead to serious consequences.

The most dangerous complications of human papillomavirus infection are:

1. Cervical cancer.This disease occurs in women due to infection with human papillomavirus types 16 or 18.It has been shown that this disease does not occur in the absence of papillomavirus.If earlier they were talking about cervical cancer developing from erosion or ectropion, now this has been modified and denied;
2. Rectal cancer.Unlike the first disease, it may have other causes.
3. Throat cancer.Also caused by type 16 virus;
4. Lung cancer can occur when infected with types 16, 18, 11, 2, 6, and 30;
5. Respiratory failure, which occurs with the growth of malignant papillomas of the respiratory tract (larynx, trachea);
6. Contact bleeding from genital warts.If they develop on the external genitalia, perineum, or vagina, they are sexually caused.In other areas (nose, mouth), mechanical trauma with other objects may cause bleeding.

According to official sources, nearly half a million (470,000) new cases of cervical cancer caused by this virus are registered around the world every year.233,000 women die from this disease every year.This makes this cancer the second most frequent of all gynecological cancer pathologies (breast cancer ranks first) and the fifth most common cause of death in women.Most commonly, women under the age of 40 die from cervical cancer.

HPV and pregnancy

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

If human papillomavirus infection is detected during pregnancy:

• The first thing is to find a good gynecologist who will observe you until delivery.
• The most important thing is how women behave after infection. The doctor's strategy depends on this.
• The virus has no effect on the fetus!
• Warts and papillomas can be removed after delivery,
• minimal medications during pregnancy (only as needed),
• During childbirth, the baby may become infected as it passes through the birth canal.
• If a pregnant woman has significant changes in her cervix, they may offer a caesarean section.
• In the absence of manifestations - natural birth.

In general, cesarean sections for HPV infection are rarely performed.Manifestations of infection in children are also extremely rare or insignificant.

diagnosis

In recent years, medicine has made significant progress in diagnosing PVI.This is possible thanks to the systematization of data on HPV and its associated diseases, the study of all existing infection routes, the pathogenesis of the infection process and the many mechanisms of immune system status and possible morphological changes.

There are several ways to diagnose human papillomavirus infection, and in this case, experts follow a generally accepted algorithm:

• Sexually active women and men need to get tested for HPV.
• People living with HIV and those with symptoms of sexually transmitted diseases should also be screened.
• People with proven risk factors for PVI.
• Patients with apical papillomas in the oral and anogenital areas.
• Patients with various cervical lesions.
• Couples planning pregnancy.

Basic diagnostic methods for PVI:

1. Visually inspect the lesions.
2. Use a magnifying glass and colposcope.
3. Cytological research methods.
4. Molecular biology techniques.
5. Histological (pathomorphological) examination.

All patients investigated for the presence of PVI underwent concurrent testing for syphilis, hepatitis, and HIV, bacterioscopy with smears of urethral, vaginal, and cervical secretions, and PCR and bacteriological testing for the presence of genitourinary tract infection.

Usually, detection of papillomavirus does not cause difficulties: a gynecologist or dermatologist detects the infection during a standard examination.If appropriate symptoms are present, a targeted biopsy is performed.When a patient is diagnosed with flat condylomata localized to the anogenital area, detection of human papillomavirus serotypes using oncogenic markers is required in order to prevent the development of malignant disease.

How is human papillomavirus treated?

Currently, no cure has been developed for human papillomavirus infection in men or women.All existing options are designed to inactivate pathogens and enhance antiviral immunity; use minimally invasive methods to remove warts, genital warts and dysplasia.Surgical resection, conization, and cervixectomy are performed rarely and mainly in cases of reasonable suspicion of neoplastic pathology.

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

• If malignancy is suspected, surgical treatment is performed.It is used infrequently because severe bleeding may occur when warts are removed.During this procedure, the excised wart is sent for biopsy and the wound is sutured.
• Curettage is the removal of warts using a curette, i.e. curettage.After this, electrocoagulation is performed and a dry bandage is placed on the wound.
• Electrosurgery is used to remove small warts.But even in this case, relapse is possible.This method can also be used on large warts, but they must be soaked before starting or the electrodes must be inserted through the thickness of the wart, so the separation between the cells becomes less firm.
• Cryodestruction was performed using liquid nitrogen.
• Laser surgery currently dominates surgical treatment, that is, in addition to destruction, hemostasis is performed in parallel.In addition to vaporizing warts, laser also has a direct toxic effect on HPV, so this treatment method ranks first among the treatment options for cervical intraepithelial neoplasia and also dominates the treatment of genital warts in pregnant women (even in the final stage of development).

Cytostatic drugs and chemicals with cauterizing effects are also used.

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

Combination therapy includes a combination of the above approaches.

Top 10 misconceptions about human papillomavirus

There are enough misconceptions about HPV.We want to talk about the most common of them.So, what do people think about papillomavirus:

1. There is no reliable data on whether getting the HPV vaccine helps, so you don't have to get it.A: Yes, it is true that there are over 100 types of papillomaviruses, and it is true that there is no data to suggest that vaccines protect against all of them.However, vaccination can protect you against the most aggressive strains for 5 years.The vast majority of people who get vaccinated don't experience any side effects from the vaccine, so we think it's best to get vaccinated.
2. If you have genital warts, they can lead to cervical cancer.A: I wonder how many sleepless nights this myth has caused.In fact, things are not entirely so doom and gloom.Warts and cervical cancer are both caused by the human papillomavirus.But with a completely different strain.Therefore, genital problems may not be related to cancer.
3. Having a smear test is more effective than getting the HPV vaccine.Answer: A smear test is a screening test that checks for the presence of mutated, precancerous cells on the cervix.Vaccination is precisely to ensure that antibodies are formed in the body to protect cells from mutating when the virus enters.Therefore, it is better not to skimp on vaccinations than to wait until the cells start to turn 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 65 years or older.Regular screening is extremely important because HPV can reappear after lying dormant for many years.Analysis is recommended every three years for women ages 21 to 29 and every 3-5 years for women ages 30 to 65.
5. If there are no genital warts but the smear shows a virus, then I have cervical cancer.Answer: Do not rush to conclusions. Viruses can stay in the body for a long time, but this does not mean precancerous changes. The presence of these viruses in tests indicates an increase in their number, which occurs due to a decrease in the body's overall immunity. Therefore, based on the results of this analysis, your main concern should be the status of immunity, preferably with treatments aimed at maintaining immunity.
6. All papillomaviruses can cause cancer.Answer: Many types of HPV do not cause problems.HPV infections usually resolve on their own within a few months of infection without any intervention, with about 90% of infections resolving within 2 years.Only a small percentage of certain types of HPV infections persist and develop into cancer.
7. If you always use condoms, you won't get papillomavirus.Answer: Condoms do reduce the likelihood of contracting HPV and sexually transmitted diseases.However, protected sex is not a 100% guarantee, as papillomavirus is transmitted through any contact with mucous membranes.HPV can also be spread through contact and using the same toilets and hygiene products.If papillomas are located on the mucous membrane of the lips, the papilloma virus can be transmitted through kissing.All of the above does not eliminate the need to use condoms.
8. HPV is completely curable.A: It’s not the virus itself that can be treated, but the disease it causes.You can remove genital warts, you can remove warts, you can even cure cervical precancerous lesions.But unfortunately, the virus itself still exists in the human body.
9. Once you become infected with HPV, it can come back again and again.Truth: It's completely unnecessary.Yes, your doctor will most likely see the presence of the strain on a smear.But if you have a healthy lifestyle, eat right and therefore have good immunity, the virus will not show itself.not at all!
10. In a relationship, an HPV diagnosis means one partner is cheating on the other.Answer: It is this misunderstanding that leads many people to draw tragically incorrect conclusions and causes many couples to break up because they fail to take into account one of the most mysterious aspects of genital HPV - the ability of the virus to remain latent.Even if you and your husband have been together since school, an HPV diagnosis only means that one of you has been infected with the human papillomavirus at some point in your lives.

prevention

There are three main ways to prevent HPV:

1. Primarily, it helps to identify risk factors, prevent the spread of infection, and develop special vaccines;
2. Second, based on examination of the patient, it helps to identify the disease at its earliest stages;
3. Level 3, which is based on preventing recurrence in individuals treated for this infection.

At the state level, some preventive measures are also being taken to prevent the spread of HPV.This comes amid a desire to improve people's well-being, restricting videos and advertising based on implicit propaganda of promiscuity and launching programs to support young families.

At the medical level, preventive measures are based on health and education efforts among the population to familiarize them with the transmission routes of various sexually transmitted infections, their symptoms, treatments and, most importantly, barrier contraceptive methods to prevent infection.

Personal precautions include the following:

• reject promiscuity;
• Although it has been established that HPV can also be transmitted through close skin-to-skin contact, the use of condoms during sexual intercourse is mandatory;
• See your doctor for regular check-ups;
• Maintain a healthy lifestyle and be active;
• Treat discovered reproductive system diseases promptly.

Today, 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.Recommended for women and men ages 9-17; women under 26 are also allowed to receive the shot for preventive purposes.