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Human papillomavirus

Papilloma on the hand

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 or another type of HPV.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 until a certain time.But once the immune system is weakened, tumors appear on the skin and/or mucous membranes.This explains the relatively long incubation period: from several weeks to decades.

What is that?

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 viruses.

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

Depending on the type of virus, the disease also differs: 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 cervical dysplasia or a favorable background of cervical cancer.Human papillomavirus is transmitted through contact and household routes, 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 (especially 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, ie HPV is only transmitted from person to person.

There are three known ways to transmit this infection:

  • relationships and households (through touch);
  • sexual (genital, anal, oral-genital);
  • during 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 a person to develop benign or malignant tumors.Also, human papilloma is a virus that can affect the skin and mucous membranes, or may not detect itself at all until the immunity of the carrier of the infection is reduced.

According to world statistics, the likelihood 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;
  • representatives of men or women suffering from sexually transmitted diseases;
  • people who are too sexually active;
  • people with immune system disorders;
  • sexual partners of people who are found to be carriers of HPV or have an active form of this disease;
  • women with various cervical diseases.

All representatives of this category must undergo an examination to detect papillomatosis.It is also recommended to get tested for those who are sexually promiscuous, have many sexual partners or change them frequently.Even an act without protection can cause infection, so experts advise you to follow preventive measures for this disease.

3D model of HPV

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 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 manifestation.

In most cases (up to 90%), self-healing occurs within 6-12 months, in other cases there is a long-term chronic recurrent 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 almost absent, and many are indicated 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 HPV classification.

Simple papilloma

Their growth is provoked by human papillomavirus type 2;the growth itself is distinguished by its roughness, the presence of a keratin layer and its size from 1 mm or more.Often, such growths are not isolated, but represent local "merged" zones.Simple papilloma (also called vulgar) can be located on the palms and between the fingers;in children they are detected on the knees.

simple papilloma on the arm

Flat papilloma

Caused by human papillomavirus types 3 and 10, it has the same color as the skin and is therefore less noticeable.But in addition to the appearance of a neoplasm, flat papilloma is characterized by itching, hyperemia (redness) of the skin and pain.

Plantar papilloma

At the beginning of its development, plantar papilloma looks like whitish and shiny spots.Then it "rises" slightly above the surface of the skin.Various mosaic neoplasms may appear around the primary papilloma.Such a neoplasm complicates the patient's life - it is difficult for him to walk, and it is almost impossible to find comfortable shoes.

plantar papilloma on the feet

Filiform papilloma

The type of neoplasm in question is characteristic of women over 50 years old;they first appear in the form of small yellowish lumps.Over time, this lump grows and it turns into a bunch of "threads".

Condyloma acuminata

The appearance of the formation resembles a cauliflower or a nest.Most often, condylomas are located on the foreskin, head of the penis, near the urethra, around the anus, on the labia minora, on the vaginal mucosa, cervix, at the corner of the mouth, at the mouth of the urethra.

genital warts on the body

Bowen's disease

It looks like a single formation exclusively in the upper layer of the epidermis (usually on the head).Lesions from 5 to 50 mm look like a growing stratum corneum of the skin, sometimes covered with a crust.Caused by HPV type 16. Formation prone to degeneration into squamous cell carcinoma.

Formation in the oropharynx

Papillomatosis that blooms in the oral cavity also looks like cauliflower: white plaques on the oral mucosa.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.

papilloma in the throat

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 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.

This type of virus in men 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 a special chemical solution.At the same time, antiviral drugs are prescribed.Therefore, in the early stages of the development of this type of disease in men, it can be completely eliminated.

Human papillomavirus in women

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

Types of infections in women are divided into the following groups:

  • high oncogenicity;
  • low oncogenicity;
  • non-oncogenic type.

The most dangerous infection for women's health is the highly oncogenic type of infection.Almost always it leads to oncological diseases - malignant tumors, cervical cancer.The risk of developing such a pathology is 90%.This situation is aggravated by the fact that in the first stage of the development of the disease there are no symptoms.Sometimes, small warts may appear on the palms and soles of the feet.

With high oncogenicity type of infection, condyloma is formed.This is a formation similar to a wart, 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 over time burst and emit an unpleasant odor.

High-type HPV infection can also cause vaginal and vulvar cancer.In rarer clinical cases, nasopharyngeal cancer is possible.Keep in mind that it is almost impossible to completely cure highly oncogenic forms of HPV.

The danger of human papillomavirus infection

The characteristics of the papillomatosis virus are such that it settles either in the skin or in the mucous membranes of various organs: reproduction (both men and women), esophagus, bronchi, oral cavity, rectum.It can also be localized in the conjunctiva of the eye.

Each virus strain has its own "favorite" localization.Therefore, the most dangerous types 16 and 18, when swallowed, are immediately "directed" to the genitals, and low oncogenic viruses 6 and 11 infect the vulva and perineum area, causing the development of genital warts there.This same strain can cause papillomatosis in the respiratory tract of a child if he is born naturally of a mother with genital warts.

After infection, the disease with clear symptoms does not always develop.On the other hand, this 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 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 before they talked about the development of cervical carcinoma from erosion or ectropion, now this has been checked and denied;
  2. Rectal carcinoma.It, unlike the first disease, may 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 provoked by sex.In other locations (in the nose, mouth), bleeding can be provoked 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 registered worldwide.233 thousand women die from this disease every year.This puts this cancer in 2nd place in frequency among all cancer pathologies in gynecology (1st place in breast cancer) and in 5th place among all causes of death in women.Most often, women under the age of 40 die from cervical carcinoma.

papillomas all over the body

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 and be observed by him until birth,
  • the most important thing is the manifestation of the infection that the woman has, the doctor's tactics will depend on this,
  • The virus does not affect the fetus!
  • warts and papillomas can be removed after childbirth,
  • minimal medication (only as needed) during pregnancy,
  • during childbirth, the child can be infected while passing through the birth canal,
  • if there are significant changes in the cervix of a pregnant woman, they can offer a caesarean section,
  • if there is no manifestation - natural birth.

In general, cesarean sections for HPV infection are rarely performed.And subsequent manifestations of infection in children are also very rare or insignificant.

Diagnostics

In recent years, medicine has made significant progress in diagnosing PVI.This became possible thanks to the systematization of data on HPV and related diseases, the study of all existing infection routes, the 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 the generally accepted algorithm:

  • Sexually active women and men are required to 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 pointed papillomas in the oral cavity and anogenital area.
  • Patients with various cervical pathologies.
  • Couples planning pregnancy.

Basic diagnostic methods of PVI:

  1. Visual inspection of lesions.
  2. Using a magnifying glass and colposcope.
  3. Cytological research methods.
  4. Molecular biology techniques.
  5. Histological examination (pathomorphology).

All patients examined for the presence of PVI are simultaneously tested for syphilis, hepatitis and HIV, smears are taken for bacterioscopic examination of urethral, vaginal and cervical discharge, and PCR and bacteriological examinations are prescribed for the presence of urogenital infections.

As a rule, papillomavirus detection does not cause difficulties: the infection is detected during a standard examination by a gynecologist or dermatologist.If appropriate symptoms occur, a targeted biopsy is performed.In the case when the patient is diagnosed with a flat condyloma localized in the anogenital region, to prevent the development of a malignant disease, a human papillomavirus serotype test with oncogenic markers is carried out.

How to treat human papillomavirus?

Currently, methods for the radical treatment of human papillomavirus infection in men or women have not been developed.All existing schemes aim to inactivate pathogens and strengthen antiviral immunity;Warts, condylomas and dysplasia are removed using minimally invasive methods.Surgical removal, conization and removal of the cervix are rarely practiced and especially in cases of reasonable 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 when the wart is removed, severe bleeding may occur.During this manipulation, the cut wart is sent for biopsy, and the wound is sutured.
  • Curettage is the removal of warts using a curette, i.e. by 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 for large warts, but before starting it must be soaked or the electrode must be inserted into the thickness of the wart, so the separation between cells becomes less strong.
  • Cryodestruction is done with liquid nitrogen.
  • Laser surgery now occupies a leading position in surgical treatment, that is, in addition to destruction, hemostasis is carried out in parallel.In addition to the fact that the laser vaporizes warts, it also has a direct toxic effect on HPV, so this treatment method is in first place in the treatment options for 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 a cauterizing effect are also used.

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

Combined treatment includes a combination of the above methods.

many papillomas on the hands

TOP 10 myths about 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 papillomavirus:

  1. There is no reliable data on whether vaccination against HPV helps, so you should not get vaccinated.Answer: Yes, indeed, there are more than 100 papillomaviruses, and there is actually no data that the vaccine will protect against all of them.However, vaccination will protect you against the most aggressive strains for 5 years.Most recipients do not experience any side effects from the vaccine, so, in our opinion, it is better to continue getting the vaccine.
  2. If you have genital warts, this will lead to cervical cancer.Answer: It is unknown how many sleepless nights this myth has caused.Actually, the situation is not entirely bleak.Both warts and cervical cancer are caused by the human papillomavirus.But with a completely different strain.So genital problems may have nothing to do with cancer.
  3. It is more effective to get a smear test than to get the HPV vaccine.Answer: A smear test is a screening test to see if you have mutated, precancerous cells on your cervix.And vaccination aims to ensure that antibodies are formed in the body, protecting cells from mutation when the virus enters.Therefore, it is better not to skimp on the vaccine 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 all cervical cancer deaths occur in women aged 65 and over.Regular screening is very important because HPV can re-emerge after years of silence.It is recommended to perform an analysis every three years for women aged 21 to 29 years, and every 3-5 years between 30 and 65 years.
  5. If there is no condyloma, but the smear reveals the virus, then I have cervical cancer.”Answer: do not rush to conclusions.Viruses can stay in the human body for a long time, but this does not mean a precancerous condition.The appearance of this virus in the test shows that its number has increased, and this is due to a decrease in the overall immunity of the body.Therefore, the main thing you need to pay attention to based on the results 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 go away on their own, without any intervention, within a few months of infection, and about 90% are cured within 2 years.And only a small percentage of infections with certain types of HPV can persist and develop into cancer.
  7. If you always use a condom, you will not be infected with papillomavirus.Answer: Condoms do reduce the chance of contracting HPV and sexually transmitted diseases.However, protected sex is not a 100% guarantee, because the papillomavirus is spread through any contact with mucous membranes.HPV can also be transmitted through contact, using the same toilet and hygiene items.If the papilloma is located on the mucous membrane of the lips, then the transmission of the papillomavirus through kissing is possible.All of the above does not eliminate the need to use condoms.
  8. HPV can be completely cured.Answer: It is not the virus itself that can be treated, but the disease it causes.You can get rid of genital warts, you can remove warts, you can even cure cervical precancerous conditions.But the virus itself, unfortunately, remains in the human body.
  9. Once you get HPV, it will come back again and again.Truth: Not necessary at all.Yes, the doctor will most likely notice the presence of tension on the smear.But if you live a healthy lifestyle, eat right and, as a result, have good immunity, the virus will not manifest itself.Not at all!
  10. In a relationship, an HPV diagnosis means one partner has cheated on the other.Answer: It is this myth that leads many people to tragically wrong conclusions and causes many couples to break up because they do not 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 man have been together since school, an HPV diagnosis only means that one of you has contracted the human papillomavirus infection at some point in your life.

Prevention

HPV prevention is based on the following three methods:

  1. Primers, which help to identify risk factors, prevent the spread of infection, as well as the development of special vaccines;
  2. Secondary, which is based on the examination of the patient, helps to identify the disease at an early stage;
  3. Tertiary, which is based on preventing the development of relapse in individuals treated for this infection.

At the state level, several preventive measures are also being taken to prevent HPV transmission.This is the desire to improve the well-being of the population, limit videos and advertising, which are based on hidden propaganda about promiscuity, and introduce programs to support young families.

At the medical level, preventive measures are based on carrying out hygiene work and education among the population by familiarizing them with the transmission routes of various sexual infections, their symptoms, treatment methods and, most importantly, contraceptive methods that prevent their infection.

Individual preventive measures include the following:

  • rejection 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;
  • visit the doctor regularly for check-ups;
  • maintaining a healthy lifestyle, active sports;
  • immediately treat diseases of the reproductive system that are identified.

Currently, 2 types of vaccines have been created and introduced into medical practice.These drugs are completely harmless to humans, because the virus contained in them is not alive.It is recommended to prescribe it to women and men aged 9-17 years;it is also allowed to be administered for preventive purposes to women under the age of 26.