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human papillomavirus

papillomas on the hand

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

The virus affects the skin and mucous membranes: various warts, papillomas and condylomas form on them.The human papillomavirus lives in human blood and does not manifest itself until a certain time.But as soon 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?

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 looks like a small nipple.The size of papillomas can be one to two cm.Places of appearance: oral cavity, nose, pharynx, vocal cords;It can form in 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 of types 3 and 10, and genital warts are caused by viruses of types 6 and 11. Some types of viruses (16, 18, 31, 33, 35) cause cervical dysplasia or a favorable background for the development of neck canceruterine.The human papillomavirus is transmitted by contact and domestic routes, remaining on the skin and mucous membranes.

The 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 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 carrier of the virus, that is, HPV is transmitted only from person to person.

There are three known ways to transmit this infection:

  • contact and home (through touch);
  • sexual (genital, anal, oral-genital);
  • in mother-to-child 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 differently, causing a person to develop benign or malignant tumors.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;
  • people who are too sexually active;
  • 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 must undergo examination for papillomatosis.It is also recommended to take the test for those people who are in favor of free sexual relations, have many sexual partners or change them frequently.Even an unprotected act can cause infection, so experts advise following preventive measures against this disease.

HPV 3D model

Human papillomavirus: incubation period

Normally, 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 manifestations.

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.

The clinical symptoms of human papillomavirus are quite variable: 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 these skin growths: they serve as the basis for HPV classification.

simple papillomas

Its growth is caused by the 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.Most often, these growths are not isolated, but rather represent a localized "fused" zone.Simple papillomas (also called vulgar) can be located on the palms and between the fingers;In children they are detected in the knees.

simple papillomas on the arm

Flat papillomas

Caused by human papillomavirus types 3 and 10, they are identical in color to the skin and, 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 shiny, whitish spot.Then it "rises" slightly above the level of the skin surface.Multiple mosaic neoplasms may appear around the main papilloma.These neoplasms complicate the patient's life: it is difficult for him to walk and it is almost impossible to find comfortable shoes.

plantar papillomas on the foot

Filiform papillomas

This type of neoplasia in question is characteristic of women over 50 years of age;They first appear in the form of small bumps of a yellowish tint.Over time, these bumps grow and become a group of numerous "threads."

Condylomata acuminata

The appearance of the formations resembles cauliflower or cockscomb.Most often, condylomas are found on the foreskin, the head of the penis, near the urethra, around the anus, on the labia minora, on the vaginal mucosa, the cervix, in the corners of the mouth and in 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).A 5 to 50 mm lesion looks like a growing stratum corneum of the skin, sometimes covered with scabs.Caused by HPV type 16. The formations are prone to degenerate into squamous cell carcinoma.

Formations in the oropharynx.

Flourishing papillomatosis in the oral cavity also resembles cauliflower - white plaques on the oral mucosa.It occurs in older people.Laryngeal papillomatosis can descend into 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.

papillomas 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 located in the following places:

  • on the head and shaft of the penis;
  • on the skin of the scrotum;
  • in the perineum area;
  • in the mucous membrane.

Such a 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 special chemical solutions.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 between 20 and 45 years old are the most susceptible to the virus.But here it is worth noting the fact 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 the 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 aggravated by the fact that in the early stages of development the disease has no symptoms.Occasionally small warts may appear on the palms and soles.

With a highly oncogenic type of infection, condylomas are formed.They are formations similar to warts, but with jagged edges.These formations can appear in the vagina, anus and perineum.Sometimes condylomas can take the form of bubbles with fluid, 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, nasopharyngeal cancer may occur.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 on the skin or mucous membrane of various organs: reproductive (both male and female), esophagus, bronchi, oral cavity and rectum.It can also be located in the conjunctiva of the eyes.

Each strain of the virus has its own "favorite" location.Thus, the most dangerous types 16 and 18, when ingested, immediately "go" to the genitals, and the low-oncogenic viruses 6 and 11 infect the area of the vulva and perineum, causing the development of genital warts there.These same strains can cause papillomatosis in a child's respiratory tract if born naturally to a mother with genital warts.

After infection, a disease with pronounced symptoms does not always develop.On the contrary, the disease usually goes unnoticed and does not have 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 papillomavirus.And if before there was talk of the development of cervical carcinoma due to erosion or ectropion, now this has been reviewed and denied;
  2. Rectal carcinoma.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 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 due to condylomas.If they are on the external genitalia, perineum, or vagina, then they are caused by sex.In other places (in the nose, mouth), bleeding can be caused by mechanically damaging 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 every year from this disease.This places this cancer in 2nd place in frequency among all oncological pathologies in gynecology (first place in breast cancer) and in 5th place among all causes of mortality in women.Most often, women under 40 years of age die from cervical carcinoma.

papillomas all over the body

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 is to find a good gynecologist and be observed by him until delivery.
  • 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 as needed) during pregnancy,
  • During childbirth, the child can become infected while passing through the birth canal,
  • if there are pronounced changes in the cervix of the pregnant woman, she may be offered a cesarean section,
  • in the absence of manifestations - natural childbirth.

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

Diagnosis

In recent years, medicine has made significant advances in the diagnosis of PVI.This was possible thanks to the systematization of data on HPV and the diseases associated with it, the study of all existing routes of infection, many mechanisms of 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 get tested for HPV.
  • HIV-infected patients 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 suffering from various pathologies of the cervix.
  • Couples planning a pregnancy.

Basic diagnostic methods of PVI:

  1. Visual inspection of injuries.
  2. Using 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, smears are taken for bacterioscopic examination of discharge from the urethra, vagina and cervix, and PCR and bacteriological examination are prescribed for the presence of urogenital infections.

As a rule, the detection of papillomavirus does not cause difficulties: the infection is detected during standard examinations carried out by a gynecologist or dermatologist.If appropriate symptoms occur, a targeted biopsy is performed.In the event that a patient is diagnosed with flat condylomas located in the anogenital region, to prevent the development of malignant diseases, testing for human papillomavirus serotypes with an oncogenic marker is performed.

How to treat human papillomavirus?

At the moment, 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, condylomas and dysplasia are removed using minimally invasive methods.Surgical excision, conization and removal of the cervix are rarely performed and mainly 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 as often because when a wart is removed, severe bleeding can occur.During this manipulation, the removed wart is sent for a biopsy and the wound is sutured.
  • Curettage is the removal of a wart by curettage, that is, by curettage.After this, electrocoagulation is performed and a dry bandage is placed over the wound.
  • Electrosurgery is used to remove small warts.But even in this case, relapses are possible.This method can also be used for large warts, but before starting they must be soaked or an electrode must be 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, 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, which is why this treatment method takes the first place in the choice of treatment for cervical intraepithelial neoplasia and is also dominant in the treatment of genital warts in pregnant women (even in the later stages of development).

Cytostatic drugs and chemicals with a cauterizing effect are also used.

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

Combination treatments include 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 ones.So what do people say about papillomaviruses?

  1. There is no reliable data on whether the HPV vaccine helps, so vaccination is not necessary.Answer: Yes, in fact, there are over 100 papillomaviruses and there is really no data that the vaccine protects against all of them.However, vaccination will protect you from the most 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 best to get vaccinated anyway.
  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 fact, things are not so bleak.Both warts and cervical cancer are caused by the human papillomavirus.But with completely different strains.Therefore, genital problems may have nothing to do with cancer.
  3. It is more effective to have a smear test than to receive the HPV vaccine.Answer: A smear test is a screening test to see if you have mutated precancerous cells in the cervix.And vaccination is aimed precisely at ensuring that antibodies form in the body, protecting cells from mutation when the virus enters.Therefore, it is definitely better not to skimp on vaccines 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 cases of cervical cancer and 41% of all deaths from cervical cancer occur in women age 65 and older.Regular screening is extremely important because HPV can reappear after years of being silent.It is advisable to perform the analysis every three years for women between 21 and 29 years old, and every 3-5 years between 30 and 65 years old.
  5. If there are no condylomas, but the smear reveals viruses, then I have cervical cancer." Answer: do not rush to 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 the tests indicates that their number has increased, and this is due to a decrease in the general immunity of the body. Therefore, the main thing that should be paid attention to based on the result of this analysis is the state of immunity, and it is better to conduct atreatment intended to maintain it.
  6. All papillomaviruses cause cancer.Answer: Many types of HPV do not cause problems.HPV infections generally disappear on their own, without any intervention, within a few months of being acquired, and about 90% resolve within 2 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 contract the papillomavirus.Answer: A condom certainly reduces the chance of contracting HPV and sexually transmitted diseases.However, protected sex is not a 100% guarantee, since the papillomavirus is transmitted through any mucosal contact.HPV can also be transmitted through contact, using the same toiletries and hygiene items.If papillomas are located on the mucous membrane of the lips, then transmission of the papillomavirus through a kiss 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 diseases it caused.It can get rid of genital warts, it can eliminate them, and it can even cure a precancerous condition of the cervix.But, unfortunately, the virus itself remains in the human body.
  9. Once you get HPV, it will come back again and again.Truth: Not at all necessary.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.You are welcome!
  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 has 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 an HPV infection at some point in your life.

Prevention

HPV prevention is based on the following three methods:

  1. Primary, which helps to identify risk factors, prevent the spread of infections, as well as the development of special vaccines;
  2. Secondary, which is based on the examination of the patient, helping to identify the disease at the initial stage;
  3. Tertiary, which is based on preventing the development of relapses in individuals treated for this infection.

At the state level, a number of preventive measures are also being taken to prevent the spread of HPV.This is the desire to improve the well-being of the population, limiting videos and advertising, which are based on hidden propaganda of promiscuity, and introducing support programs for young families.

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

Individual preventive measures include the following:

  • rejection of promiscuous sexual relations;
  • mandatory use of condoms during sexual relations, although it has been 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;
  • quickly treat identified diseases of the reproductive system.

Today, 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 living.It is recommended to prescribe them to both women and men between 9 and 17 years old;Its administration is also allowed for preventive purposes to women under 26 years of age.