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Human papilloma virus

papillomas of 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 of HPV or another.There are currently more than 70 varieties of the human papillomavirus.

The virus affects the skin and mucous membranes: various warts, papillomas and condylomas form on them.The human papilloma virus lives in the human blood and does not manifest itself until a certain time.But as soon as the immune system weakens, formations 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 mucous membrane lesions.Modern medicine has identified more than a hundred types of virus.

A papilloma is a tumor, considered benign, that grows on the surface of the skin and looks like a small pimple.The size of the papillomas can be from one to two centimeters.Places of appearance: oral cavity, nose, pharynx, vocal cords;it can form on 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 types 6 and 11. Some types of viruses (16, 18, 31, 33, 35) cause cervical dysplasia or a favorable background for the development of uterine cancerneck.The human papillomavirus is transmitted by contact and household route, remaining in the skin and mucous membranes.

Human papilloma virus is divided into two groups -high and low risk.The low-risk group includes virus types (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 a carrier of the virus, that is, HPV is transmitted only from person to person.

Three ways of transmission of this infection are known:

  • contact-bit (by 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, causing a person to develop benign or malignant tumors.Also, human papilloma is a virus that can affect the skin and mucous membranes or 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:

  • women who are pregnant;
  • patients who often suffer from various diseases;
  • persons with non-traditional orientation;
  • male or female representatives suffering from sexually transmitted diseases;
  • people who are too sexually active;
  • people with disorders of the immune system;
  • 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 should undergo an examination to detect papillomatosis.It is also recommended to examine those people who are supporters of free sexual relations, have many sexual partners or often change them.Even an unprotected act can cause an infection, so experts advise to follow preventive measures for this disease.

3D model of HPV

Human papillomavirus: incubation period

Usually, when infected with the 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 a possible malignancy of the process (depending on the type of virus).

Classification and symptoms of HPV

The clinical symptoms of the human papilloma virus are quite 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 provoked by human papillomavirus type 2;the growths themselves are distinguished by their roughness, the presence of a keratinized layer and a size of 1 mm or more.Very often, such growths are not isolated, but represent a localized "fused" area.Simple (also called vulgar) papillomas can be located on the palms and between the fingers;in children they are found on the knees.

simple papillomas of the hand

Flat papillomas

Caused by human papillomavirus types 3 and 10, they are identical in color to the skin and are therefore the least 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 very beginning of their development, plantar papillomas look like a whitish shiny spot.Then it "rises" slightly above the level of the skin's surface.Multiple mosaic neoplasms can appear around the primary papilloma.Such 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 feet

Filiform papillomas

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

Pointed condylomas

The appearance of the formations resembles a cauliflower or a rooster's comb.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, at the mouth of the urethra.

genital warts on the body

Bowen's disease

It appears as a single formation exclusively in the upper layer of the epidermis (usually on the head).A 5 to 50 mm lesion appears as a growing stratum corneum of the skin, sometimes crusted over.It is caused by HPV type 16. 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.It occurs in elderly 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), hoarse voice 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 localized in the following places:

  • on the head and body of the penis;
  • on the skin of the scrotum;
  • in the perineal area;
  • on the mucous membrane.

A virus of this type 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 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.

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 leads to an oncological disease - a malignant tumor, cervical cancer.The risk of developing such a pathology is 90%.The situation is aggravated even more by the fact that in the first stages of development the disease shows no symptoms.Sometimes small warts may appear on the palms and soles of the feet.

In a type of infection with high oncogenicity, condylomas are formed.These are formations similar to warts, but with jagged edges.Such formations can appear in the vagina, anus and perineum.Sometimes condylomas can be in the form of bubbles with liquid, which over time burst and emit an unpleasant odor.

A high type of HPV infection can also cause cancer of the vagina and vulva.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 danger of infection with human papillomavirus

The properties of the papillomatosis virus are such that it settles either in the skin or in the mucous membrane of various organs: reproductive (both male and female), esophagus, bronchi, oral cavity, 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, are immediately "directed" to the genitals, and the low-oncogenic viruses 6 and 11 infect the vulva and the perineum area, causing the development of genital warts there.These same strains can cause papillomatosis in the respiratory tract of a child 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 most often goes unnoticed and does not lead to serious consequences.

The most dangerous complications of human papilloma virus infection are:

  1. Cervical cancer.Appears 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 earlier they talked about the development of carcinoma of the cervix from erosion or ectropion, now this has been revised and denied;
  2. Rectal carcinoma.It, unlike the first disease, 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 from condylomas.If they are on the external genitalia, perineum or in the vagina, then they are provoked by intercourse.In other places (in the nose, mouth) bleeding can be provoked by mechanical injury 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 in the world.233 thousand women die from this disease every year.This puts this cancer in 2nd place in frequency among all cancer pathologies in gynecology (first place in breast cancer) and in 5th place among all causes of mortality in women.Women under the age of 40 die most often from cervical cancer.

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 a human papillomavirus infection is detected during pregnancy:

  • the first thing is to find a good gynecologist and be monitored 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 medication (only if necessary) during pregnancy,
  • during birth, the child can become infected while passing through the birth canal,
  • if there are pronounced changes in the cervix of a pregnant woman, they may suggest a cesarean section,
  • in the absence of manifestations - natural birth.

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

Diagnosis

In recent years, medicine has made significant progress in the diagnosis of PVI.This became possible thanks to the systematization of data on HPV and related 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, and in this case experts adhere to generally accepted algorithms:

  • Sexually active women and men should be screened for HPV.
  • HIV-infected patients and those with STD symptoms 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 pregnancy.

Main diagnostic methods of PVI:

  1. Visual inspection of lesions.
  2. Using a magnifying glass and a colposcope.
  3. Cytological research methods.
  4. Molecular biological techniques.
  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 discharge from the urethra, vagina and cervix, and PCR and bacteriological examination for the presence of urogenital infections are prescribed.

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

How to treat human papilloma virus?

Currently, 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 dysplasias are removed with minimally invasive methods.Surgical excision, conization and removal of the cervix are practiced rarely and mainly in case of reasonable suspicion of oncological pathology.

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

  • In case of suspected malignancy, surgical treatment is performed.It is not used so often, because heavy bleeding can occur when removing a wart.During this manipulation, the excised wart is sent for biopsy and the wound is sutured.
  • Curettage is the removal of a wart with a curette, i.e.by curettage.Electrocoagulation is then performed and a dry dressing 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 for large warts, but before starting, they should be soaked or an electrode should be placed in the thickness of the wart so that the separation between the cells becomes less strong.
  • Cryodestruction is performed with liquid nitrogen.
  • Currently, laser surgery occupies a leading position in surgical treatment, i.e., 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, so this method of treatment is in the first place when choosing treatment for cervical intraepithelial neoplasia, and it 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 used only in combination with other methods, as it has no specific effect, but activates only components of the immune system.

Combination treatments include a combination of the above methods.

many papillomas on hands

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 people are saying about papillomaviruses:

  1. There is no reliable data on whether the HPV vaccination helps, so you do not need to get vaccinated.Answer: Yes, there are indeed more than 100 papillomaviruses and there is really no evidence that the vaccine protects against all of them.However, vaccination will protect you from the most aggressive strains for 5 years.The majority of recipients did not have any side effects from the vaccine, so we think it is better to get vaccinated anyway.
  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.So genital problems may have nothing to do with cancer.
  3. It is more effective to get a pap smear than the HPV vaccine.Answer: A Pap smear is a screening test to see if you have mutated, precancerous cells on your cervix.And vaccination aims to ensure the formation of antibodies in the body, protecting cells from mutation when the virus enters.So it's definitely better not to vaccinate than to wait until the cells start to turn malignant.
  4. Older women should not be screened for HPV.Answer: One in four cases of cervical cancer and 41% of all cervical cancer deaths occur in women age 65 or older.Regular screening is extremely important because HPV can reappear after years of silence.It is recommended that the analysis be done every three years for women aged 21 to 29 years and every 3-5 years between 30 and 65 years.
  5. If there are no warts, but the pap 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 a precancerous condition.The appearance of these viruses in the tests shows that their number has increased, and this happens as a result of a decrease in the general immunity of the body.Therefore, the main thing you should pay attention to based on this analysis result 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 acquiring them, and about 90% resolve within 2 years.And only a minority of infections with certain types of HPV can persist and develop into cancer.
  7. If you always use a condom, you won't catch the papillomavirus.Answer: A condom certainly reduces the chance of contracting HPV and STDs.However, protected sex is not a 100% guarantee, since the papillomavirus is transmitted through any contact of mucous membranes.HPV can also be transmitted by touching, using the same toilets and sanitary items.If the papillomas are located on the mucous membrane of the lips, then it is possible to transmit the papillomavirus through a kiss.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 has caused.You can get rid of genital warts, you can remove warts, you can even cure a precancerous condition 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: It's not necessary at all.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. 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 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 ability of the virus to remain latent.Even if you and your significant other have been together since school, an HPV diagnosis only means that one of you has contracted human papillomavirus 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 infection, as well as the development of special vaccines;
  2. Secondary, which is based on an examination of the patient, which helps to identify the disease at the earliest stage;
  3. Tertiary, which is based on preventing the development of relapses in persons 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, limit videos and advertisements that are based on hidden propaganda of promiscuity, and introduce programs to support young families.

At the medical level, preventive measures are based on carrying out sanitary and educational work among the population with familiarization with the ways 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 the following:

  • refusal of indiscriminate sexual contacts;
  • mandatory use of a condom during intercourse, although it has been established that HPV can also be transmitted through close skin contact;
  • periodically visit a doctor for an examination;
  • maintaining a healthy lifestyle, active sports;
  • timely treatment of identified diseases of the reproductive system.

Nowadays, 2 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 both women and men aged 9-17 years;it is also allowed to be applied for preventive purposes to women under 26 years of age.