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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 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 appear until a certain time.But once 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 the virus.

A 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 from one to two cm.Places of occurrence: 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 types 3 and 10, and genital warts are caused by types 6 and 11. Some types of viruses (16, 18, 31, 33, 35) cause the development of the background of the cervix or favorable development of the cervix.Human papillomavirus is transmitted through contact and household routes, remaining on the skin and mucous membranes.

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

There are three known ways of transmission of this infection:

  • contact and family (through 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 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 it may not be detected at all until the immunity of the carrier of the infection decreases.

According to world statistics, the likelihood of developing this disease increases several times in the following categories of citizens:

  • women who are pregnant;
  • patients who often suffer from various diseases;
  • people with non-traditional orientation;
  • male or female representatives who suffered 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 suffering from various cervical diseases.

All representatives of these categories should undergo examination to detect papillomatosis.It is also recommended to do tests for those people who are fans of free sexual relations, have many sexual partners or change them frequently.Even an unprotected action can cause infection, so experts advise to follow preventive measures for this disease.

3D model of HPV

Human papillomavirus: incubation period

Typically, 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 relapse 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 their size from 1 mm or more.Very often, such growths are not isolated, but represent a localized "united" area.Simple papillomas (also called vulgar) can be located on the palms of the hands and between the fingers;in children they are discovered on the knees.

simple papillomas on the arm

Flat papillomas

Caused by human papillomavirus 3 and 10, they are identical in color to the skin and are therefore less visible.But in addition to the appearance of neoplasms, flat papillomas are characterized by itching, hyperemia (redness) of the skin and pain.

Plantar papilloma

At the beginning of their development, plantar papillomas look like a white, shiny spot.Then it "rises" slightly above the level of the skin surface.Multiple mosaic neoplasms may appear around the main 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 papilloma on the foot

Filiform papilloma

This type of neoplasia in question is characteristic of women over 50 years old;they first appear in the form of small lumps with a yellow tint.Over time, these lumps grow and they turn into a group of multiple "threads".

Condylomas acuminata

The appearance of the formations resembles cauliflower or turkey.Most often, condylomas are located on the foreskin, the head of the penis, near the urethra, around the anus, on the labia minora, on the vaginal mucosa, on the cervix, in the corners of the mouth, in 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 lesion from 5 to 50 mm looks like a raised layer of corneum of the skin, sometimes covered with crusts.Caused by HPV type 16. Formations are prone to degenerate into squamous 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.Papillomatosis of the larynx can descend on 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 located in the following places:

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

A virus of this type in men can take the form of high oncogenicity.This leads to 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, 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 more susceptible to the virus.But here it is worth emphasizing 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 an infection of the high oncogenic type.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 does not show symptoms.Occasionally, small warts may appear on the palms and soles.

With 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 take the form of blisters with liquid, which over time burst and emit an unpleasant smell.

High-type 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.

Risk of human papillomavirus infection

The characteristics of the papillomatosis virus are such that it is placed either on the skin or on 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 type of virus has its "preferred" location.Thus, the most dangerous types 16 and 18, when ingested, 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.The same strains can cause papillomatosis in the respiratory tract of a child if he is 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 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 earlier it was talked about the development of cervical carcinoma 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 the type 16 virus;
  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 located in the external genitalia, perineum or vagina, then they are provoked by sex.In other places (nose, mouth), bleeding can be provoked by mechanically damaging them with other objects.

Every year, according to official sources, a little less than 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 second place in frequency among all cancer pathologies in gynecology (first place in breast cancer) and in fifth place among all causes of mortality in women.Most often, women under the age of 40 die from cervical cancer.

papilloma all over the body

HPV and pregnancy

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 observed by him until delivery,
  • the most important thing is what manifestations of the 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 birth,
  • the minimum of drugs (only as needed) during pregnancy,
  • during birth, the child can become infected by passing through the birth canal,
  • if there are significant changes in the cervix of the pregnant woman, she can offer a cesarean section,
  • in the absence of manifestations - natural birth.

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

Diagnosing

In recent years, medicine has made significant progress in the diagnosis of PVI.This was made 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 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 papilloma in the oral cavity and anogenital area.
  • Patients suffering from various cervical pathologies.
  • Couples planning pregnancy.

Basic methods of diagnosing PVI:

  1. Visual inspection of lesions.
  2. Using a magnifying glass and colposcope.
  3. Cytological research methods.
  4. Molecular biological 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, detection of papillomavirus does not cause difficulties: the infection is detected during standard examinations by a gynecologist or dermatologist.If appropriate symptoms appear, a targeted biopsy is performed.In the case when a patient is diagnosed with flat condylomas localized in the anogenital region, to prevent the development of malignant diseases, testing of human papillomavirus serotypes with an oncogenic marker is performed.

How to treat human papillomavirus?

At the moment, methods for the radical treatment of human papillomavirus infection in men or women have not been developed.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 practiced 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, heavy bleeding can occur.During this manipulation, the cut wart is sent for biopsy, and the wound is sutured.
  • Curettage is the removal of a wart using a curettage, i.e.After that, electrocoagulation is performed, and a dry bandage 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 must be soaked or an electrode must be inserted into the thickness of the wart, so the separation between the cells becomes less strong.
  • Cryodestruction is performed with liquid nitrogen.
  • Laser surgery currently 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 toxic effect directly on HPV, so this treatment method is in the first place in the choice of treatment for intraepithelial neoplasia of the cervix, as well as it is 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 treatment method is used only in combination with other methods, as it does not have any specific effect, but only activates components of the immune system.

Combination treatments include a combination of the above methods.

many papillomas on the hands

TOP 10 myths about the 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 papillomaviruses:

  1. There is no reliable data on whether the HPV vaccination helps, so you do not need to get vaccinated.Answer: Yes, indeed, there are more than 100 papillomaviruses and there is really no evidence that the vaccine will protect 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 still best to vaccinate.
  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.In fact, things are not entirely bleak.Both warts and cervical cancer are caused by the human papillomavirus.But with completely different strains.So problems in the genitals may have nothing to do with cancer.
  3. It is more effective to do a smear test than to get the HPV vaccine.Answer: The smear test is a screening test to see if you have mutated, precancerous cells in your cervix.And the vaccination is intended precisely to ensure that antibodies are formed in the body, protecting cells from mutation when the virus enters.So it is definitely better not to save on 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 cases of cervical cancer and 41% of all cervical cancer deaths occur in women age 65 and older.Regular screening is extremely important because HPV can reappear after years of silence.It is recommended that the analysis be performed every three years for women aged 21 to 29 years and every 3-5 years from 30 to 65 years.
  5. If there is no condyloma, but the stain reveals viruses, then I have cervical cancer". Answer: do not jump to conclusions. Viruses can stay 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 happens as a result of the decrease in the general immunity of the organism. Therefore, the main thing you should pay attention to based on this test result is the state ofimmunity and it is better to carry out treatment aimed at preserving it.
  6. All papillomaviruses cause cancer.Answer: Many types of HPV do not cause problems.HPV infections usually clear up on their own, without any intervention, within a few months of getting them, 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 catch papillomavirus.Answer: Condoms certainly reduce the likelihood of contracting HPV and sexually transmitted diseases.However, protected sex is not a 100% guarantee, as the papillomavirus is transmitted through any mucosal contact.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 the 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 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 spots.But if you lead a healthy lifestyle, eat right and, as a result, have good immunity, viruses will not appear.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 incorrect conclusions and caused many couples to break up because they did not consider 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 contracted a human papillomavirus infection at some point in your life.

Preventing

HPV prevention is based on the following three methods:

  1. Primary, which helps identify risk factors, prevent the spread of infection, and develop special vaccines;
  2. Secondary, which is based on the examination of the patient, helping to identify the disease in the initial stage;
  3. tertiary, which is based on preventing the development of relapses in individuals who are treated for this infection.

At the state level, a number of preventive measures are being taken to prevent the spread of HPV.This is the desire to improve the well-being of the population, limiting videos and advertisements, which are based on the covert propaganda of promiscuity, and introducing 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 transmission routes of various sexually transmitted infections, their symptoms, treatment methods and, most importantly, methods of contraception preventing their infection.

Individual preventive measures include the following:

  • rejection of promiscuous sexual relations;
  • mandatory use of a condom during sexual intercourse, although it has been proven that HPV can also be transmitted through close skin contact;
  • periodically visit a doctor for examination;
  • maintaining a healthy lifestyle, active sports;
  • immediate 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, as the viruses they contain are not alive.It is recommended to prescribe both females and males aged 9-17 years;are also allowed to be administered for preventive purposes to women under the age of 26.