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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 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.The human papillomavirus lives in human blood and appears only for a certain period of time.But 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) changes tissue growth patterns.It causes various skin diseases and mucosal changes.Modern medicine identifies more than a hundred types of the virus.

A papilloma is a benign tumor that grows on the surface of the skin and looks like a small nipple.The size of the papillomas can be one or two cm.Places of occurrence: oral cavity, nose, pharynx, vocal cords;it can develop in the bladder and other places.

Diseases also differ depending on the type of virus: warts are caused by human papillomavirus types 2 and 4, flat warts by types 3 and 10, and genital warts by types 6 and 11.Some virus types (16, 18, 31, 33, 35) cause the development of cervical cancer or a favorable background for cervical dysplasia.The human papillomavirus spreads through contact and household contact, remaining on the skin and mucous membranes.

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

How can you get infected?

The source of the infection is a sick person or virus carrier, that is, HPV is only spread from person to person.

There are three known ways of transmission of the infection:

  • contact and housekeeping (through touch);
  • sexual (genital, anal, oral-genital);
  • in childbirth from mother to child.

HPV affects the skin and mucous membranes: various warts, papillomas, and condylomas develop on them.

Risk factors

It is an interesting fact that different types of HPV can manifest themselves differently, which can cause the development of benign or malignant tumors.In addition, 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 the disease increases several times in the following categories:

  • pregnant women;
  • patients who often suffer from various diseases;
  • persons of non-traditional orientation;
  • male or female representatives suffering from sexually transmitted diseases;
  • excessively sexually active people;
  • people with immune system disorders;
  • sexual partners of persons found to be HPV carriers or suffering from an active form of this disease;
  • women with various cervical diseases.

All representatives of these categories must undergo an examination to detect papillomatosis.It is also recommended to carry out the examination for those who are supporters of free sexual relations, have many sexual partners or change them frequently.Even a single unprotected act can cause infection, so experts advise you to take preventive measures against this disease.

3D model of HPV

Human papillomavirus: incubation period

The incubation period for infection with human papillomavirus is typically 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, a long-term chronic recurrent course with malignancy of the process is possible (depending on the type of virus).

Classification and symptoms of HPV

Clinical symptoms of human papillomavirus are quite diverse - in some types they are practically absent, and many of them are manifested in the growth of papillomas in different parts of the body.

There are several types of such skin growth - 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 characterized by their roughness, the presence of a keratinized layer and their size of 1 mm or more.Very often, such growths are not isolated, but represent a localized "merged" zone.Simple (aka vulgar) papillomas can be located on the palms and between the fingers;in children, it is seen on the knees.

simple papillomas on the arm

Flat papillomas

It is caused by human papillomavirus types 3 and 10, and they are the same color as the skin, so they are the least noticeable.But in addition to the appearance of neoplasms, flat papillomas are characterized by itching, erythema (redness) and pain.

Plantar papillomas

At the beginning of their development, plantar papillomas look like a whitish, shiny spot.Then it "rises" slightly above the level of the skin surface.Several mosaic neoplasms may appear around the main papilloma.Such neoplasms make life difficult for the patient - it is difficult to walk and it is almost impossible to find comfortable shoes.

plantar papillomas on the feet

Filiform papillomas

This type of neoplasm is typical for women over 50;they first appear in the form of small bumps with a yellowish tint.Over time, these bumps grow and turn into groups of numerous "threads".

Condylomas acuminata

The appearance of the formations resembles cauliflower or cauliflower.Condylomas are most often found on the foreskin, the head of the penis, near the urethra, around the anus, on the labia minora, on the mucous membrane of the vagina, on 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).The 5-50 mm lesion looks like a growing cornea of the skin, sometimes covered with a crust.It is caused by HPV type 16.The formations are prone to squamous cell carcinoma.

Formations in the oropharynx

Blooming papillomatosis also looks like cauliflower in the oral cavity: white plaques on the oral mucosa.It occurs in the elderly.Laryngeal papillomatosis can descend into the trachea, bronchi, and lung tissue and occurs in children and adults.Signs of papillomatosis of the larynx 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 can occur in men without 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.

Viruses of this type can be highly oncogenic in men.This leads to genital cancer.But if you start treatment on time, the risk of oncogenic diseases is minimized.Warts caused by the HPV virus are removed surgically or with special chemical solutions.At the same time, antiviral drugs are prescribed.Therefore, it can be completely eliminated in the early stages of the development of this type of disease in men.

Human papillomavirus in women

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

This type of infection in women can be divided into the following groups:

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

The most dangerous infection for women's health is high-type 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 further complicated by the fact that the disease shows no symptoms in the first stage of development.Occasionally, small warts may appear on the palms and soles.

With the 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 appear in the form of bubbles with fluid, which burst over time and emit an unpleasant odor.

A high type of HPV infection can also cause vaginal and vulvar cancer.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 risk of human papillomavirus infection

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

Each strain of the virus has its own "favorite" localization.Thus, the most dangerous types 16 and 18 are immediately "aimed" at the genitals when ingested, while the low oncogenic viruses 6 and 11 infect the vulva and perineum, causing the formation of genital warts there.The same strains can cause papillomatosis in the respiratory tract of a child born naturally to a mother with genital warts.

A disease with pronounced symptoms does not always develop after infection.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.In women, it develops as a result of human papillomavirus type 16 or 18 infection.It has been proven that this disease does not occur in the absence of papillomavirus.And if they used to talk about cervical cancer arising from erosion or ectropion, now this was revised and denied;
  2. Rectal carcinoma.This, 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 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 vagina, they are provoked by sex.It can cause bleeding in other places (nose, mouth) if mechanically injured by other objects.

According to official sources, just under half a million (470,000) new cases of cervical cancer are registered worldwide every year.233,000 women die from this disease every year.This makes this cancer the 2nd most common cancer in gynecology (first after breast cancer) and the 5th leading cause of death in women.Most often, women under the age of 40 die from cervical cancer.

papillomas all over the body

HPV and pregnancy

The human papillomavirus does not affect the reproductive function, that is, the virus does not prevent a woman from having children.

If human papillomavirus infection is detected during pregnancy:

  • the first thing is to find a good gynecologist and take care until delivery,
  • the most important thing is what manifestations of the infection a woman has, the doctor's tactics depend on this,
  • The virus has no effect on the fetus!
  • warts and papillomas can be removed after childbirth,
  • minimal medication (only as needed) during pregnancy,
  • during childbirth, the child can become infected by passing through the birth canal,
  • if there are pronounced changes in the cervix of the pregnant woman, a caesarean section may be recommended,
  • in the absence of manifestations - natural birth.

In general, cesarean sections due to HPV infection are rarely performed.Later manifestations of infection in children are also extremely rare or insignificant.

Diagnostics

In recent years, medical science has made significant progress in diagnosing PVI.This became possible thanks to the systematization of data on HPV and related diseases, all existing routes of infection, several mechanisms of the pathogenesis of the infectious process and the state of the immune system, as well as possible morphological changes.

There are many 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 with proven risk factors for PVI.
  • Patients with pointed papillomas in the oral cavity and anogenital area.
  • Patients with various pathologies of the cervix.
  • Couples planning pregnancy.

Basic diagnostic methods of PVI:

  1. Visual inspection of changes.
  2. Use of magnifier 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, a swab is taken for bacterioscopic examination of the secretions of the urethra, vagina and cervix, and PCR and bacteriological tests are prescribed for the presence of urogenital infections.

Detection of the papillomavirus is usually not difficult: the infection is detected during routine examinations by a gynecologist or dermatologist.If appropriate symptoms are present, a targeted biopsy is performed.In the event that the patient is diagnosed with flat condylomas localized in the anogenital region, in order to prevent the development of malignant diseases, the human papillomavirus serotypes are tested with an oncogenic marker.

How do we treat human papillomavirus?

Currently, no methods have been developed for the radical treatment of human papillomavirus infection in men or women.All existing systems are aimed at inactivating the pathogen and strengthening antiviral immunity;warts, condylomas and dysplasias are removed using minimally invasive methods.Surgical excision, conization and removal of the cervix is rarely used, and mainly in cases of strong suspicion of oncological pathology.

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

  • In case of suspicion of a malignant tumor, surgical treatment is performed.It is not used as often because severe bleeding can occur when removing the wart.During the manipulation, the excised wart is sent for biopsy and the wound is sutured.
  • Curettage is the removal of the wart with a curette, i.e. curettage.After that, electrocoagulation is performed and a dry bandage is applied to the wound.
  • Electrosurgery is used to remove small warts.But even in this case, a relapse is possible.This method can also be used for large warts, but they must be soaked before starting, or an electrode must be placed in the thickness of the wart, so the separation between the cells is less strong.
  • Cryodestruction is performed with liquid nitrogen.
  • Laser surgery currently plays a leading role in surgical treatment, that is, in addition to destruction, hemostasis also occurs in parallel.In addition to the fact that the laser vaporizes the wart, it also has a direct toxic effect on HPV, so this treatment method is the first choice for the treatment of cervical intraepithelial tumors, as well as for the treatment of genital warts in dominant pregnant women (even in the last stages of development).

Cytostatic drugs and cauterizing chemicals are also used.

Immunotherapy - this treatment method is used only in combination with other methods, as it has no specific effect, but only activates the components of the immune system.

Combined 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 of these.So what people say about papillomaviruses:

  1. There is no reliable data on whether the HPV vaccine helps, so you do not need to get the vaccine.Answer: Yes, indeed, there are more than 100 papillomaviruses, and there is really no evidence that the vaccine protects against all of them.However, the vaccine protects you against the most aggressive strains for 5 years.The vast majority of those vaccinated did not experience any side effects from the vaccination, so in our opinion it is still worth getting vaccinated.
  2. If you have genital warts, it leads to cervical cancer.Answer: It is unknown 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 tribes.So genital problems have nothing to do with cancer.
  3. A smear test is more effective than the HPV vaccine.Answer: A Pap smear is a screening test to make sure you have mutated, cancer-preventing cells on your cervix.And the purpose of the vaccine is to ensure that the body produces antibodies that protect the cells from mutation when the virus enters.So it is definitely better not to skimp on vaccination than to wait for the cells 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 deaths from cervical cancer occur in women aged 65 or older.Regular screening is extremely important because HPV can reappear after years of silence.The analysis should be performed every three years for women aged 21-29, and every 3-5 years between the ages of 30-65.
  5. If there are no condylomas, but the 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 cancer-preventing 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, based on the results of the analysis, the most important thing you should pay attention to 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 clear up on their own without intervention within a few months of getting it, and about 90% clear up within 2 years.And only a small percentage of infections with certain types of HPV can survive and develop into cancer.
  7. If you always use a condom, you will not get the papillomavirus.Answer: Condoms certainly reduce the likelihood of contracting HPV and sexually transmitted diseases.However, protected sex is not a 100% guarantee, since the papillomavirus spreads through any contact of the mucous membranes.HPV can also be transmitted by touching, using the same toilet and hygiene equipment.If papillomas are found on the mucous membrane of the lips, it is possible to transmit the papillomavirus through kissing.All of the above does not eliminate the need to use a condom.
  8. HPV is completely curable.Answer: The virus itself cannot be treated, but the diseases caused by it.It can get rid of genital warts, remove warts, and even cure cervical cancer.But the virus itself unfortunately remains in the human body.
  9. Once you get HPV, it comes back again and again.Truth: Not necessary at all.Yes, the doctor will most likely see the presence of strains on smears.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: This myth has led many people to tragically wrong 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 man have been together since school, an HPV diagnosis only means that one of you has contracted the human papillomavirus infection in your lifetime.

Prevention

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 and helps to identify the disease in the initial stage;
  3. Tertiary, which is based on the prevention of relapses in individuals treated with this infection.

Many preventive measures are also taken at the state level to prevent the spread of HPV.This is to improve the well-being of the population, limit videos and advertisements based on hidden propaganda of promiscuity, and introduce programs to support young families.

At the medical level, preventive measures are based on health and educational work among the population, learning about the transmission methods of various sexually transmitted infections, their symptoms, treatment methods and, most importantly, methods of contraception against infection.

Individual preventive measures include:

  • refusal to have sexual intercourse;
  • mandatory condom use during sexual intercourse, although it has been established that HPV can also be transmitted through close skin contact;
  • visit a doctor regularly for examination;
  • maintaining a healthy lifestyle, active sports;
  • immediately treat 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, since the viruses in them are not alive.It is recommended to prescribe them to both women and men aged 9-17;They can also be administered to women under 26 for preventive purposes.