Human papillomavirus (HPV or HPV) is a group of viruses belonging to the family of papillomaviruses that damage the skin and mucous membranes. HPV is the number one sexually transmitted viral infection. The peak of infection occurs between 18 and 30 years of age. According to statistics from different countries, 80-90% of people are infected with HPV. But don't be afraid. Our immune system is able to kill the pathogen and not bring the case to disease.
How does the human papillomavirus spread?
Source of infection - carriers of the infection and those with clinical manifestations of HPV.
The virus only spreads from person to person.
It is present in urine, saliva and genital secretions.
The infection enters the body in three ways:
- Contact and household. Infection occurs by touching the skin and mucous membranes of an infected person. The risk of acquiring human papillomavirus is especially high if there are scratches, cuts, wounds, abrasions in the contact area. The virus can remain viable in the external environment for a while, so infection is possible through public showers, pools, baths, clothes, utensils, hygiene items;
- Sexual. This is the main route of infection. The infection occurs in any sexual intercourse: genital, anal, oral-genital. With a single contact with an infected partner, the probability of infection is 60%;
- At birth, during pregnancy. An infected mother can infect the baby in the womb and through the birth canal.
Human papillomavirus infection is characterized by a latent course. After infection, the virus does not appear until a certain point. We may not even be aware of its presence in the body. Normally, the immune system fights the human papillomavirus, gradually destroying it, preventing the pathology from developing.
Such self-medication lasts from 6 months to 2 years, depending on the characteristics of the body. But if the immune system is weak, the virus enters the active phase, starting to manifest. The chance of self-healing decreases with age, by 80% in people under 30 years of age. The first symptoms of HPV in the body may appear after a few weeks or decades. It all depends on the resistance of the body and the type of papilloma virus you are infected with.
HPV types
About 200 types or strains of human papillomavirus are now known. They are divided into 4 groups according to the risk of cancer. Each type is indicated by a number assigned to it in the order of opening.
Identify the types of HPV that are:
- never causes cancer (1, 2, 3, 4, 5, 10, 28, 49);
- very rarely causes cancer (6, 11, 13, 32, 40-44, 51, 72);
- average oncogenic risk (26, 30, 35, 52, 53, 56, 58, 65);
- most often results in malignant transformation (16, 18, 31, 33, 39, 45, 50, 59, 61, 62, 64, 68, 70, 73).
The last group most dangerous to health.
Of the high oncogenic risk human papillomaviruses, types 16, 18, 31, 33, 52, 58 are the most common.
HPV accounts for 7-8% of all cancers. This is why:
- 99% of women with cervical cancer;
- 93% of anal cancers; 51% of vulvar cancers;
- 36% of cases of penile cancer;
- 63% of oropharyngeal cancers.
Human papillomavirus types registered since 2003.
| Species name in 2003–2010. | Other types (strains) of the species | Species name since 2010 |
|---|---|---|
| Human Papillomavirus 1 (HPV1) | - | Mupapillomavirus 1 |
| Human Papillomavirus 2 (HPV2) | HPV27, HPV57 | Alphaapapillomavirus 4 |
| Human Papillomavirus 4 (HPV4) | HPV65, HPV95 | Gamma Papillavirus 1 |
| Human Papillomavirus 5 (HPV5) | HPV8, HPV12, HPV14, HPV19, HPV20, HPV21, HPV25, HPV36, HPV47 | Betapapillomavirus 1 |
| Human Papillomavirus 6 (HPV6) | HPV11, HPV13, HPV44, HPV74, PcPV | Alphapapillomavirus 10 |
| Human Papillomavirus 7 (HPV7) | HPV40, HPV43, HPV91 | Alphapapillomavirus 8 |
| Human Papillomavirus 9 (HPV9) | HPV15, HPV17, HPV22, HPV23, HPV37, HPV38, HPV80 | Betapapillomavirus 2 |
| Human Papillomavirus 10 (HPV10) | HPV3, HPV28, HPV29, HPV77, HPV78, HPV94 | Alphaapapillomavirus 2 |
| Human Papillomavirus 16 (HPV16) | HPV31, HPV33, HPV35, HPV52, HPV58, HPV67 | Alphapapillomavirus 9 |
| Human Papillomavirus 18 (HPV18) | HPV39, HPV45, HPV59, HPV68, HPV70, HPV85 | Alphapapillomavirus 7 |
| Human Papillomavirus 26 (HPV26) | HPV51, HPV69, HPV82 | Alphapapillomavirus 5 |
| Human Papillomavirus 32 (HPV32) | HPV42 | Alphapapillomavirus 1 |
| Human Papillomavirus 34 (HPV34) | HPV73 | Alphapapillomavirus 11 |
| Human Papillomavirus 41 (HPV41) | - | Nupapillomavirus 1 |
| Human Papillomavirus 48 (HPV48) | - | Gamma Papillavirus 2 |
| Human Papillomavirus 49 (HPV49) | HPV75, HPV76 | Betapapillomavirus 3 |
| Human Papillomavirus 50 (HPV50) | - | Gamma Papillavirus 3 |
| Human Papillomavirus 53 (HPV53) | HPV30, HPV56, HPV66 | Alphapapillomavirus 6 |
| Human Papillomavirus 54 (HPV54) | - | Alphapapillomavirus 13 |
| Human Papillomavirus 60 (HPV60) | - | Gamma Papillomavirus 4 |
| Human Papillomavirus 61 (HPV61) | HPV72, HPV81, HPV83, HPV84, HPVcand62, HPVcand86, HPVcand87, HPVcand89 | Alphaapapillomavirus 3 |
| Human 63 Papillomavirus (HPV63) | - | Mupapillomavirus 2 |
| Human Papillomavirus 71 (HPV71) | - | deleted |
| Human Papillomavirus 88 (HPV88) | - | Gamma Papillavirus 5 |
| Human Papillomavirus Cand90 (HPVcand90) | - | Alphapapillomavirus 14 |
| human papillomavirus cand92 (HPVcand92) | - | Betapapillomavirus 4 |
What are the symptoms of human papillomavirus infection?
During the transition to the active form, HPV affects the skin, genital mucosa, anal region, larynx, nasopharynx. This is facilitated by:
- decreased immunity;
- smoking, alcohol;
- hypothermia;
- vitamin deficiency;
- pregnancy;
- hormonal disorders;
- other sexually transmitted diseases;
- early onset of sexual activity;
- Frequent exchange of sexual partners.
HPV appears as growths, bumps on the skin and mucous membranes called papillomas. They can be divided into two groups: warts and condylomas. Other symptoms may be observed depending on the location of the papillomas. For example, if they are located in the larynx of the vocal cords, hoarseness of the sound may be observed, if breathing difficulties may occur in the nose, if the outflow of urine in the ureter is damaged.
Warts
Warts are the most common manifestation of human papillomavirus infection on the skin.
These are round formations with clear borders and a rough surface. Their size usually does not exceed 10 mm.
Human papillomavirus causes the following types of warts:
- Smooth or vulgar. Most common. They protrude above the skin in the form of dense, gray-yellow, keratinized rough-surfaced formations. It is formed on the back of the hand, on the fingers, between the fingers. They tend to unite with each other;
- Flat or youthful. They usually occur in children and adolescents. These are fleshy or pale brown formations that rise slightly above skin level. These usually appear on the face, neck, shoulders, hands, in several groups;
- Talp. It is formed on the soles of the feet in the places that put the most pressure: on the heels, under the toes. Unlike other warts, their growth is inward. They resemble calluses in appearance, but have a rough rather than smooth surface, destroying the skin pattern. Plantar warts are painful under pressure, painful when walking;
- Threaded. These are elongated outgrowths, soft to the touch, on legs up to 4 mm long. Their color ranges from flesh to dark brown. It is formed on the neck, skin of the eyelids, armpits, groin, under the mammary glands.
Warts
Warts are papillomas that form on the mucous membranes of the reproductive system, the oral cavity, and the upper respiratory tract.
There are points and flats:
- Pointed. They are soft conical, papillary in shape or pink. It is formed in the genital area, on the mucous membranes of the external and internal genitals, on the anus, less commonly in the oral cavity. It can appear as a rash of several warts that merge with each other and form something similar to the spine. Genital warts can be easily injured during intercourse, gynecological examination, douching;
- Flat. They look like a small bulge located in the deep layers of the mucosa. It is almost impossible to detect them with a simple check. Flat warts are more dangerous than genital warts, especially if they are located on the mucous membranes of the vagina and cervix. They grow in depth and width and tend to degenerate into cancerous tumors.
Human papillomavirus infection in women
Human papillomavirus is particularly dangerous in the field of gynecology because it causes cervical cancer in women.
In 99% of cases, one of the high oncogenic HPV types is found with the development of a tumor process.
The biggest threat is HPV types 16 and 18. These pathogens account for 70% of cervical cancers and pre-cancerous conditions.
The first step on the path to malignancy is structural changes in cells, thickening, and proliferation of mucous membranes. This condition is called cervical dysplasia. Changes in dysplasia are not critical and can be reversed if treatment is started on time. The point is not to let the situation take its toll.
According to the size and depth of the affected area, 3 degrees of dysplasia are distinguished:
- easy;
- medium;
- difficult.
The higher the rate of dysplasia, the greater the risk that the altered cells will degenerate into a tumor. A mild grade often goes away on its own, and a severe one, if left untreated, is more likely to develop into cancer.
In women, there are no symptoms in the early stages of cervical dysplasia caused by the human papillomavirus. No disturbance in the menstrual cycle, pain in the lower abdomen, discomfort, bleeding. The diagnosis can only be made after an examination. Severe dysplasia can be associated with a secondary infection, an inflammatory process in the vagina (colpitis) and cervix (cervicitis).
Signs of inflammation include:
- itching, burning;
- pain, patching during intercourse;
- foul-smelling vaginal discharge;
- Aching pains in the lower abdomen.
Cervical dysplasia due to papilloma virus, if left untreated, develops into a malignancy in 10 to 12 years. But this is the average figure. The behavior of altered cells is unpredictable and highly dependent on the state of the immune system and the presence of risk factors.
Human papillomavirus in men
Human papillomavirus infection is rare in men. However, a man infected with HPV is primarily at risk for a woman with whom he has an intimate relationship. It is highly likely to infect your partner, even if it is asymptomatic.
Among the manifestations of HPV are genital warts in the foreskin, head of the penis, urethra, and around the anus. Their occurrence is provoked by severe weakening of the immune system, hypothermia, chronic nervous stress, overload. Condylomas often cause pain during intercourse, causing itching.
Complications of HPV in men include the development of phimosis (narrowing of the foreskin that prevents the vagina from being removed), malignancies of the penis, anal region, erectile dysfunction. The risk group includes homosexuals, bisexuals, and immunocompromised men.
Diagnostics
If warts or genital warts appear, a doctor should be consulted and the human papillomavirus examined. Only a specialist can determine the nature of the formations, determine their cause. Depending on the location of the papillomas, you may need to consult a dermatologist, podologist, venereologist, urologist, gynecologist, otolaryngologist.
Given the risk of cervical cancer, women are advised that a gynecologist perform regular tests to detect the pathogen in time and to cure the smallest changes it causes at an early stage.
The following tests are used to confirm HPV:
- Check the problem area;
- Examination mirrors in gynecological chair (for women);
- Oncocytological smear. In gynecological and urological examinations, the surface of the mucosa is taken with a special brush (Papanicolaou test or PAP test). The test allows you to evaluate the shape, size and location of the cells under a microscope. Identification of epithelial cell changes, damage, dysplasia, or tumor transformation;
- Smear for PCR analysis. This analysis of human papillomavirus makes it possible to detect the DNA of the pathogen, to determine its type and amount;
- Colposcopy (examination of the cervix with an optical device). It is performed when highly oncogenic HPV and abnormalities in oncocytology are detected. In this study, the physician examines the surface of the cervix in detail for multiple growth;
- Histological examination (biopsy). It is performed when suspicious tissue sites are detected during colposcopy. A small area of tissue (up to 5 mm) is taken for examination under a microscope.
How is the treatment done?
The fight against human papillomavirus infection is only done with the help of a doctor. The use of alternative methods, such as treatment of papillomas with celandine, iodine, treatment of papillomas with oil, treatment with washing soap, is most often ineffective. In addition, such methods of wart extermination can worsen the condition, cause complications, and damage the surrounding healthy skin. It is not recommended to use them at your own risk. You should consult a professional first.
Modern treatment includes monitoring, medication, surgery, and prevention of complications. Unfortunately, there are no specialty drugs today that would kill HPV.
Treatment is carried out in a comprehensive way in three areas:
- surgical;
- strengthening the immune system;
- Use of topical and systemic antiviral drugs.
Removal of papillomas is performed using hardware and operational methods:
- laser technologies;
- cryotherapy (freezing with liquid nitrogen);
- removal with a scalpel;
- radio wave surgery (removal with a radio knife);
- electrocoagulation (moxibustion with electric current);
- moxibustion with aggressive chemicals.
The specific method is selected based on the type, location, and size of the formation. Removal of papillomas does not eliminate the virus 100%, it does not guarantee that the formations will not reappear later.
Immunostimulatory antiviral drugs are prescribed for systemic papillomavirus infection. It is used for various localizations of papillomas, helping to activate the body's defenses in the fight against infection. Any medicine for HPV should be prescribed by a doctor. During therapy, repeated studies are performed to assess its effectiveness.
Peculiarities of papilloma treatment in some places
Treatment for papillomas in the mouth includes tumor removal and supportive drug therapy. The need to get rid of growths in the oral cavity is associated with constant discomfort, high mucosal sensitivity, ease of damage to the chewing process of food, speech disorder, and the risk of oncological transformation.
Systemic immunostimulants, topical ointments and gels, and surgical techniques are used to treat papillomas in the eyelids. Eye growths should be removed if they are prone to overgrowth, reduce the vision available to the eye, and impair vision. Human papillomavirus infection of the eye is often accompanied by other infectious lesions of bacterial origin that lead to inflammation of the eyelids and mucous membranes. Laser therapy, cryodestruction and electrocoagulation are used to remove papillomas.
The types of HPV that cause skin lesions are usually harmless. The treatment of papillomas of the face and body is performed mainly for cosmetic purposes in order to get rid of the imperfections. In addition, convex formations are uncomfortable. You can easily touch them with clothes, jewelry, injury. In some cases, treatment of papillomas on the skin is not necessary as they disappear spontaneously.
The most dangerous genital papillomas. Treatment of human papillomavirus in men and women in the genital area is performed by hardware and surgical methods in combination with anti-immune drugs. The mode of therapy is chosen individually for each patient.
In the treatment of children's papillomas, immunologists and pediatricians prescribe immunostimulatory drugs and vitamins to increase protection. Often, this step is enough to make the formation disappear without surgery. If papilloma removal is required, cryodestruction and laser are used as the safest methods that do not cause complications.
How to prevent HPV infection?
Many carriers of the virus are dangerous to everyone. How to avoid infection, prevent the appearance of papillomas on the skin or mucous membranes?
Vaccination is considered to be the most effective method. It is advisable to perform it during adolescence (11–12 years) before sexual activity begins, as the main route of infection is sexual contact. The human papillomavirus vaccine can be given later in age 45, but it will only work if there is no HPV in the body.
Papilloma virus vaccines provide almost 100% protection against infections and cancer.
Three vaccines have been developed and are being used successfully in practice:
- protects against HPV types 6, 11, 16, 18;
- also protects against HPV types 31, 33, 45, 52, 58;
- is effective against HPV types 16 and 18.
Routine HPV vaccination is performed in 55 countries. Including America, Canada, France, Australia, Germany, Switzerland, Norway.
In addition to vaccination, methods for preventing HPV include:
- quitting bad habits (smoking, alcohol);
- a healthy diet balanced with vitamins;
- delays the onset of sexual activity in adolescents;
- is a regular sexual partner;
- regular checkup and examination by a gynecologist.
To prevent plantar warts, you should wear closed shoes in public swimming pools, showers, and changing rooms. These operations reduce the risk of infection not only with HPV but also with nail fungus (onychomycosis).
Dentists help cure plantar warts on the legs and hands caused by HPV and other types of warts, remove painful calluses, remove calluses, and cure nails quickly. They perform hardware medical pedicures, ingrown toenails, and foot care for diabetic feet.
If you are worried about any problems with the skin of your feet or nails, consult a doctor, find out the cause of the discomfort, and get information on the methods that can be eliminated.