Human papillomavirus infection is one of the most common in the world. The situation is aggravated by the fact that the problem is rarely discussed openly in society and people come to the doctor already in the last stages of the disease. Another difficulty is that a virus that has already entered the body cannot be cured. The only way to protect yourself from it is timely vaccination.
What is HPV?
Human papillomavirus (HPV) is an enveloped DNA virus of relatively small size and simple structure. HPV tolerates high temperatures, exposure to ultraviolet rays, ether, chloroform, and chemicals. The activity of the virus is neutralized by X-rays.
HPV is not a specific virus, but a large group of genetically heterogeneous pathogenic infectious agents of various types. There are about 600 of them in nature, but most of these viruses only spread among animals and are absolutely safe for humans. Of the total number of HPVs, only about a hundred affect the human epithelium and mucous membranes. In the vast majority of cases, the virus is sexually transmitted. The likelihood of infection can be affected by various factors related to a person's health and behavior.
Diseases associated with HPV have been known since ancient times. The documents that have come down to us speak of warts on the hands and soles of the feet and papillomas on the genitals. However, the opportunity to influence the spread of the virus only appeared at the beginning of the 21st century, along with the creation of effective vaccines against HPV. Work on vaccine development intensified after the connection between virus infection and the development of malignant tumors, mainly cervical cancer, was established.
All human papillomaviruses known in medicine are divided into types according to whether they are capable of causing cancer. According to the classification proposed by the International Agency for Research on Cancer (IARC), there are 3 high-risk groups of HPV:
- group 1 - high carcinogenic risk,
- group 2A - probably carcinogenic risk,
- group 2B - possible carcinogenic risk.
About 14 types of human papillomaviruses are oncogenic, that is, they can cause cancer. Viruses types 16 and 18 are responsible for 75% of cervical cancer cases.
The infectious process during HPV infection proceeds without a typical inflammatory reaction, as it is the only virus studied that does not enter the blood of an infected person. HPV penetrates through the mucous membranes into the basal layer of the epidermis. It is the lower layer of the skin, made up of cells capable of dividing. The constant splitting process ensures rapid skin renewal.
The incubation period for human papillomavirus infection is 3 months on average. In addition, the disease proceeds in three forms:
- latent (latent), when a person has no clinical symptoms, but becomes a carrier of the virus and begins to infect his sexual partners;
- subclinical with minimal symptoms depending on the serotype of the virus;
- clinical (manifest) with abundant rashes in the genital area.
Important!Virus infection and disease are not the same. At a young age, when the immune system works at full capacity, it is able to independently remove the pathogen from the body. In many countries around the world, HPV screening is only done after 30 years, as it was previously uninformative.
Once inside a healthy cell, the virus starts making its own DNA in it. The cells morphologically change, grow, turning into warts, warts and other skin formations.
In an infected cell, the virus exists in two forms:
- benign - outside the cell chromosome,
- malignant - when the DNA of the virus is introduced into the genome of the cell.
Interesting facts about the human papillomavirus
- In both developed and underdeveloped countries, HPV is the most common sexually transmitted infection.
- The virus particles are so microscopic in size that even a condom does not help 100% from infection during intercourse.
- About 75% of people get infected during a single intercourse without a condom.
- Most of the infected fall into the age group from 20 to 24 years, the main risk group are young people between the ages of 17 and 33.
- The risk of infection is directly related to the immunological status: when immunity is weakened, for example during pregnancy, the likelihood of infection increases significantly.
- HPV itself is not a fatal disease; the risk of death arises when the neoplasms turn into malignant tumors.
Clinically, HPV manifests itself in several ways:
- Common warts on the back of the hands, feet, between the toes, on the scalp.
- Long filamentous warts on the arms (butcher's warts).
- A cluster of flat warts raised slightly above the skin in the genital area, along the edge of the hair growth, on the skin of the forearms.
- Hereditary Lewandowski-Lutz disease. It is manifested by a large number of small dark warts or pronounced pigmentation.
- Genital warts on the vaginal mucosa and on the male genital organs.
HPV affects the skin epithelium and mucous membranes of the male and female genitals, the upper respiratory tract, the rectum, and other organs. Warts, warts and papillomas reduce the quality of life, worsen the appearance and affect self-esteem.
Where to go in case of illness
Since the disease is often asymptomatic, it is often discovered by accident during a medical examination. Various neoplasms on the skin - papillomas on the neck, in the armpit, under the breast, on the genitals and other parts of the body - usually become a cause for concern and require medical attention.
If papillomas, warts and other neoplasms appear on the skin, you should immediately consult a dermatologist or dermatovenerologist.
To determine the degree of risk of developing cancer, a cytological analysis of tissues is performed:
- To determine the oncogenicity of neoplasms on the skin, one of the warts is removed and its cells are examined to assess the presence of changes in them. Oncology is evidenced by degeneration or already degeneration in cancer cells.
- To assess the development of cervical cancer, a cytological examination of scraped from the mucous membrane of the cervix and cervical canal is performed. The analysis is performed according to a technique specially developed for the early diagnosis of precancerous diseases of the cervix - Papanicolaou stain (PAP test).
- To confirm the presence of the virus in the body and determine its type, PCR analysis of smears from the cervical canal in women and from the urethra in men is prescribed. Molecular biological PCR is used in addition to cervical screening in women over the age of 30. The analysis is prescribed even for questionable results of cytology.
In 10-15% of infected people, the test detects several variants of the virus at the same time.
Important!It is necessary to consult a doctor at the first neoplasms noticed on the skin or mucous membranes. Early cancer detection offers a great chance for full recovery.
In the presence of papillomas on the skin and genital warts on the mucous membranes of the genitals, it is necessary to undergo an oncological examination at least once every 2 years.
There is no specific treatment for HPV today. Despite ongoing research around the world, a drug for the destruction of the human papillomavirus has not yet been created.
It has been shown that the risk of HPV infection is directly related to a person's immune status: with reduced immunity, the virus behaves more aggressively and more often causes the transformation of warts and papilloma cells into malignant tumors. In this regard, there is an opinion that drugs from the immunomodulator group can be used as drug therapy for the disease.
However, the clinical effectiveness of drugs for increasing immunity has not been proven by any scientific research, and they are not used anywhere in the world, except in post-Soviet countries. Most experts believe that manufacturers' assurances about the high efficiency and absolute safety of these funds are nothing more than a marketing ploy.
Immunity is a complex multi-component system, and modern science has no knowledge of which links of this system need to be stimulated to fight viruses.
In clinical practice, mainly destructive methods of treatment are used: the removal of warts and papillomas by electrocoagulation, laser, cryodestruction, radiosurgery and chemicals. After some time after removal, neoplasms may reappear on the skin, as destructive methods are unable to fight the virus itself. With a recurring course, repeated removal is indicated.
Specificity of treatment in women
The question of the effectiveness of treatment and prevention of HPV in women is of particular importance, since the virus is a major cause of the development of cervical cancer. It is the fourth most common cancer in women around the world.
HPV in women manifests itself in the form of pale pink papillary growths in the external genitalia, vestibule and walls of the vagina, cervix, urethra. Formations on the cervix are detected when examined by a gynecologist using mirrors.
All women over the age of 21 who are sexually active are encouraged to be screened for HPV annually. If HPV is detected at screening, a PAP test is ordered.
If both analyzes confirmed the presence of a virus in the body, a more detailed examination is prescribed, including an analysis to identify pathological changes in the tissues.
If the result of both tests is negative, the next full examination can be performed after 3 years. The risk group includes women with a negative PAP test, but with a positive HPV screening result: they are assigned a colposcopy (examination of the cervix) and a biopsy - taking a tissue sample for research. The next exam is expected no later than one year later.
Important!HPV is not an obstacle to pregnancy and childbirth - the risk of passing the virus to your baby is minimal. If a woman does not have HPV and has not been vaccinated against the infection, vaccination should be postponed until the end of the breastfeeding period.
Treatment for men
In men, HPV is often asymptomatic, but men carry the virus and infect their sexual partners. If papillomas appear, they are usually localized on the foreskin and glans penis, scrotum, anus and urethra.
The complex of treatment includes the destruction of papillomas with the aim of physically damaging their cells.
Traditional medicine offers many recipes for getting rid of papillomas, but it is necessary to understand that removing any neoplasms on the skin without consulting a specialist and cytological examination of cells can lead to extremely negative consequences. The aggressive effect on cancer cells accelerates their growth and leads to the rapid development of malignant neoplasms.
From folk recipes for removing papillomas deserve attention:
- celandine juice helps to get rid of papillomas when applied to the formation itself and its root several times a day;
- alcoholic tincture of dandelion flowers - lubricate several times a day until it completely disappears;
- a mixture of squeezed garlic gruel with any cream or butter is applied to the papillomas in the form of a compress for 2-3 hours.
Important!Before using any traditional medicine, you should consult your doctor!
Removal of papillomas by surgical methods
Modern medicine offers various effective methods of surgical removal of papillomas:
- laser therapy - efficiency reaches 90%, but there is a risk of relapse and wounds heal for a long time;
- cryotherapy is highly effective, but the procedure requires high precision in order not to damage healthy tissues;
- removal with chemical preparations is now rarely used due to poor efficiency and the risk of damage to the mucous membranes.
It is worth removing papillomas when:
- considerable aesthetic discomfort,
- high risk of injury
- the probability of degeneration into malignant neoplasms.
Papillomas should only be removed in a medical facility on the advice of a doctor.
What to do if the papilloma is damaged
Injury to the papilloma is dangerous with the risk of infection of the wound and the acceleration of the growth of new formations.
In case of accidental damage to the papilloma, it is necessary to treat the lesion site with an aseptic agent and apply a bactericidal adhesive plaster to the wound. If possible, you should consult a specialist.
The best treatment is prevention
The main method of protection against HPV is timely vaccination. Vaccination in all developed countries is carried out for girls aged 9 to 11 and, for example, in the United States and Canada, boys are also vaccinated to reduce the number of carriers of the virus.
Important!The most effective vaccination is before the start of sexual activity. Although the vaccine can be obtained at any time, it will only protect against types of HPV that a person has not yet encountered.
Two HPV vaccines have been registered and approved for use. The vaccine, made in the United States, protects against HPV types 16 and 18, which cause cervical cancer, and against types 6 and 11, a common cause of warts, genital warts, and other cancers. The vaccine produced in Belgium protects against the 16th and 18th types of viruses.
HPV vaccines have undergone numerous clinical trials and have been shown to be highly effective and completely safe. They contain only viral envelope proteins that act as antigens for immune cells. The risk of developing cervical cancer after vaccination is reduced by more than 90%.
HPV is a very common infection that in many cases can significantly reduce the quality of life. Despite the lack of drugs for the virus, timely vaccination and a serious attitude to methods of protection from infections during sexual intercourse will help to avoid the disease.