Human papillomavirus (HPV or HPV) is a group of viruses from the papillomavirus family that infect the skin and mucous membranes. HPV ranks first among sexually transmitted viral infections. The peak of infection is between 18 and 30 years. According to statistics from different countries, 80-90% of people are infected with HPV. But do not be afraid in advance. Our immune system can destroy the pathogen and does not cause disease.
How is human papillomavirus transmitted?
Source of infection - people with infection and clinical manifestations of HPV.
The virus is only transmitted from person to person.
Available in urine, saliva and genitals.
Infection enters the body in three ways:
- Contact and home. The infection occurs by touching the skin and mucous membranes of an infected person. The risk of human papillomavirus infection is particularly high if there are scratches, cuts, wounds, abrasions in the contact area. The virus can survive in the external environment for some time, so infection is possible through public showers, swimming pools, baths, clothes, utensils, hygiene;
- Sex. This is the main route of infection. Infection occurs through all types of sexual intercourse: genital, anal, oral-genital. The probability of infection in a single contact with an infected partner is 60%;
- At birth, during pregnancy. An infected mother can infect her baby through the uterus and birth canal.
Human papillomavirus infection is characterized by a latent pattern. After infection, the virus does not manifest itself to a certain point. We may not be aware of its presence in the body. Normally, the immune system fights human papillomavirus, gradually destroying it, preventing the development of pathology.
This type of self-medication lasts from 6 months to 2 years, depending on the characteristics of the organism. However, if the immunity is weak, the virus enters an active phase and begins to manifest itself. The chances of self-healing decrease with age; For people under the age of 30, these are 80%. The first symptoms of HPV in the body may appear after a few weeks or decades. It all depends on the body's resistance and the type of papilloma virus it infects.
Types of HPV
About 200 species or strains of human papillomaviruses are known. They are divided into 4 groups according to cancer risk. Each species is identified by a number assigned to it in the opening order.
Identify HPV types:
- never causes cancer (1, 2, 3, 4, 5, 10, 28, 49);
- very rarely causes cancer (6, 11, 13, 32, 40 - 44, 51, 72);
- has a medium oncogenic risk (26, 30, 35, 52, 53, 56, 58, 65);
- gives the most malignant transformation (16, 18, 31, 33, 39, 45, 50, 59, 61, 62, 64, 68, 70, 73).
The last group most dangerous to health.
The most common types of human papillomaviruses with high oncogenic risk are 16, 18, 31, 33, 52, 58.
HPV accounts for 7-8% of all cancers. The reason is:
- 99% of cervical cancer cases in women;
- 93% of anal cancer cases;
- 51% of vulvar cancers;
- 36% of penile cancer cases;
- 63% of oropharyngeal cancers.
Types of human papillomavirus registered since 2003.
| Name of species in 2003-2010. | Other species (strains) included in the species | Name of species since 2010 |
|---|---|---|
| Human papillomavirus 1 (HPV1) | - | Mupapillomavirus 1 |
| Human papillomavirus 2 (HPV2) | HPV27, HPV57 | Alphapapillomavirus 4 |
| Human papillomavirus 4 (HPV4) | HPV65, HPV95 | Gammapapillomavirus 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 | Alphapapillomavirus 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) | - | Gammapapillomavirus 2 |
| Human papillomavirus 49 (HPV49) | HPV75, HPV76 | Betapapillomavirus 3 |
| Human papillomavirus 50 (HPV50) | - | Gammapapillomavirus 3 |
| Human papillomavirus 53 (HPV53) | HPV30, HPV56, HPV66 | Alphapapillomavirus 6 |
| Human papillomavirus 54 (HPV54) | - | Alphapapillomavirus 13 |
| Human papillomavirus 60 (HPV60) | - | Gammapapillomavirus 4 |
| Human papillomavirus 61 (HPV61) | HPV72, HPV81, HPV83, HPV84, HPVcand62, HPVcand86, HPVcand87, HPVcand89 | Alphapapillomavirus 3 |
| Human papillomavirus 63 (HPV63) | - | Mupapillomavirus 2 |
| Human papillomavirus 71 (HPV71) | - | deleted |
| Human papillomavirus 88 (HPV88) | - | Gammapapillomavirus 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, mucous membranes of the genitals, anal area, larynx, nasopharynx. Makes it easy:
- decreased immunity;
- smoking, alcohol;
- hypothermia;
- vitamin deficiency;
- pregnancy;
- hormonal diseases;
- other sexually transmitted diseases;
- early onset of sexual activity;
- Frequent change of sexual partners.
HPV manifests itself as growths and bumps on the skin and mucous membranes called papillomas. They are divided into two groups: warts and condylomata. Depending on the location of the papillomas, other symptoms are also noted. For example, if they are located in the larynx in the vocal cords, there is hoarseness, difficulty breathing through the nose, and urinary incontinence.
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 is generally not more than 10 mm.
Human papillomavirus causes the following warts:
- Simple or vulgar. The most common. Keratinized with a rough surface, they stretch over the skin in the form of dense compounds of gray-yellow color. Occurs on the back of the hands, on the fingers, between the fingers. They tend to unite with each other;
- Straight or young. It usually occurs in children and adolescents. These are flat or light brown formations that rise slightly above the level of the skin. They usually appear in several groups on the face, neck, shoulders, and hands;
- Plantar. They occur in the plantar part of the foot in the areas of greatest pressure: on the heels, under the toes. Unlike other warts, it contains growths. They look like calluses, but do not have a smooth surface, they destroy the skin pattern. Vegetative warts are painful to the pressure, painful when walking;
- Threaded. These are soft to the touch, extending to one foot up to 4 mm long. They range in color from flesh to dark brown. It forms on the skin of the neck, eyelids, underarms, groin and under the mammary glands.
warts
Condylomata are papillomas that form on the mucous membranes of the reproductive system, oral cavity and upper respiratory tract.
Sharp and straight:
- was marked. These are fleshy or pink papillary-shaped soft cone-shaped growths. It occurs in the genital area, in the mucous membranes of the external and internal genitals, in the anus, and less so in the oral cavity. It can look like a rash of many warts that stick together to form something like a ridge. Warts of the genitals are easily injured during contact, gynecological examination, douching;
- Apartment. They look like small bumps in the deep layers of the mucous membrane. It is almost impossible to detect them with a simple inspection. Straight warts are more dangerous than the genitals, especially if they are located in the mucous membranes of the vagina and cervix. They grow in depth and width and tend to turn into a cancerous tumor.
Human papillomavirus infection in women
Human papillomavirus is especially dangerous in gynecology because it causes cervical cancer in women.
In 99% of cases, with the development of a tumor process, one of the types of highly oncogenic HPV is found.
The greatest danger comes from HPV types 16 and 18. These pathogens account for 70% of cancers and the precancerous condition of the cervix.
The first step towards a malignant tumor is structural changes in the cells, thickening and proliferation of the mucous membrane. This condition is called cervical dysplasia. Changes in dysplasia are not critical and can be reversed if treatment is started on time. The main thing is not to let the situation go its own way.
There are 3 degrees of dysplasia depending on the size and depth of the affected area:
- light;
- average;
- heavy.
The higher the degree of dysplasia, the higher the risk of the modified cells becoming a tumor. Mild degrees often go away on their own, and severe degrees, if left untreated, are more likely to turn into cancer.
Women with human papillomavirus have no symptoms in the early stages of cervical dysplasia. There is no violation of the menstrual cycle, pain in the abdomen, discomfort, bleeding. Diagnosis can be made only after examination. With severe dysplasia, it is possible to add a secondary infection and develop an inflammatory process in the vagina (colpitis) and cervix (cervititis).
Symptoms of inflammation include:
- itching, burning;
- pain, spot during sexual intercourse;
- foul-smelling vaginal discharge;
- Painful pains in the lower abdomen.
Cervical dysplasia due to papilloma virus, if left untreated, can turn into a malignant tumor in 10 to 12 years. But this is average data. The behavior of altered cells is unpredictable and largely depends 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 especially dangerous for a woman with whom he has an intimate relationship. Although asymptomatic, the partner is more likely to be infected.
One of the manifestations of HPV is genital warts in the urinary tract, around the anus, on the artificial skin at the head of the penis. Their occurrence is provoked by a strong weakening of the immune system, hypothermia, chronic nervous stress, overwork. Condylomata often cause pain and itching during sexual intercourse.
Complications of HPV in men include the development of phimosis (narrowing of the bone marrow, which prevents the removal of the eyes), malignant tumors of the penis, anal area, erectile dysfunction. The risk group includes homosexuals, bisexuals and men with immunity.Diagnostics
When warts or genital warts appear, you should see a doctor and be tested for human papillomavirus. Only a specialist will be able to determine the nature of the formations and determine their causes. Depending on the location of the papillomas, you may need to consult a dermatologist, podologist, venereologist, urologist, gynecologist, otorhinolaryngologist.
Given the risk of cervical cancer, it is recommended that women have regular gynecological examinations to detect the pathogen in a timely manner and to treat the slightest changes in its early stages.
The following tests are used to confirm HPV:
- check the problem area;
- Examination on mirrors in the gynecological chair (for women);
- Oncocytological smear. During gynecological and urological examination, it is removed from the surface of the mucous membrane with a special brush (Papanicolaou test or PAP test). The test allows you to evaluate the shape, size and location of cells under a microscope. Identify changes, damage, dysplasia, or tumor transformation of epithelial cells;
- smear for PCR analysis. For human papillomavirus, this test allows you to detect the DNA of the pathogen, determine its type and quantity;
- Colposcopy (examination of the cervix with an optical device). High oncogenic HPV and oncocytology are performed when abnormalities are detected. In this study, the doctor examines the surface of the cervix in detail due to excessive growth;
- Histological examination (biopsy). Colposcopy is performed when suspicious tissue sites are found. A small tissue area (up to 5 mm) is taken for examination under a microscope.
How is the treatment performed?
The fight against human papillomavirus infection is carried out only with the participation of one doctor. The use of alternative methods such as treatment of papillomas with celandine, iodine, treatment of papillomas with oil, treatment with laundry soap is not the most effective. In addition, methods such as destroying warts 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 first consult a specialist.
Modern treatment prevents observation, medication, surgery and complications. Unfortunately, there is no specific drug that kills HPV today.
Treatment is comprehensive in three areas:
- surgical;
- strengthen the immune system;
- Use of local and systemic antiviral drugs.
Removal of papillomas is carried out by hardware and surgical methods:
- laser technologies;
- cryotherapy (freezing with liquid nitrogen);
- lifting with a scalpel;
- radio wave operation (extraction with a radio knife);
- electrocoagulation (approach with electric current);
- moxibustion with aggressive chemicals.
A special method is selected taking into account the type, location and size of the formation. Removal of papillomas does not eliminate the virus 100%, nor does it guarantee that subsequent formations will not reappear.
Immunostimulating, antiviral drugs are prescribed from systemic drugs for human papillomavirus infection. Used for different localization of papillomas, helps to activate the body's defenses in the fight against infection. Any medication for HPV should be prescribed by a doctor. Repeated studies are performed to evaluate the effectiveness of therapy.
Peculiarities of treatment by location of papillomas
Treatment of oral papillomas includes removal of growths and supportive medication. The need to get rid of growths in the oral cavity is associated with constant anxiety, hypersensitivity of the mucous membranes, ease of damage during chewing, speech disorders and the risk of oncological transformation.
Systemic immunostimulants, topical ointments and gels, and surgical techniques are used to treat eyelid papillomas. Growths in the eyes should be eliminated if they are prone to excessive growth, decreased vision in the eye, and loss of vision. Human papillomavirus infection in the eyes is often accompanied by other infectious lesions of bacterial origin that cause inflammation of the eyelids and mucous membranes. Laser therapy, cryodestruction, electrocoagulation are used to remove papillomas.
HPV types that cause skin damage are generally harmless. Treatment of papillomas on the face and body is carried out mainly for cosmetic purposes to get rid of blemishes. In addition, convex formations are unfavorable. They are easy to touch and injure with clothes and jewelry. In some cases, papillomas do not require treatment on the skin because they disappear on their own.
The most dangerous papillomas in the genital area. Treatment of manifestations of human papillomavirus in men and women in the genital area is carried out by means of apparatus and surgery in combination with medication for immunity. The method of therapy is selected individually for each patient.
When treating papillomas in children, immunologists and pediatricians prescribe immunostimulating drugs and vitamins to increase the immune system. Often this step is enough for the formation to disappear without surgery. If papillomas need to be removed, cryodestruction and laser are used as the most reliable methods that do not cause complications.
How can HPV infection be prevented?
Many carriers in the environment are dangerous to everyone. How to avoid infection, to prevent the formation of papillomas on the skin or mucous membranes?
Vaccination is the most effective method. It is recommended to exercise in adolescence (11-12 years) before sexual activity, because the main route of infection is sexual intercourse. The human papillomavirus vaccine can then be given until the age of 45, but it will only work if there is no HPV in the body.
Papilloma virus vaccines protect against infections and cancer almost 100%.
Three vaccines have been developed and successfully used in practice:
- Protects against HPV types 6, 11, 16, 18;
- additionally protects against HPV types 31, 33, 45, 52, 58;
- It is effective against HPV types 16 and 18.
Routine HPV vaccination is available in 55 countries. These include the United States, Canada, France, Australia, Germany, Switzerland and Norway.
In addition to vaccination, HPV prevention methods include:
- to give up bad habits (smoking, alcohol);
- healthy diet balanced with vitamins;
- to delay the onset of sexual activity in adolescents;
- a regular sexual partner;
- Regular check-ups and examinations by a gynecologist.
To prevent plantar warts, you should wear indoor shoes in public pools, showers and locker rooms. These actions will reduce the risk of infection not only with HPV, but also with nail fungus (onychomycosis).
Podiatristians will help treat plantar warts, which cause HPV and other types of warts on the feet and hands, remove painful calluses, calluses, and quickly treat nail fungus. Pedicure in the form of a device, removed from the inside of the nails, performs foot care for diabetic feet.
If you have any problems with the skin of the feet or nails, consult a doctor, find out the cause of the discomfort, learn about ways to eliminate it.