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Human papillomavirus: symptoms, women, men, treatment

Papillomavirus infection is a topic that is being talked about all over the world right now. The virus, which has been shown to cause warts and smaller formations (papillomas) on the skin, can lead to the development of cancers of the reproductive organs in women and men, as well as cancers of the rectum and throat. Vaccines designed to protect a person from the most dangerous strains of the virus themselves can cause severe reactions.

Types of papillomavirus infection

Warts and cervical cancer are caused by two different types of the same virus (called strains). The mere fact that a papillomavirus infection is determined to have occurred does not mean that a person will develop papillomavirus cancer: it is possible if a strain from the carcinogenic group enters the body. At the same time, infection with any strain increases the risk of another virus entering the body.

In total, approximately 600 strains of papillomaviruses have been isolated that differ from each other in proteome and sequence on their coats. Scientists divide them into 27 species and 5 genera.

The following types of human papillomavirus can be distinguished based on their ability to cause cancer:

  1. Low risk of cancer (they are less likely to cause cancer when they enter the body). These are the viruses numbered 3, 11, 32, 34, 40-44, 6, 51, 61, 13. 72 and 73.
  2. Has an average carcinogenic risk. These are strains 35, 53, 30, 52, 45, 56, 58. They cause formation on the skin and mucous membranes with a higher probability of malignancy than in the first case.
  3. Highly carcinogenic strains. First, this is papillomavirus type 16, which causes cervical cancer in every 2 women (41-54%), and type 18, which causes the disease in every 1 in 10 carriers. Highly carcinogenic also includes strains numbered 31, 33, 39, 50, 59, 64, 68, 70, 82.

The dangers of papillomavirus infection

The characteristic of papilloma virus is that it can be deposited in the skin or in the mucous membranes of various organs: reproductive organs (male and female), esophagus, bronchi, oral cavity, rectum. It can also be localized in the conjunctiva of the eye.

Each strain has its own "favorite" location. So the most dangerous types 16 and 18 "enter" the genitals as soon as they are hit, while the low-carcinogenic viruses 6 and 11 affect the vulva and perineum, leading to the development of genital warts. If the child was born naturally from a mother with genital warts, these same strains may cause respiratory papillomatosis in the child.

Severely symptomatic illness does not always occur after infection. Instead, the disease is most often overlooked without serious consequences.

The most dangerous complications of HPV infection are:

  • Cervical cancer. It occurs in women due to infection with HPV type 16 or 18. It has been shown that the disease does not occur in the absence of papillomavirus. If before they talked about cervical cancer caused by erosion or valgus, now it has been revised and denied;
  • Rectal cancer. Unlike the first disease, it may have other causes;
  • Throat Cancer. It is also caused by type 16 virus;
  • Lung cancer, which can occur when infected with 16, 18, 11, 2, 6, 30 viruses;
  • Respiratory failure, which develops with the growth of malignant papillomas of the respiratory tract (larynx, trachea);
  • Wart contact bleeding. If they are in the vulva, perineum, or vagina, they are sexually stimulated. Using different positioning (nose, mouth), bleeding can be induced by mechanically injuring them with other objects.

According to official sources, fewer than one million (470, 000) new cases of cervical cancer caused by this virus are registered in the world each year. Every year 233, 000 women die from the disease. This makes this neoplastic disease the second most frequent of all cancer pathologies in gynecology (1st in breast cancer) and the 5th most common cause of death in women. In most cases, women under the age of 40 die from cervical cancer.

way for spreading

Papillomaviruses are extremely common. According to modern data, it can be found in 90% of the world's population.

How HPV is spread:

  • Sexuality (with any type of sexuality). Condoms reduce the likelihood of their penetration into the body (37. 8 percent with condoms, 89. 3 percent without it), but do not completely prevent infection: the diameter of the holes in latex is designed to keep sperm out, whileThe size of the virus is too small;
  • The home way, when the virus penetrates damaged skin. This happens in swimming pools, bathrooms, when using shared towels, nail tools, utensils;
  • From mother to child, during labor: more often - independent births, but also caesarean sections, there is also the possibility of the virus entering the laryngeal membrane;
  • with saliva - with a kiss;
  • Contact - When skin or mucous membranes are rubbed against or cut into papilloma, wart or condyloma acuminatum, the integrity is destroyed. This is how self-infection usually happens.

If a person's immunity is strong when the virus comes in, there is little chance that the disease will develop: the microbes are likely to remain inactive. Your risk of developing the disease increases if:

Human papillomavirus on the skin
  • Early (before age 16) initiation of sexual activity or at least petting;
  • Frequent (more than once in 3 years) changing sexual partners;
  • Genital infections such as recurrent thrush, chlamydia, gonorrhea, ureaplasmosis;
  • abortion;
  • Cervical disease: erosion, eversion;
  • constant pressure;
  • Bad habits: smoking, drinking;
  • long-term use of contraceptives;
  • Violation of metabolic processes;
  • Vitamin deficiency.

Condyloma acuminatum in pregnant women is an indication for a caesarean section - to avoid infecting the child's respiratory tract. Therefore, the child is less likely to "get" microbes from the mother. Carcinogenic types of the virus do not spread through households because the structures that carry the virus are not located on the skin. Therefore, the first "acquaintance" with these microbes usually occurs during sexual intercourse, which usually occurs during adolescence. This justifies the need to take steps (especially vaccinations) before the first sexual experience.

How does papillomavirus infection manifest itself?

Symptoms of HPV depend on the strain that enters the body and the clinical form it causes. So, it could be:

  1. papilloma- single or multiple. These are mushroom-like growths on skin-colored stems, or have a yellow, brown, or black tint. They are found on the skin under the breast, on the neck, in the armpits, on the face, and on the mucous membranes of the mouth, nose, or genitals. Papillomas are more common in women. Often they are just cosmetic flaws and they cause discomfort or pain. Rarely, papillomas can become malignant.
  2. wart, including the soles of the feet. These are brown mushroom formations. On the palms and soles of the feet, they occur where friction is greatest and can cause pain when pressed. Plantar warts may have a shaft that extends into healthy tissue. They can become inflamed and injured.
  3. condyloma acuminatum. These are papillary growths that merge into each other, similar to cauliflower. Condyloma acuminatum forms on the mucous membranes: on the genitals, on the perineum. If they arise as a result of anal sex, they take up positions around the anus. Condyloma acuminatum can also be located on the mucous membranes of internal organs: bladder, bowel. This can lead to symptoms such as painful urination or defecation, which is a violation of physiological functions.
  4. Cervical Precancer - Dysplasia, caused by human papillomavirus - no clinical manifestations. This disorder may be suspected on colposcopy; detected by cytology of cervical smear.
  5. cervical cancerdoes not appear immediately. In the early stages, there are no symptoms. Women should be wary of itching in the genital area, changes in the nature of genital discharges (they may become more abundant, may appear bloody, may have an unpleasant odor), menstrual irregularities, bleeding after sex or mid-cycle. In later stages, the disease is characterized by swelling of the legs (usually on one side) and pain in the spine or lower back.
  6. Bowenoid papulosis. This is the name for a precancerous condition that is more common in men. It is characterized by the appearance of varying numbers of spots and patches on the skin, ranging in color from pink or yellowish to reddish-brown or purple. The surface of such patches can be smooth or warty; they are painful to touch.
  7. Bowen's disease- This is a cancer of the skin and mucous membranes that develops from the cells of the surface layer. It looks like a bright red skin defect that is unevenly contoured and covered with scales and warty growths.

In men, human papillomavirus causes a specific disease called squamous cell carcinoma of the penis. The reason for this is the type 16 virus. The latter alters the cells of the male reproductive tract under the influence of cigarette smoke and acquires malignant features under the influence of herpes simplex virus type 2, if the man's DNA contains the Ras gene, if the PUVA is treated, then chemotherapy, or if the person is infected with AIDSVirus. Squamous cell carcinoma looks different. This can be a spot on the top of the skin with a wart-like growth on top, or it can look like an ulcer that destroys the penis. The tumor is on the head or foreskin.

Rectal cancer caused by human papillomavirus is also more common in men. It mostly happens to people with non-traditional orientations. It is characterized by painful bowel movements, the discharge of blood or pus from the rectum.

Papillomavirus infection of any kind does not appear immediately after infection: the first symptoms must take anywhere from 14 days to several years (depending on immunity and favorable factors).

diagnosis

Papillomavirus analysis is not necessary in order to make a diagnosis in the presence of external papilloma or warts. If other clinical forms of infection are present, you will need:

  1. Physical examination:Women - gynecologists, men - urologists.
  2. colposcopy(Women) - The cervix is examined under a microscope. During the study, tests were performed using Lugol solution, Papanicolaou test (smear from the cervical canal and cervix), cervical biopsy, smear by PCR method and Digene test.
  3. Urethroscopy and Proctoscopy(male). When examining the urethra or rectum, biopsies of suspected precancerous or cancerous changes are also performed, and smears are done by PCR methods and the Digene test.

Therefore, testing for the virus can only be done in the office of a gynecologist (for women) or a urologist (for men). This is a PCR study of a cervical or urethral smear, or Digene test, using material taken from a biopsy or scraped epithelial cells.

treat

How HPV is treated depends on the form of infection. Therefore, if we are talking about warts, papillomas or condyloma acuminatum, the treatment is carried out in two stages:

  1. The formation is removed by various methods. This can be surgical excision with a scalpel, burning with a laser or electrical current, which is more effective in the case of papilloma and condyloma acuminatum. For the treatment of warts, the method of cryo-destruction - the necrosis of pathological tissue with the help of liquid nitrogen at a very low temperature is successfully used.
  2. Appointing immunomodulators, whose task is to activate one's own immunity, should no longer allow the virus to "raise its head" (drugs that completely destroy the virus have not yet been invented).

Also, it is important to make sure to prevent reinfection: stop having sexual contact with an infected partner (preferably - get treatment with him), avoid frequent changes of sexual partners, avoid going to baths, saunas, swimming pools.

Treatment for human papillomavirus cancer depends on the stage at which the cancer is detected. It usually consists of three parts: surgery to remove the tumor, chemotherapy and radiation therapy. When to apply the last two treatments -- only after surgery, not surgery or surgery -- the oncologist decides after examination.

A vaccine that can cure human papillomavirus infection is in development.

prevention

Given the danger of human papillomavirus infection and its significant prevalence, several vaccines against human papillomavirus have been synthesized.

All vaccines are certified and tested. They don't contain the virus themselves, but a single protein on the capsule of a given strain of virus, so they don't cause disease. Testing is recommended even before puberty - at ages 9-14, that is, until the child is still unfamiliar with the virus. So far, clear advice only applies to girls, as cervical cancer only occurs from contracting the virus and the death rate is extremely high. Boys are also vaccinated at the same age.

It doesn't look like you can find any money to save a child from such a severe neoplastic disease. In addition, the introduction of one of these vaccines has been incorporated into national immunization programs in some countries around the world, as well as in 18 states in the United States. But there are many "buts":

  • Studies have shown that vaccines can reduce, but not completely prevent, the risk of cervical cancer;
  • According to official data, 8% of all side effects observed during vaccination (or 0. 003% of all vaccinations) were caused by serious side effects: death, disability, life- and health-threatening illness. 56 vaccinated adult women also reported deaths that were not found to be related to the vaccination itself;
  • In response to the vaccine, some teens responded with a rise in body temperature that caused convulsions, and some developed respiratory failure, which was fatal. It has been suggested that this response can be observed in carriers of a certain gene. At the same time, no research on the human genome has been done before vaccination, so there is no way to know if the child is a carrier of the gene;
  • After vaccination, Guillain-Barré syndrome was registered - a disease that causes paralysis of the legs and arms (usually reversible), muscle weakness and its complete "shutdown" affects all muscles, including the respiratory muscles;
  • Cases of increased thromboembolic risk have been noted. This complication occurred in 56 people, including 19 people with pulmonary embolism and 4 people who died;
  • It's unclear how vaccination affects fertility and pregnancy: It's been too short since the first girls were vaccinated.

On the one hand, there is still evidence that vaccinated women maintain normal (according to the Pap test) state of cervical cells for at least 5 years. On the other hand, it is too early to talk about the long-term outcomes of vaccination. In any case, if a girl is taught "from an early age" that preventive checks, including those from a gynecologist, are good for her, we can expect any disease to be detected at an early stage.

Therefore, it is up to parents to decide whether to vaccinate their children.