The human papillomavirus (HPV or HPV) is a group of viruses in the papillomavirus family that causes damage to the skin and mucous membranes. HPV ranks first among sexually transmitted viral infections. The peak of infection occurs between 18 and 30 years. According to statistics from different countries, 80 to 90% of people are infected with HPV. But don't be afraid beforehand. Our immune system is able to destroy the pathogen and not lead to disease.
How is the human papillomavirus transmitted?
Source of infection - carriers of the infection and people with clinical manifestations of HPV.
The virus is only transmitted from person to person.
It is present in urine, saliva and genital secretions.
The infection enters the body in three ways:
- Contact and family. The infection occurs by touching the skin and mucous membrane of an infected person. The risks of contracting the human papillomavirus are especially high if there are scratches, cuts, wounds or abrasions in the contact area. The virus is able to maintain viability for some time in the external environment, therefore, infection is possible in a public shower, pool, bath, through clothes, dishes, hygiene items;
- Sexual. This is the main route of infection. The infection occurs with any type of sexual intercourse: genital, anal, oral-genital. The probability of infection with a single contact with an infected partner is 60%;
- At delivery, 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 manifest itself to some extent. We may not even be aware of its presence in the body. Normally, the immune system fights against the human papillomavirus, gradually destroying it, preventing the development of the pathology.
This self-healing takes from 6 months to 2 years, depending on the characteristics of the organism. But if the immune system is weak, the virus enters an active phase, begins to manifest itself. The chances of self-healing decrease with age, for people under 30 are 80%. The first symptoms of the presence of HPV in the body can appear after a few weeks or decades. It all depends on the resistance of the body and the type of papilloma virus with which it is infected.
Types of HPV
About 200 types or varieties of human papillomavirus are now known. They are divided into 4 groups according to the risk of cancer. Each type is assigned a number that was assigned to it in the order of opening.
Identify the types of HPV that:
- 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);
- most often gives 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 human papillomaviruses at high oncogenic risk, types 16, 18, 31, 33, 52, 58 are the most common.
HPV is responsible for 7 - 8% of all cancers. It's the reason:
- 99% of cervical cancer cases in women;
- 93% of anal cancer cases;
- 51% of vulvar cancers;
- 36% of penile cancer cases;
- 63% of oropharyngeal cancer cases.
Types of human papillomavirus registered since 2003.
| Species name in 2003—2010. | Other types (strains) included in the species | Species name 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 |
| Cand90 human papillomavirus (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, the mucous membranes of the genitals, the anal region, the larynx, the 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 change of sexual partners.
HPV manifests itself as lumps, bumps on the skin and mucous membranes, called papillomas. They are divided into two groups: warts and condyloma. Other symptoms are also observed, depending on the location of the papillomas. For example, if they are located in the larynx on the vocal cords, hoarseness of the voice is observed, if in the nose breathing difficulties are possible, if in the ureter there is a violation of the flow of urine.
Warts
Warts are the most common manifestation of human papillomavirus infection on the skin.
These are rounded formations with clear boundaries and a rough surface. Its size generally does not exceed 10 mm.
The human papillomavirus causes the following types of warts:
- Simple or common. More common. They protrude above the skin in the form of dense yellowish-gray formations with a rough keratinized surface. Formed on the back of the hands, on the fingers, between the fingers. They tend to merge;
- Simple or young. They usually occur in children and adolescents. They are flattened pulp or light brown formations, slightly rising above the level of the skin. They usually appear on the face, neck, shoulders, hands in groups of several;
- Plant. It forms on the plantar part of the foot in places of greatest pressure: on the heel, under the toes. Unlike other warts, its growth is internal. In appearance, they resemble calluses, but have a rough rather than smooth surface, they destroy the skin pattern. Plantar warts are painful under pressure, painful when walking;
- Chained. They are elongated protuberances, soft to the touch, on a leg up to 4 mm in length. Its color ranges from the flesh to the dark brown. Formed in the neck, skin of the eyelids, in the armpits, groin, under the mammary glands.
Warts
Condylomas are papillomas that form on the mucous membranes of the reproductive system, mouth and upper respiratory tract.
There are pointed and flat:
- Pointed. They are growths in the form of a soft cone of a papillary form of flesh or pink color. It forms in the genital region, in the mucous membrane of the external and internal genital organs, anus, less frequently in the oral cavity. It can appear as an eruption of many warts that merge, forming something similar to a crest. Genital warts are easily injured during sexual intercourse, gynecological examination, hygienic shower;
- Flat. They look like small bumps, located in the deep layers of the mucous membrane. It is almost impossible to detect them with a simple inspection. Flat warts are more dangerous than genital warts, especially if they are located on the mucous membrane of the vagina and cervix. They grow in depth and width and tend to degenerate into a cancerous tumor.
Human papillomavirus infection in women
The human papillomavirus is especially dangerous in the field of gynecology, as 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 biggest threat comes from HPV types 16 and 18. These pathogens are responsible for 70% of cancers and precancerous conditions of the cervix.
The first step on the path to a malignant tumor is structural changes in cells, thickening, proliferation of the mucous membrane. This condition is called cervical dysplasia. Changes in dysplasia are not critical and reversible if treatment is started on time. The main thing is not to let the situation take its course.
According to the size and depth of the affected area, 3 degrees of dysplasia are distinguished:
- light;
- medium;
- heavy.
The greater the degree of dysplasia, the greater the risk of degeneration of cells altered in a tumor. A mild degree usually goes away on its own, and a severe degree, if left untreated, is highly likely to develop into cancer.
In the early stages of cervical dysplasia in women, caused by the human papillomavirus, there are no symptoms. There is no interruption of the menstrual cycle, pain in the lower abdominal region, discomfort, bleeding. The diagnosis can only be made after examination. With a severe degree of dysplasia, it is possible to attach a secondary infection, develop an inflammatory process in the vagina (colitis) and in the cervix (cervicitis).
Signs of inflammation include:
- itching, burning;
- pain, spots during intercourse;
- fetid vaginal discharge;
- aching pain in the lower abdomen.
Cervical dysplasia due to the papilloma virus, if left untreated, turns into a malignant tumor in 10 to 12 years. But those are the average data. The behavior of the altered cells is unpredictable and depends a lot 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 a danger to a woman with whom he has an intimate relationship. He is very likely to infect his partner, even if he is asymptomatic.
Of the manifestations of HPV, there are genital warts on the foreskin, on the head of the penis, in the area of the urethra, around the anus. Its occurrence is caused by a strong weakening of the immune system, hypothermia, chronic nervous stress and overwork. Condylomata usually cause pain during intercourse, itching.
HPV complications in men include: the development of phimosis (narrowing of the foreskin, which prevents removal of the glans), malignant tumors of the penis, anal area, erectile dysfunction. The risk group includes homosexuals, bisexuals and immunocompromised men.
Diagnosis
When warts or genital warts appear, you need to see a doctor and get tested for human papillomavirus. Only a specialist can determine the nature of the formations, establish their cause. Depending on the location of the papillomas, it may be necessary to consult a dermatologist, podiatrist, venereologist, urologist, gynecologist, otorhinolaryngologist.
Given the risk of cervical cancer, women are advised to undergo regular examinations by a gynecologist in order to detect the pathogen in a timely manner and cure the smallest changes caused by it in the early stages.
The following tests are used to confirm HPV:
- Inspection of the problem area;
- Examination in a gynecological chair in mirrors (for women);
- Smear of oncocytology. It is obtained during a gynecological and urological examination of the mucous membrane surface with a special brush (Pap test or PAP test). The test allows you to assess the shape, size and nature of the location of cells under a microscope. Identify changes, damage, dysplasia or tumor transformation of epithelial cells;
- Smear for PCR analysis. This analysis of the human papillomavirus allows the detection of the pathogen's DNA, determining its type and quantity;
- 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 doctor examines the cervical surface in detail due to a multiple enlargement;
- Histological examination (biopsy). It is performed when suspicious tissue sites are detected during colposcopy. A small area of tissue (up to 5 mm) is removed for examination under a microscope.
How is the treatment done?
The fight against human papillomavirus infection is carried out exclusively with the participation of a doctor. The use of alternative methods, such as treatment of papillomas with celandine, iodine, treatment with papillomas with oil, treatment with washing powder, in most cases is not effective. In addition, these methods of destruction of warts can worsen the condition, cause complications and injure the surrounding healthy skin. It is not recommended to use them at your own risk. You must first consult an expert.
Modern treatment includes observation, medication, surgery and prevention of complications. Unfortunately, today there are no specific drugs that destroy HPV.
Treatment is carried out comprehensively in three areas:
- surgical
- ;
- strengthening the immune system;
- the use of local and systemic antivirals.
Papillomas are removed using hardware and operational methods:
- laser technologies;
- cryotherapy (freezing with liquid nitrogen); removing
- with a scalpel;
- radio wave surgery (scalpel removal);
- electrocoagulation (moxibustion with electric current);
- moxibustion with aggressive chemicals.
The specific method is selected taking into account the type, location and size of the formation. The removal of papillomas does not eliminate the virus 100%, it does not guarantee that later formations will not reappear.
Of systemic drugs for papillomavirus infection, immunostimulating and antiviral agents are prescribed. They are used for different locations of papillomas, they help to activate the body's defenses to fight infections. All HPV drugs must be prescribed by a doctor. During therapy, repeated studies are carried out to evaluate its effectiveness.
Peculiarities of the treatment of papillomas by location
Treatment for papillomas in the mouth includes removal of tumors and supportive drug therapy. The need to get rid of growths in the oral cavity is associated with constant discomfort, high sensitivity of the mucous membrane, ease of injury in the process of chewing food, speech impairment and risk of oncological transformation.
For the treatment of papillomas on the eyelids, systemic immunostimulating agents, ointments and local gels and surgical methods are used. Tumors in the eyes should be removed if they are subject to overgrowth, reduce the vision available to the eye and impair vision. Infection of human papillomavirus in the eyes is usually accompanied by other infectious lesions of bacterial origin, leading to inflammation of the eyelids and mucous membranes. To remove papillomas, laser therapy, freezing and electrocoagulation are used.
The types of HPV that cause skin damage are generally harmless. The treatment of papillomas on the face and body is done mainly for cosmetic purposes, in order to eliminate imperfections. In addition, convex formations are inconvenient. It is easy to touch them with clothes, jewelry, wounds. In some cases, the treatment of papillomas on the skin is not necessary, as they disappear spontaneously.
The most dangerous papillomas in the genital region. The treatment of manifestations of human papillomavirus in men and women in the genital area is performed by hardware and surgical methods in combination with the intake of immunity medications. For each patient, the therapy method is selected individually.
In the treatment of papillomas in children, immunologists and pediatricians prescribe immunostimulating drugs, vitamins to improve defenses. Often, this step is sufficient for the formation to disappear without surgery. If it is necessary to remove papillomas, freezing and laser are the safest methods and do not cause complications.
How to prevent HPV infection?
A large number of carriers of the virus are dangerous for everyone. How to prevent infection, prevent the appearance of papillomas on the skin or mucous membranes?
Vaccination is considered the most effective method. It is advisable to perform it in adolescence (11 - 12 years old) before the beginning of sexual activity, since sexual contact is the main route of infection. The human papillomavirus vaccine can be applied later, until the age of 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 successfully applied in practice:
- protects against HPV types 6, 11, 16, 18;
- additionally protects against HPV types 31, 33, 45, 52, 58;
- is effective against HPV types 16 and 18.
Routine HPV vaccination is carried out in 55 countries. Among them are America, Canada, France, Australia, Germany, Switzerland, Norway.
In addition to vaccination, HPV prevention methods include:
- giving up bad habits (smoking, alcohol);
- healthy nutrition balanced with vitamins;
- delaying the onset of sexual activity in adolescents;
- a regular sexual partner;
- regular check-ups and exams by a gynecologist.
To prevent plantar warts, you must wear closed shoes in public pools, showers, changing rooms. These actions will reduce the risk of infection not only by HPV, but also by nail fungus (onychomycosis).
Podiatrists will help you heal plantar warts caused by HPV and other types of warts on the feet and hands, remove painful calluses and calluses and quickly cure nail fungus. They perform medical pedicure, removal of ingrown toenails, foot care for diabetic feet.
If you are concerned about a skin problem on your feet or nails, go to the doctor for a consultation, find out the cause of the discomfort, get information on the methods by which it can be eliminated.