Human papillomavirus (HPV or HPV) is a group of viruses in the papillomavirus family that damage the skin and mucous membranes. HPV ranks first among sexually transmitted viral infections. The peak of the infection occurs between the ages of 18 and 30 years. According to statistics from different countries, 80 to 90% of people are infected with HPV. But don't worry in advance. Our immune system is able to destroy the pathogen and not bring the case to disease.
How is the human papillomavirus transmitted?
Source of infection - carriers of 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 household. Infection occurs by touching the skin and lining of an infected person. The risk of developing human papillomavirus is particularly high if there are scratches, cuts, wounds and abrasions in the contact area. The virus can remain viable in the external environment for some time, so infection is possible in a public shower, pool, bath, through clothing, dishes, and toiletries.
- Sexually. This is the main route of infection. 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%;
- When giving birth during pregnancy. An infected mother can infect the baby in the womb and through the birth canal.
The infection with the human papillomavirus is characterized by a latent course. After infection, the virus does not manifest itself until a certain point in time. We may not even be aware of its presence in the body. Usually, the immune system fights the human papillomavirus, gradually destroying it, thereby preventing the development of pathology.
Such self-healing takes 6 months to 2 years, depending on the characteristics of the organism. But when the immune system is weak, then the virus goes into an active phase and begins to manifest. The chances of self-healing decrease with age; in people under 30 it is 80%. The first symptoms of the presence 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 papillomavirus it is infected with.
HPV types
About 200 species or varieties of human papillomavirus are currently known. They are divided into 4 groups depending on the cancer risk. Each of the types is identified by a number assigned to it in the order in which it was opened.
Identify HPV types that:
- never causes cancer (1, 2, 3, 4, 5, 10, 28, 49);
- very rarely causes cancer (6, 11, 13, 32, 40 - 44, 51, 72);
- have an average oncogenic risk (26, 30, 35, 52, 53, 56, 58, 65);
- most often leads to malignant transformation (16, 18, 31, 33, 39, 45, 50, 59, 61, 62, 64, 68, 70, 73).
The last group that is most dangerous to health.
Of the human papilloma viruses with a high oncogenic risk, types 16, 18, 31, 33, 52, 58 are the most common.
HPV accounts for 7 - 8% of all cancers. This is the reason:
- 99% of women with cervical cancer;
- 93% of anal cancer cases;
- 51% of vulvar cancers;
- 36% of penile cancer cases;
- 63% of cases of oropharyngeal cancer.
Human papillomavirus types registered since 2003.
| Name of the species in 2003-2010. | Other species (trunks) in the species | includesspecies 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 |
| 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, the mucous membranes of the genitals, the anal region, the larynx and the nasopharynx. This is made easier by:
- decreased immunity;
- smoking, alcohol;
- hypothermia;
- vitamin deficiency;
- pregnancy;
- hormonal disorders;
- other sexually transmitted diseases;
- early onset of sexual activity;
- frequent change of sexual partner.
HPV manifests itself in growths, bumps on the skin and mucous membranes, so-called papillomas. They are divided into two groups: warts and condylomas. Depending on the location of the papillomas, other symptoms are also noted. For example, if they are located in the larynx on the vocal cords, hoarseness of the voice is observed, if breathing difficulties are possible in the nose, if there is a violation of the urine outflow in the ureter.
warts
Warts are the most common manifestation of an infection with the human papillomavirus on the skin.
These are rounded formations with clear boundaries and a rough surface. Their size usually does not exceed 10 mm.
Human papillomavirus causes the following types of warts:
- Simple or vulgar. Most common. They protrude above the skin in the form of dense formations of gray-yellow color with a keratinized rough surface. Formed on the back of the hand, on the fingers, between the fingers. They tend to merge with one another;
- Flat or youthful. They usually occur in children and adolescents. These are flat formations of flesh or light brown color, slightly protruding above the level of the skin. They usually appear on the face, neck, shoulders, and hands in groups of several;
- Plantar. They form on the plantar part of the foot in places with the greatest 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, they destroy the skin pattern. Plantar warts are painful to pressure, painful when walking;
- thread. These are elongated, soft-to-the-touch growths on a leg up to 4 mm long. Their color ranges from flesh to dark brown. Formed on 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 ones:
- showed. They are soft cone-shaped growths of papillary shape, fleshy or pink in color. Formed in the genital area, on the mucous membrane of the external and internal genital organs, anus, less often in the oral cavity. May appear as a rash of many warts that fuse together to form something like a comb. Genital warts can be easily injured during intercourse, gynecological exams, and showering.
- flat. They look like small bulges that are located in the deep layers of the mucous membrane. It's almost impossible to spot them with a simple inspection. Flat warts are more dangerous than genital warts, especially if they are on the lining of the vagina and cervix. They grow in depth and breadth and tend to degenerate into a cancerous tumor.
Human papillomavirus infection in women
The human papillomavirus is particularly dangerous in the field of 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 threat comes from HPV types 16 and 18. These pathogens make up 70% of cancers and precancerous diseases of the cervix.
The first step on the way to a malignant tumor are structural changes in the cells, thickening and proliferation of the mucous membrane. This condition is known as cervical dysplasia. Changes in dysplasia are not critical and are reversible if treatment is started on time. The main thing is not to let the situation take its course.
Depending on the size and depth of the affected area, a distinction is made between 3 degrees of dysplasia:
- easy;
- medium;
- difficult.
The higher the degree of dysplasia, the higher the risk of altered cells degenerating into a tumor. A mild degree often goes away on its own, and a severe one, if left untreated, is most likely to turn into cancer.
In the early stages of cervical dysplasia in women caused by the human papillomavirus, there are no symptoms. There is no disruption of the menstrual cycle, pain in the lower abdomen, discomfort, bleeding. The diagnosis can only be made after the examination. With a severe degree of dysplasia, it is possible to attach a secondary infection, develop an inflammatory process in the vagina (colpitis) and in the cervix (cervicitis).
Signs of inflammation are:
- Itching, burning;
- pain, spots during intercourse;
- foul-smelling vaginal discharge;
- aching pain in the lower abdomen.
Cervical dysplasia due to the papillomavirus turns into a malignant tumor within 10 to 12 years if left untreated. However, these are the average dates. The behavior of the changed 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 primarily a danger to a woman with whom he has a close relationship. It is very likely that he will infect his partner even if he is asymptomatic.
Of the manifestations of HPV, genital warts are located on the foreskin, the head of the penis, in the area of the urethra around the anus. Their appearance is provoked by a severe weakening of immunity, hypothermia, chronic nervous stress and overload. Condylomas often cause pain and itching during intercourse.
Complications of HPV in men include: the development of phimosis (narrowing of the foreskin, which prevents the glans from being removed), malignant tumors of the penis, anal region, erectile dysfunction. The risk group includes homosexual, bisexual and immunocompromised men.
Diagnosis
If warts or genital warts appear, you need to see a doctor and get tested for the human papillomavirus. Only a specialist can determine the type of formations and determine their cause. Depending on the location of the papillomas, you may need to consult a dermatologist, podiatrist, venereologist, urologist, gynecologist, or ENT doctor.
In view of the risk of cervical cancer, women are advised to have regular gynecological examinations in order to identify the pathogen in good time and to cure the smallest changes caused by it at an early stage.
The following tests are used to confirm HPV:
- Inspection of the problem area;
- Examination in a gynecological chair on mirrors (for women);
- Oncocytology smear. It is taken from the surface of the mucous membrane with a special brush (Papanicolaou test or PAP test) during a gynecological and urological examination. The test allows you to assess the shape, size, and location of cells under a microscope. Identify changes, damage, dysplasia or tumor transformation of epithelial cells;
- smear for PCR analysis. This analysis for the human papillomavirus allows you to detect the DNA of the pathogen, determine its type and amount;
- Colposcopy (examination of the cervix with an optical device). It is performed when high oncogenic HPV and abnormalities in oncocytology are detected. In this study, the doctor examines the surface of the cervix due to a multiple increase in detail.
- Histological examination (biopsy). It is performed when suspicious sites of tissue are discovered during the colposcopy. A small area of tissue (up to 5 mm) is removed for examination under a microscope.
How is the treatment carried out?
The fight against infection with the human papillomavirus is carried out exclusively with the participation of a doctor. The use of alternative methods such as treating papillomas with celandine, iodine, treating papillomas with oil, and treating with laundry soap are mostly ineffective. In addition, such methods of destroying warts can worsen the condition, provoke complications and injure the surrounding healthy skin. It is not recommended to use them at your own risk. You need to contact a specialist first.
Modern treatment includes observation, medication, surgery and prevention of complications. Unfortunately, there are no specific drugs that destroy HPV today.
The treatment is carried out comprehensively in three areas:
- surgical;
- Strengthening the immune system;
- the use of local and systemic antiviral drugs.
Removal of papillomas is done by hardware and operating 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 taking into account the type, location and size of the formation. Removing papillomas does not eliminate 100% of the virus and does not guarantee that the formations will not reappear later.
Of the systemic drugs for infection with human papillomavirus, immunostimulating, antiviral agents are prescribed. They are used to localize papillomas in different ways and help to activate the body's defenses in the fight against infections. All drugs for HPV should be prescribed by a doctor. Repeated studies are conducted over the course of therapy to assess effectiveness.
Special features of the treatment of papillomas by location
Treatment of papillomas in the mouth includes removal of the growth and supportive drug therapy. The need to get rid of growths in the oral cavity is fraught with constant discomfort, high sensitivity of the mucous membrane, slight injury when chewing food, impaired speech and the risk of oncological transformation.
For the treatment of papillomas on the eyelids, systemic immunostimulatory agents, local ointments and gels, as well as surgical methods are used. The growths on the eyes must be removed if they have a tendency to overgrow, reduce vision to the eye, and impair vision. Human papillomavirus infection in the eyes 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. Treatment of papillomas on the face and body is mainly done for cosmetic purposes, to get rid of imperfections. In addition, convex formations are impractical. It is easy to touch with clothing, jewelry, or injuries. In some cases, treatment for papillomas on the skin is not necessary because they disappear spontaneously.
The most dangerous papillomas in the genital area. Treatment of the manifestations of human papillomavirus in men and women in the genital area is carried out by hardware and surgical methods in combination with the use of drugs for immunity. The therapy method is selected individually for each patient.
In the treatment of papillomas in children, immunologists and pediatricians prescribe immune-stimulating drugs, vitamins to strengthen the immune system. Often this step is enough for the formation to go away without surgery. When papillomas need to be removed, cryodestruction and laser are used as the safest method that does not cause complications.
How can an HPV infection be prevented?
A large number of virus carriers are dangerous for everyone. How to avoid infection, prevent papillomas from appearing on the skin or mucous membranes
Vaccination is considered to be the most effective method. It is advisable to do it in adolescence (11-12 years) before starting sexual activity, as the main route of infection is the sexual route of infection. The human papillomavirus vaccine can be done later until the age of 45, but it will only work if there is no HPV in the body.
Papillomavirus vaccines offer almost 100% protection against infection and cancer.
Three vaccines have been developed and are used successfully in practice:
- protects against HPV 6, 11, 16, 18 types;
- also 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 diet balanced with vitamins;
- delay in beginning sexual activity in adolescents;
- a regular sexual partner;
- regular examinations and examinations by a gynecologist.
To avoid plantar warts, closed shoes should be worn in public swimming pools, showers and changing rooms. These measures reduce the risk of infection not only with HPV, but also with nail fungus (onychomycosis).
Podiatrists will help you cure 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 hardware pedicures, ingrown toenail removal, and foot care for diabetic feet.
If you are concerned about problems with the skin of the feet or nails, contact the doctor to determine the cause of the discomfort and learn about the methods that can be used to get rid of it.