Human papillomavirus (HPV or HPV) is a group of viruses of the papillomavirus family that damage the skin and mucous membranes. HPV ranks first among sexually transmitted viral infections. The peak of infection occurs between the ages of 18 and 30. According to statistics from different countries, 80-90% of people are infected with HPV. But don't be afraid in advance. Our immune system is capable of destroying the pathogen, not causing disease.
How is 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 housekeeping. 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, abrasions in the contact area. The virus is able to remain viable for some time in the external environment, therefore infection is possible in a public shower, swimming pool, bath, through clothing, dishes, hygiene items;
- Sexual. It is the main route of infection. The infection occurs during any type of sexual intercourse: genital, anal, oral-genital. The probability of infection with a single contact with an infected partner is 60%;
- During childbirth, during pregnancy. An infected mother can infect the baby in utero and through the birth canal.
Infection with human papillomavirus is characterized by a latent course. After infection, the virus does not manifest itself until a certain time. We may not even be aware of its presence in the body. Normally, the immune system fights against the human papillomavirus, gradually destroys it, preventing the development of pathology.
Such self-healing takes 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, they 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 what type of papilloma virus it is infected with.
Types of HPV
About 200 types or varieties of human papillomavirus are currently known. They are divided into 4 groups according to cancer risk. Each type is designated by a number 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);
- have a moderate oncogenic risk (26, 30, 35, 52, 53, 56, 58, 65);
- most often results in a malignant transformation (16, 18, 31, 33, 39, 45, 50, 59, 61, 62, 64, 68, 70, 73).
The last group most dangerous to health.
Among the high risk oncogenic human papillomaviruses, 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 cases of cervical cancer 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 recorded since 2003.
| Name of the species 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 |
| Human papillomavirus cand90 (HPVcand90) | - | Alphapapillomavirus 14 |
| Human papillomavirus cand92 (HPVcand92) | - | Betapapillomavirus 4 |
What are the symptoms of human papillomavirus infection?
When transitioning to the active form, HPV affects the skin, mucous membranes of the genitals, anal area, larynx, nasopharynx. This is facilitated by:
- decrease in immunity;
- smoking, alcohol;
- hypothermia;
- vitamin deficiency;
- pregnancy;
- hormonal disorders;
- other sexually transmitted diseases;
- early onset of sexual activity;
- frequent change of sexual partners.
HPV is manifested by growths, bumps on the skin and mucous membranes, called papillomas. They are divided into two groups: warts and condyloma. Other symptoms are also noted depending on the location of the papillomas. For example, if they are located in the larynx on the vocal cords, then hoarseness of the voice is observed, if in the nose difficulty in breathing is possible, if in the ureter there is a violation of the outflowurine.
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. Their size usually does not exceed 10 mm.
Human papillomavirus causes the following types of warts:
- Simple or vulgar. The most common. They protrude above the skin in the form of dense formations of gray-yellow color with a rough keratinized surface. Formed on the back of the hands, on the fingers, between the fingers. They tend to merge with each other;
- Flat or young. They usually occur in children and adolescents. They are flat formations of flesh or pale brown in color, rising slightly above the level of the skin. They usually appear on the face, neck, shoulders, hands in groups of several;
- Plantar. Formed on the plantar part of the foot in places of greatest pressure: on the heels, under the toes. Unlike other warts, their growth is inward. In appearance, they look like calluses, but they have a rough surface rather than smooth, they destroy the skin pattern. Plantar warts are painful on pressure, painful when walking;
- Threaded. They are elongated, soft-to-the-touch growths on a leg measuring up to 4mm in length. Their color ranges from flesh to dark brown. Formed on the neck, the 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, the oral cavity and the upper respiratory tract.
There are tips and flats:
- Pointed. These are soft, cone-shaped growths of papillary flesh or pink color. Formed in the genital area, on the mucous membrane of the external and internal genitalia, the anus, less often in the oral cavity. They can appear as a rash of many warts merging with each other, forming something similar in appearance to a ridge. Genital warts are easily injured during sexual intercourse, pelvic examination, douching;
- Flat. They look like small bulges, 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 particularly dangerous in the field of gynecology because it causes cancer of the cervix 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 account for 70% of cancers and precancerous conditions of the cervix.
The first step towards a malignant tumor is the structural modification of cells, thickening and 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.
Depending on the size and depth of the affected area, there are 3 degrees of dysplasia:
light- ;
- medium;
- heavy.
The higher the degree of dysplasia, the greater the risk of degeneration of the damaged cells into a tumor. A mild degree often goes away on its own, and a severe degree, if left untreated, is very likely to turn into cancer.
In the early stages of cervical dysplasia in women, caused by 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 examination. With a severe degree of dysplasia, it is possible to attach a secondary infection, to develop an inflammatory process in the vagina (colpitis) and the cervix (cervicitis).
Signs of inflammation include:
- itching, burning;
- pain, spotting during intercourse;
- foul-smelling vaginal discharge;
- aching pain in the lower abdomen.
Cervical dysplasia due to papilloma virus, if left untreated, turns into a malignant tumor within 10 to 12 years. But these are the average data. The behavior of altered cells is unpredictable and depends largely on the state of the immune system and the presence of risk factors.
Human papillomavirus in humans
Infection with human papillomavirus is rare in men. However, a man infected with HPV is above all a danger to a woman with whom he is in an intimate relationship. He is very likely to infect his partner even if he is asymptomatic.
Among the manifestations of HPV are genital warts on the foreskin, the head of the penis, in the area of the urethra, around the anus. Their appearance is provoked by a strong weakening of the immune system, hypothermia, chronic nervous stress, overwork. Condylomas often cause pain during intercourse, itchy.
The complications of HPV in men include: development of phimosis (narrowing of the foreskin, which prevents the glans from being removed), malignant tumors of the penis, anal area, erectile dysfunction. The risk group includes homosexuals, bisexuals, and immunocompromised men.
Diagnostics
If warts or genital warts appear, you should see a doctor and get tested for human papillomavirus. Only a specialist will be able to determine the nature of the formations, establish their cause. Depending on the location of the papillomas, you may need to see a dermatologist, podiatrist, venereologist, urologist, gynecologist, otolaryngologist.
Given the risk of cervical cancer, women are advised to undergo regular examinations by a gynecologist in order to timely detect the pathogen and cure the slightest changes caused by itat 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 during a gynecological and urological examination of the surface of the mucous membrane with a special brush (Papanicolaou test or PAP test). 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 of human papillomavirus allows you to detect the DNA of the pathogen, determine its type and quantity;
- Colposcopy (examination of the cervix with an optical device). It is performed when highly oncogenic HPVs and abnormalities in oncocytology are detected. In this study, the doctor examines in detail the surface of the cervix due to a multiple increase;
- Histological examination (biopsy). It is performed when suspicious tissue sites are detected during colposcopy. A small area of tissue (up to 5mm) 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 treatment of papillomas with celandine, iodine, treatment of papillomas with oil, treatment with laundry soap, most often is not effective. Also, such methods of destroying warts can worsen the condition, cause complications, and injure surrounding healthy skin. It is not recommended to use them at your own risk. First you need to consult a specialist.
Modern treatment includes observation, medication, surgery and prevention of complications. Unfortunately, today there is no specific drug that destroys HPV.
Processing is carried out globally in three areas:
- surgical;
- strengthening of the immune system;
- the use of local and systemic antiviral drugs.
Removal of papillomas is carried out by physical and operational methods:
- laser technologies
- ; cryotherapy
- (freezing with liquid nitrogen);
- removal with a scalpel;
- radio wave surgery (removal with radio knife); electrocoagulation
- (moxibustion with electric current);
- moxibustion with harsh chemicals.
The specific method is chosen taking into account the type, location and size of the training. Removal of papillomas does not eliminate the virus 100%, does not guarantee that later the formations will not appear again.
Among systemic drugs for infection with papillomavirus, immunostimulating antiviral agents are prescribed. They are used for different locations of papillomas, help activate the body's defenses in the fight against infections. Any HPV medication should be prescribed by a doctor. During treatment, repeated studies are conducted to assess its effectiveness.
Particularities of the treatment of papillomas by localization
Treatment for papillomas in the mouth includes removal of the growths 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 during the process of chewing food, speech disorders and the risk of oncological transformation.
For the treatment of papillomas on the eyelids, systemic immunostimulating agents, local ointments and gels, and surgical methods are used. Growths in the eyes should be removed if they are prone to overgrowth, reduce the sight available to the eyes, and impair vision. Eye infection with human papillomavirus is often accompanied by other infectious lesions of bacterial origin, resulting in inflammation of the eyelids and mucous membranes. To remove papillomas, laser therapy, cryodestruction, electrocoagulation are used.
The types of HPV that cause skin damage are generally harmless. The treatment of papillomas on the face and body is carried out mainly for cosmetic purposes in order to get rid of blemishes. In addition, convex formations are impractical. It is easy to touch them with clothes, jewelry, wounds. In some cases, treatment of papillomas on the skin is not necessary, as they go away on their own.
The most dangerous papillomas in the genital area. Treatment of manifestations of the human papillomavirus in men and women in the genital area is carried out by surgical equipment and methods in combination with taking drugs for immunity. For each patient, the therapy method is selected individually.
When treating papillomas in children, immunologists and pediatricians prescribe immunostimulating drugs, vitamins to strengthen defenses. Often, this step is enough for the formation to go away without surgery. If it is necessary to remove papillomas, cryodestruction and a laser are used as the safest methods that do not cause complications.
How to prevent infection with HPV?
A large number of carriers of the virus are dangerous for everyone. How to avoid infections, 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) before the onset of sexual activity, because it is sexual contact that is the main route of infection. The human papillomavirus vaccine can be given 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 practiced in 55 countries. Among them are America, Canada, France, Australia, Germany, Switzerland, Norway.
In addition to vaccination, methods of preventing HPV include:
- give up bad habits (smoking, alcohol);
- a healthy diet balanced with vitamins;
- delaying the onset of sexual activity in adolescents;
- a regular sexual partner;
- regular check-ups and examination by a gynecologist.
To prevent plantar warts, you should wear closed-toe 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).
Podiatrists will help you cure plantar warts caused by HPV and other types of warts on feet and hands, remove painful calluses, calluses, and cure nail fungus fast. They perform physical medical pedicure, ingrown toenail removal, foot care for diabetic feet.
If you are concerned about skin problems on the feet or nails, come to the doctor for consultation, find out the cause of the discomfort, get information on the methods by which it can be eliminated.