Human papillomavirus (HPV or HPV) is a group of viruses of the papillomavirus family that cause 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, 80-90% of people are infected with HPV. But don't be afraid in advance. Our immune system is able to destroy the pathogen and not lead the case to the 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.
Infection enters the body in three ways:
- Contact and family. Infection occurs by touching the skin and mucous membrane of an infected person. The risks of contracting the human papillomavirus are particularly 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, in a swimming pool, in a bathroom, through clothes, dishes, hygiene items;
- Sexual. 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%;
- During childbirth, during pregnancy. An infected mother can infect the baby in utero and through the birth canal.
Human papillomavirus infection is characterized by a latent course. After infection, the virus does not manifest itself up to a point. We may not even be aware of its presence in the body. Normally, the immune system fights the human papillomavirus, gradually destroys it, preventing the development of pathology.
Such 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, it is 80%. The first symptoms of the presence of HPV in the body can appear after a few weeks or after decades. It all depends on the resistance of the body and the type of papilloma virus with which it is infected.
Types of HPV
Currently, about 200 types or varieties of human papillomaviruses are known. They are divided into 4 groups based on the risk of cancer. Each of the types is designated by a number that has been assigned to it in the order of opening.
Identifies 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 a malignant transformation (16, 18, 31, 33, 39, 45, 50, 59, 61, 62, 64, 68, 70, 73).
The last most dangerous group for health.
Of the human papillomaviruses with high oncogenic risk, types 16, 18, 31, 33, 52, 58 are the most common.
HPV accounts for 7-8% of all cancers. That's the reason:
- 99% of cervical cancer cases in women;
- 93% of anal cancer cases;
- 51% of vulvar tumors;
- 36% of penile cancer cases;
- 63% of oropharyngeal cancer cases.
Types of human papillomavirus registered since 2003.
| Name of the species in 2003-2010. | Other types (strains) included in the species | Name of the 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, 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 changes of sexual partners.
HPV manifests itself as growths, bumps on the skin and mucous membranes, called papillomas. They are divided into two groups: warts and condylomas. 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 there is a hoarseness of the voice, if in the nose, breathing can be difficult, if in the ureter there is a violation of the outflow of urine.
Warts
Warts are the most common manifestation of human papillomavirus infection on the skin.
These are rounded formations with clear borders 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 keratinized rough surface. Formed on the back of the hands, on the fingers, between the fingers. They tend to merge with each other;
- Flat or youthful. They usually occur in children and adolescents. These are flat formations of flesh or light brown color, rising slightly above the level of the skin. They usually appear on the face, neck, shoulders, hands in multiple groups;
- Footbed. They form on the plantar part of the foot at the points of greatest pressure: on the heels, under the toes. Unlike other warts, their growth is internal. In appearance, they resemble calluses, but have a rough rather than smooth surface, destroying the skin pattern. Plantar warts are painful on pressure, painful when walking;
- With 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. It forms on the neck, on the skin of the eyelids, in the armpits, on the groin, under the mammary glands.
Warts
Condylomas are papillomas that form on the mucous membranes of the reproductive system, oral cavity and upper respiratory tract.
There are pointed and flat:
- Pointed. They are soft cone-shaped growths of a papillary form of flesh or pink color. Formed in the genital area, on the mucous membrane of the external and internal genital organs, anus, less often in the oral cavity. They can appear as a rash of many warts that merge with each other, forming something similar in appearance to a ridge. Genital warts are easily injured during intercourse, gynecological examination, douching;
- Plate. They look like small swellings, 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 found on the mucous membrane of the vagina and cervix. They grow deep and wide and tend to degenerate into a cancerous tumor.
Human papillomavirus infection in women
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 highly oncogenic HPV types 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 are structural changes in the cells, thickening, proliferation of the mucosa. This condition is called cervical dysplasia. Changes in dysplasia are not critical and reversible if treatment is started on time. The important 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;
- means;
- heavy.
The greater the degree of dysplasia, the greater the risk of degeneration of the altered cells into a tumor. A mild degree often goes away on its own, and a severe one, if left untreated, is highly likely to turn into cancer.
In the early stages of cervical dysplasia in women, caused by the human papillomavirus, there are no symptoms. There are no interruptions in 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 the cervix (cervicitis).
Signs of inflammation include:
- itching, burning;
- pain, spotting during intercourse;
- foul-smelling vaginal discharge;
- aching pains in the lower abdomen.
Cervical dysplasia due to the papilloma virus, if left untreated, turns into a malignant tumor within 10-12 years. But this is the average figure. The behavior of the altered cells is unpredictable and largely depends on the state of the immune system and the presence of risk factors.
Human papillomavirus in humans
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. You are very likely to infect your partner with you even if you are asymptomatic.
Among the manifestations of HPV, there are genital warts on the foreskin, the head of the penis, in the area of the urethra, around the anus. Their occurrence is provoked by a strong weakening of the immune system, hypothermia, chronic nervous stress, overwork. Condylomas often cause pain during sexual intercourse, cause itching.
Complications of HPV in men include: development of phimosis (narrowing of the foreskin, which prevents removal of the glans penis), malignant tumors of the penis, anal region, erectile dysfunction. The risk group includes homosexuals, bisexuals and immunocompromised men.
Diagnostics
If 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, otolaryngologist.
Given the risk of cervical cancer, women are advised to undergo regular examinations by a gynecologist to promptly detect the pathogen and treat the smallest changes caused by it in the early stages.
The following tests are used to confirm HPV:
- Inspection of the problem area;
- Examination on a gynecological chair on mirrors (for women);
- Oncocytology smear. It is taken during a gynecological and urological examination from the mucosal surface with a special brush (Papanicolaou test or PAP test). The test allows you to evaluate the shape, size, nature of the position of cells under the microscope. Identify changes, damage, dysplasia or tumor transformation of epithelial cells;
- Smear for PCR analysis. This analysis for human papillomavirus allows 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 HPV 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 5 mm) is taken for examination under the microscope.
How is the treatment carried out?
The fight against human papillomavirus infection is carried out exclusively with the participation of a doctor. The use of alternative methods, such as the treatment of papillomas with celandine, iodine, the treatment of papillomas with oil, treatment with laundry soap, is very often not effective. Additionally, such methods of 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 must first consult a specialist.
Modern treatment includes observation, medication, surgery and the prevention of complications. Unfortunately, there are no specific drugs that destroy HPV today.
The treatment is carried out comprehensively in three areas:
- surgical;
- strengthen the immune system;
- the use of local and systemic antiviral drugs.
Removal of papillomas is performed with 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 harsh chemicals.
The specific method is selected taking into account the type, location and size of the formation. Removal of papillomas does not get rid of the virus by 100%, it does not guarantee that later the formations will no longer appear.
Among the systemic drugs for papillomavirus infection, immunostimulating antiviral agents are prescribed. They are used for the different localization of papillomas, they help activate the body's defenses in the fight against infections. Any HPV medication should be prescribed by a doctor. During the course of therapy, repeated studies are performed to evaluate its effectiveness.
Peculiarities of papilloma treatment by location
Treatment for papillomas in the mouth includes removal of 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 on the eyes should be removed if they are prone to overgrowth, reduce the vision available to the eye and impair vision. Human papillomavirus infection in the eye is often accompanied by other infectious lesions of bacterial origin, which lead to inflammation of the eyelids and mucous membranes. To remove papillomas, laser therapy, cryodestruction, electrocoagulation are used.
The types of HPV that cause skin lesions are generally harmless. The treatment of papillomas on the face and body is mainly carried out for cosmetic purposes to eliminate imperfections. In addition, convex formations are uncomfortable. It is easy to touch them with clothes, jewelry, wounds. In some cases, treatment of papillomas on the skin is not required, as 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 intake of immunity drugs. The method of therapy is selected individually for each patient.
When treating papillomas in children, immunologists and pediatricians prescribe immunostimulating drugs, vitamins to improve the defenses. Often this step is sufficient for the formation to disappear without surgery. If it is necessary to remove papillomas, cryodestruction and a laser are used as safer methods that do not cause complications.
How to prevent HPV infection?
A large number of virus carriers around is dangerous for everyone. How to avoid infection, prevent the appearance of papillomas on the skin or mucous membranes?
Vaccination is considered the most effective method. It is recommended to perform it in adolescence (11-12 years) before the onset of sexual activity, since sexual contact is the main route of infection. The human papillomavirus vaccine can be given as late as the age of 45, but it will only work if there is no HPV in the body.
Papilloma virus vaccines offer nearly 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;
- 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 balanced nutrition with vitamins;
- delay 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 shoes in public swimming pools, showers, changing rooms. These actions will reduce the risks of infection not only with HPV, but also with nail fungus (onychomycosis).
Podiatrists will help you treat plantar warts caused by HPV and other types of warts on the feet and hands, remove painful corns, corns and quickly cure nail fungus. They perform hardware medical pedicure, ingrown toenail removal, foot care for diabetic feet.
If you are concerned about any problems with the skin of the feet or nails, come to the doctor for a consultation, find out the cause of the discomfort, inquire about the methods by which it can be eliminated.