Human papillomavirus (HPV or HPV) is a group of viruses in the papillomavirus family that cause damage to the skin and mucous membranes. HPV ranks first among sexually transmitted viral infections. The peak of the infection occurs between 18 and 30 years. According to statistics from different countries, 80 to 90% of people are infected with HPV. But do not be afraid in advance. Our immune system is able to destroy the pathogen and prevent 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 household. Infection occurs by touching the skin and mucous membranes of an infected person. The risks of getting the human papillomavirus are especially high if there are scratches, cuts, wounds, abrasions in the contact area. The virus is able to maintain viability in the external environment for some time, due to which the infection is possible in a public shower, pool, bathroom, through clothes, dishes, hygiene items;
- Sexual. This is the main route of infection. Infection occurs during any type of sexual intercourse: genital, anal, oral-genital. The probability of infection from single contact with an infected partner is 60%;
- At birth, 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 appear until a certain point. We may not even be aware of its presence in the body. Usually the immune system fights against the human papilloma virus, gradually destroying it, preventing the development of pathology.
Such self-medication takes from 6 months to 2 years, depending on the characteristics of the organism. But if the immune system is weak, then the virus enters an active phase, begins to manifest itself. The chances of self-medication decrease with age; for people under 30 they are 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 body's resistance and the type of papilloma virus it is infected with.
HPV types
About 200 species or varieties of human papillomaviruses are now known. They are divided into 4 groups according to the risk of cancer. Each of the types is marked with a number that has been assigned to it in the order of opening.
Identify the types of HPV that:
- never cause cancer (1, 2, 3, 4, 5, 10, 28, 49);
- very rarely cause cancer (6, 11, 13, 32, 40 - 44, 51, 72);
- have a medium oncogenic risk (26, 30, 35, 52, 53, 56, 58, 65);
- most often give a malignant transformation (16, 18, 31, 33, 39, 45, 50, 59, 61, 62, 64, 68, 70, 73).
Of the human papillomaviruses with a high oncogenic risk, types 16, 18, 31, 33, 52, 58 are the most common.The last group most dangerous to health.
HPV represents 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 cases of penile cancer;
- 63% of cases of oropharyngeal cancer.
Types of human papillomaviruses registered since 2003
| Name of the species in 2003-2010. | Other species (strains) included in the species | Name of the species from 2010 |
|---|---|---|
| Human Papillomavirus 1 (HPV1) | - | Mupapilloma virus 1 |
| Human Papillomavirus 2 (HPV2) | HPV27, HPV57 | Alphapapilloma virus 4 |
| Human Papillomavirus 4 (HPV4) | HPV65, HPV95 | Gamma papilloma virus 1 |
| Human papillomavirus 5 (HPV5) | HPV8, HPV12, HPV14, HPV19, HPV20, HPV21, HPV25, HPV36, HPV47 | Betapapilloma virus 1 |
| Human papillomavirus 6 (HPV6) | HPV11, HPV13, HPV44, HPV74, PcPV | Alphapapilloma virus 10 |
| Human Papillomavirus 7 (HPV7) | HPV40, HPV43, HPV91 | Alphapapilloma virus 8 |
| Human papillomavirus 9 (HPV9) | HPV15, HPV17, HPV22, HPV23, HPV37, HPV38, HPV80 | Betapapilloma virus 2 |
| Human Papillomavirus 10 (HPV10) | HPV3, HPV28, HPV29, HPV77, HPV78, HPV94 | Alphapapilloma virus 2 |
| Human Papillomavirus 16 (HPV16) | HPV31, HPV33, HPV35, HPV52, HPV58, HPV67 | Alphapapilloma virus 9 |
| Human Papillomavirus 18 (HPV18) | HPV39, HPV45, HPV59, HPV68, HPV70, HPV85 | Alphapapilloma virus 7 |
| Human Papillomavirus 26 (HPV26) | HPV51, HPV69, HPV82 | Alphapapilloma virus 5 |
| Human Papillomavirus 32 (HPV32) | HPV42 | Alphapapilloma virus 1 |
| Human papillomavirus 34 (HPV34) | HPV73 | Alphapapilloma virus 11 |
| Human Papillomavirus 41 (HPV41) | - | Nupapilloma virus 1 |
| Human Papillomavirus 48 (HPV48) | - | Gamma Papilloma Virus 2 |
| Human Papillomavirus 49 (HPV49) | HPV75, HPV76 | Betapapilloma virus 3 |
| Human papillomavirus 50 (HPV50) | - | Gamma Papilloma Virus 3 |
| Human Papillomavirus 53 (HPV53) | HPV30, HPV56, HPV66 | Alphapapilloma virus 6 |
| Human Papillomavirus 54 (HPV54) | - | Alpha-papillomavirus 13 |
| Human Papillomavirus 60 (HPV60) | - | Gamma papilloma virus 4 |
| Human Papillomavirus 61 (HPV61) | HPV72, HPV81, HPV83, HPV84, HPVcand62, HPVcand86, HPVcand87, HPVcand89 | Alphapapilloma virus 3 |
| Human Papillomavirus 63 (HPV63) | - | Mupapilloma virus 2 |
| Human Papillomavirus 71 (HPV71) | - | deleted |
| Human Papillomavirus 88 (HPV88) | - | Gamma papilloma virus 5 |
| human papillomavirus cand90 (HPVcand90) | - | Alphapapilloma virus 14 |
| Human papillomavirus cand92 (HPVcand92) | - | Betapapilloma virus 4 |
What are the symptoms of human papillomavirus infection?
During the transition to the active form, HPV affects the skin, genital mucosa, anal area, larynx, 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 as growths, bumps on the skin and mucous membranes called papillomas. They are divided into two groups: warts and warts. Other symptoms are also noted depending on the location of the papillomas. For example, if they are located in the larynx of the vocal cords, then there is hoarseness of the voice, if there are possible breathing difficulties in the nose, if there is a violation of urine flow in the ureter.
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:
- Plain or vulgar. Most often. They protrude above the skin in the form of dense formations of gray-yellow color with a keratinized rough surface. It is formed on the back of the hands, on the fingers, between the fingers. They tend to merge with each other;
- Flat or youthful. They are usually found in children and adolescents. These are flat, fleshy or pale brown formations that rise slightly above the level of the skin. They usually appear on the face, neck, shoulders, arms in groups of several;
- Plantar. It is formed 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. In appearance they look like calluses, but have a rough rather than smooth surface, they destroy the skin pattern. Plantar warts are painful under pressure, painful when walking;
- thread. These are elongated growths, soft to the touch, on a leg up to 4 mm long. Their color is from flesh to dark brown. It is formed on the neck, the skin of the eyelids, in the armpits, groin, under the mammary glands.
Warts
Warts are papillomas that form on the mucous membranes of the reproductive system, mouth and upper respiratory tract.
There are pointed and flat:
- Targeted. They are soft conical growths with a papillary shape of flesh or pink color. It is formed in the genital area, on the mucous membrane of the external and internal genitals, the anus, less often in the oral cavity. They can appear as a rash on many warts, which merge with each other, forming something similar to the appearance of the ridge. Genital warts are easily injured during intercourse, gynecological examination, syringes;
- Flat. They look like small bumps located in the deep layers of the mucosa. It is almost impossible to find them with a simple check. Flat warts are more dangerous than genital warts, especially if they are located on the lining of the vagina and cervix. They grow in depth and width and tend to degenerate into a cancerous tumor.
Human papillomavirus infection in women
Human papillomavirus is particularly dangerous in 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 detected.
The biggest threat comes from HPV types 16 and 18. These pathogens account for 70% of cervical cancers and precancerous conditions.
The first step on the way to a malignant tumor are the 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 main thing is not to let the situation develop.
According to the size and depth of the affected area, there are 3 degrees of dysplasia:
- medicine;
- Wednesday;
- heavy.
The higher the degree of dysplasia, the higher the risk of degeneration of altered cells into a tumor. The mild degree often disappears on its own, and the severe degree, if left untreated, is very likely to transform into cancer.
In the early stages of cervical dysplasia in women caused by human papillomavirus, there are no symptoms. No menstrual irregularities, lower abdominal pain, discomfort, bleeding. The diagnosis can be made only after examination. In severe dysplasia, it is possible to attach a secondary infection, to develop an inflammatory process in the vagina (colpitis) and cervix (cervicitis).
Signs of inflammation include:
- itching, burning;
- pain, spotting during intercourse;
- unpleasant-smelling vaginal discharge;
- pain in the lower abdomen.
Cervical dysplasia due to papillomavirus, if left untreated, transforms into a malignant tumor within 10 to 12 years. But these are the average data. 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 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. It is very likely to infect your partner, even if he is asymptomatic.
From 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 appearance is provoked by a strong weakening of the immune system, hypothermia, chronic nervous stress, fatigue. Warts often cause pain during intercourse, cause itching.
Complications of HPV in men include: development of phimosis (narrowing of the foreskin, which prevents the removal of the head), malignant tumors of the penis, anal region, erectile dysfunction. The risk group includes homosexuals, bisexuals, men with immune deficiency.
Diagnostics
When warts or genital warts appear, you should see a doctor and get tested for human papillomavirus. Only a specialist can determine the nature of the formations, to determine their cause. Depending on the location of the papillomas, you may need 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 detect the pathogen in a timely manner and to cure the slightest changes caused by it in the early stages.
The following tests are used to confirm HPV:
- Inspection of the problem area;
- Examination of a gynecological chair on mirrors (for women);
- Oncocytological smear. It is taken during a gynecological and urological examination of the mucosal surface with a special brush (Papanicolaou test or PAP test). The test allows you to assess the shape, size, nature of the location of the 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 you to detect the DNA of the pathogen, to 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 the surface of the cervix in detail due to multiple enlargements;
- Histological examination (biopsy). It is performed when suspicious tissue sites are found during a colposcopy. A small area of tissue (up to 5 mm) is taken for examination under a microscope.
How is the treatment carried out?
The fight against human papillomavirus infection is conducted 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, is most often not effective. 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 should first consult a specialist.
Modern treatment includes monitoring, medication, surgery and prevention of complications. Unfortunately, there are no specific drugs today that kill HPV.
The treatment is comprehensive in three areas:
- surgical;
- strengthening the immune system;
- the use of local and systemic antiviral drugs.
Papilloma removal is performed by hardware and surgical methods:
- laser technologies;
- cryotherapy (freezing with liquid nitrogen);
- scalpel removal;
- radio wave operation (removal with a radio knife);
- electrocoagulation (mixing with electric current);
- mixing with aggressive chemicals.
The specific method is chosen taking into account the type, location and size of the formation. Removal of papillomas does not eliminate the virus 100%, does not guarantee that the tumors will not reappear later.
Systemic drugs for human papillomavirus infection are prescribed immunostimulatory, antiviral drugs. They are used for different localization of papillomas, help to activate the body's defenses in the fight against infection. All HPV medications must be prescribed by a doctor. In the course of therapy, multiple studies are conducted to evaluate its effectiveness.Features of the treatment of papillomas by location
Treatment of oral papillomas includes removal of the growths and maintenance 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 disorders and the risk of oncological transformation.
Systemic immunostimulatory agents, topical ointments and gels, and surgical methods are used to treat eyelid papillomas. Eye growths should be removed if they are prone to overgrowth, reduce eye visibility and impair vision. Human papillomavirus infection in the eye is often accompanied by other infectious lesions of bacterial origin, leading to inflammation of the eyelids and mucous membranes. Laser therapy, cryodestruction, electrocoagulation are used to remove papillomas.The types of HPV that cause skin lesions are usually harmless. The treatment of papillomas on the face and body is done mainly for cosmetic purposes to get rid of imperfections. In addition, the protruding formations are uncomfortable. It is easy to touch them with clothes, jewelry, to hurt. In some cases, treatment of skin papillomas is not required because they disappear spontaneously.
The most dangerous papillomas in the genital area. The 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 method of therapy is chosen individually for each patient.
In the treatment of papillomas in children, immunologists and pediatricians prescribe immunostimulatory drugs, vitamins to improve defenses. Often this step is enough for the formation to disappear without surgery. If it is necessary to remove papillomas, cryodestruction and laser are used as the safest methods that do not cause complications.
How to prevent HPV infection?
The large number of carriers of the virus 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 be performed in adolescence (11-12 years) before the onset of sexual activity, as sexual contact is the main route of infection. The human papillomavirus vaccine can be given later than the age of 45, but it will only work if there is no HPV in the body.
Papillomavirus vaccines provide almost 100% protection against infection and cancer.
Three vaccines have been developed and successfully implemented:
- protects against HPV 6, 11, 16, 18 species;
- further 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:
- quitting bad habits (smoking, alcohol);
- healthy diet balanced with vitamins;
- delayed onset of sexual activity in adolescents;
- one regular sexual partner;
- regular check-ups and gynecological check-ups.
To prevent plantar warts, you should wear closed shoes in public pools, showers, changing 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 warts on the feet, hands, remove painful calluses, calluses and quickly cure nail fungus. They perform hardware medical pedicure, removal of ingrown toenails, foot care for diabetic feet.
If you are worried 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, get information about the methods by which it can be removed.