The 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 infection occurs between the ages of 18 and 30. According to statistics from different countries, 80 to 90% of people are infected with HPV. But don't panic beforehand. Our immune system is capable of destroying the pathogen and not leading to disease.
How is the human papillomavirus spread?
Source of infection: carriers of the infection and people with clinical manifestations of HPV.
The virus spreads only from person to person.
It is present in urine, saliva, and genital secretions.
The infection enters the body in three ways:
- Contact and home. The infection occurs by touching the skin and mucous membranes 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 can remain viable for some time in the external environment, therefore, infection is possible in a shower, swimming pool, public toilet, through clothing, 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%;
- In 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 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 destroys it, preventing the development of 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, then the virus enters an active phase and begins to manifest itself. The chances of self-healing diminish with age; for people under 30, they are 80%. The first symptoms of the presence of HPV in the body can appear within a few weeks or decades. It all depends on the resistance of the body and the type of papillomavirus with which it is infected.
Types of HPV
Currently about 200 types or varieties of human papillomavirus are known. They are divided into 4 groups according to the risk of cancer. Each of the types is designated by a number that was assigned to it in the opening order.
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 an average oncogenic risk (26, 30, 35, 52, 53, 56, 58, 65);
- more frequently give a 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 high oncogenic risk human papillomaviruses, types 16, 18, 31, 33, 52, 58 are the most common.
HPV accounts for 7 to 8% of all cancers. It 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 oropharyngeal cancer cases.
Human papillomavirus types registered 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 | Betapapilomavirus 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 | Betapapilomavirus 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) | - | Nupapilomavirus 1 |
| Human Papillomavirus 48 (HPV48) | - | Gammapapillomavirus 2 |
| Human Papillomavirus 49 (HPV49) | HPV75, HPV76 | Betapapilomavirus 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) | - | removed |
| Human Papillomavirus 88 (HPV88) | - | Gammapapillomavirus 5 |
| Human papillomavirus cand90 (HPVcand90) | - | Alphapapillomavirus 14 |
| Human papillomavirus cand92 (HPVcand92) | - | Betapapilomavirus 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 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 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 hoarseness of the voice is observed, if in the nose, breathing difficulties are possible, if in the ureter there is a violation of urine outflow.
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 does not usually exceed 10 mm.
The human papillomavirus causes the following types of warts:
- Simple or vulgar. More common. They stand out on the skin in the form of dense grayish-yellow formations 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 juvenile. They usually occur in children and adolescents. These are flat, flesh-colored or pale brown formations that rise slightly above the level of the skin. They usually appear on the face, neck, shoulders, hands in groups of several;
- Plant. Formed in the plantar part of the foot in the places of greatest pressure: in the heels, under the toes. Unlike other warts, their growth is inward. In appearance, they resemble corns, but have a rough surface instead of smooth, they destroy the pattern of the skin. Plantar warts are painful on pressure, painful when walking;
- Threading. They are elongated growths, soft to the touch, on a leg up to 4 mm long. Its color ranges from meat 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, the mouth, and the upper respiratory tract.
There are tips and flats:
- pointed. They are soft, cone-shaped, papillary-shaped growths 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 sexual intercourse, gynecological examination, douching;
- Plane. 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 breadth 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 types of HPV is found.
The biggest 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 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.
According to the size and depth of the affected area, 3 degrees of dysplasia are distinguished:
- lightweight;
- medium;
- heavy.
The higher the degree of dysplasia, the greater the risk of degeneration of the altered cells in a tumor. A mild grade often goes away on its own, and a severe grade, if left untreated, is very 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 abdomen, discomfort, bleeding. The diagnosis can only be made after an exam. With a severe degree of dysplasia, it is possible to attach a secondary infection, develop an inflammatory process in the vagina (colitis) and 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 papillomavirus, if left untreated, turns into a malignant tumor in 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 is intimate. He is very likely to infect her partner even if he is asymptomatic.
Of 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. Its appearance is provoked by a strong weakening of the immune system, hypothermia, chronic nervous stress, overwork. Condylomas often cause pain during sexual intercourse, they cause itching.
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 region, erectile dysfunction. The risk group includes homosexuals, bisexuals, and immunosuppressed men.
Diagnosis
When 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 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 timely detect the pathogen 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;
- Gynecological chair exam over 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 (Pap test or PAP test). The test allows you to evaluate 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 quantity;
- Colposcopy (examination of the cervix with an optical device). It is performed when highly oncogenic HPV and abnormalities are detected in oncocytology. In this study, the doctor examines the surface of the cervix in detail due to multiple magnification;
- Histological examination (biopsy). It is carried out when suspicious tissue sites are detected during colposcopy. A small area of tissue (up to 5 mm) is taken for examination under a microscope.
How is the treatment performed?
The fight against human papillomavirus infection is carried out exclusively with the participation of a physician. The use of alternative methods, such as treatment of papillomas with celandine, iodine, treatment of papillomas with oil, treatment with laundry soap, is often not effective. Additionally, these wart-destroying methods can worsen the condition, lead to complications, and damage surrounding healthy skin. It is not recommended to use them at your own risk. You should first consult with a specialist.
Modern treatment includes observation, medication, surgery, and prevention of complications. Unfortunately, today there are no specific drugs that destroy HPV.
The treatment is carried out comprehensively in three areas:
- surgical;
- strengthen the immune system;
- the use of local and systemic antiviral drugs.
Papilloma removal is done by hardware and operational 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 the virus 100%, it does not guarantee that the formations will not reappear later.
Of the systemic drugs for papillomavirus infection, immunostimulating antiviral agents are prescribed. They are used for different locations of papillomas, they help activate the body's defenses in the fight against infections. Any medicine for HPV must be prescribed by a doctor. In the course of therapy, repeated studies are carried out to evaluate its effectiveness.
Peculiarities of the treatment of papillomas by location
Treatment of 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 in the process of chewing food, impaired speech 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 eye and affect vision. Human papillomavirus infection of the eyes is often accompanied by other infectious lesions of bacterial origin, causing 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. Treatment of papillomas on the face and body is mainly carried out for cosmetic purposes to remove blemishes. Also, convex formations are inconvenient. It is easy to touch them with clothes, jewelry, to hurt them. In some cases, it is not necessary to treat the papillomas on the skin, as they disappear spontaneously.
The most dangerous papillomas in the genital area. Treatment of human papillomavirus manifestations in men and women in the genital area is carried out by hardware and surgical methods in combination with the intake of drugs for immunity. For each patient, the method of therapy is selected individually.
When treating papillomas in children, immunologists and pediatricians prescribe immunostimulating drugs, vitamins to improve defenses. Often times, this step is enough for the formation to go away without surgery. If it is necessary to remove papillomas, cryodestruction and laser are used as safer methods that do not cause complications.
How to prevent HPV infection?
Large numbers of virus carriers 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 do it in adolescence (11 - 12 years) before the start of sexual activity, since sexual contact is the main route of infection. Vaccination against the human papillomavirus can be done later until age 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 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 the United States, Canada, France, Australia, Germany, Switzerland, Norway.
In addition to vaccination, HPV prevention methods include:
- stop bad habits (smoking, alcohol);
- healthy nutrition balanced with vitamins;
- delay the initiation of sexual activity in adolescents;
- a habitual sexual partner;
- regular check-ups and examination by a gynecologist.
To prevent plantar warts, you should wear closed shoes in public pools, showers, locker rooms. These actions will reduce the risks of infection not only from HPV, but also from nail fungus (onychomycosis).
Podiatrists will help you heal plantar warts caused by HPV and other types of warts on feet and hands, remove painful corns, calluses and quickly cure nail fungus. They perform hardware medical pedicure, ingrown toenail removal, foot care for diabetic feet.
If you are concerned about a problem with the skin of the feet or nails, go to the doctor for a consultation, find out the cause of the discomfort, obtain information on the methods by which it can be eliminated.