Human papilloma virus (HPV or HPV) is a group of viruses from the papilloma virus 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 the ages of 18 and 30. According to statistics from different countries, 80 to 90% of people are infected with HPV. But don't be afraid in advance. Our immune system is able to destroy the pathogen, not the case to lead to disease.
How is the human papilloma virus transmitted?
Source of infection - carriers of the infection and people with clinical manifestations of HPV.
The virus is transmitted only from person to person.
It is present in urine, saliva and genital secretions.
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 human papilloma virus are especially high if there are scratches, cuts, wounds, scratches in the area of contact. The virus can remain viable for some time in the outdoor environment, so infection is possible in a public shower, pool, bathtub, through clothing, utensils, hygiene items;
- Sexually. This is the main route of infection. Infection occurs by any type of sexual intercourse: genital, anal, oral-genital. The probability of infection by one contact with an infected partner is 60%;
- At birth, during pregnancy. An infected mother can infect the baby in the womb and through the birth canal.
Human papillomavirus infection is characterized by a latent course. After infection, the virus does not manifest until a certain point. We may not even be aware of its presence in the body. Usually, the immune system fights the human papilloma virus, gradually destroying it, preventing the development of pathology.
Such self-healing lasts from 6 months to 2 years, depending on the characteristics of the organism. But if the immune system is weak, the virus then goes into an active phase and begins to manifest. 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 after 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 types of human papillomavirus are now known. They are divided into 4 groups according to cancer risk. Each of the types is marked with a number assigned to it by the opening order.
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 an average 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).
The last group most dangerous to health.
Of the high oncogenic risk of human papillomavirus, 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 cervical cancer cases 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 papilloma virus registered since 2003.
| Species name in 2003-2010. | Other species (strains) included in the species | Species name since 2010. |
|---|---|---|
| Human papilloma virus 1 (HPV1) | - | Mupapiloma virus 1 |
| Human papilloma virus 2 (HPV2) | HPV27, HPV57 | Alphapapillomavirus 4 |
| Human papilloma virus 4 (HPV4) | HPV65, HPV95 | Gammapapillomavirus 1 |
| Human papilloma virus 5 (HPV5) | HPV8, HPV12, HPV14, HPV19, HPV20, HPV21, HPV25, HPV36, HPV47 | Betapapilloma virus 1 |
| Human papilloma virus 6 (HPV6) | HPV11, HPV13, HPV44, HPV74, PcPV | Alphapapillomavirus 10 |
| Human papilloma virus 7 (HPV7) | HPV40, HPV43, HPV91 | Alphapapillomavirus 8 |
| Human papilloma virus 9 (HPV9) | HPV15, HPV17, HPV22, HPV23, HPV37, HPV38, HPV80 | Betapapillomavirus 2 |
| Human papilloma virus 10 (HPV10) | HPV3, HPV28, HPV29, HPV77, HPV78, HPV94 | Alphapapillomavirus 2 |
| Human papilloma virus 16 (HPV16) | HPV31, HPV33, HPV35, HPV52, HPV58, HPV67 | Alphapapillomavirus 9 |
| Human papilloma virus 18 (HPV18) | HPV39, HPV45, HPV59, HPV68, HPV70, HPV85 | Alphapapillomavirus 7 |
| Human papilloma virus 26 (HPV26) | HPV51, HPV69, HPV82 | Alphapapillomavirus 5 |
| Human papilloma virus 32 (HPV32) | HPV42 | Alphapapillomavirus 1 |
| Human papilloma virus 34 (HPV34) | HPV73 | Alphapapillomavirus 11 |
| Human papilloma virus 41 (HPV41) | - | Nupapiloma virus 1 |
| Human papilloma virus 48 (HPV48) | - | Gammapapillomavirus 2 |
| Human papilloma virus 49 (HPV49) | HPV75, HPV76 | Betapapillomavirus 3 |
| Human papilloma virus 50 (HPV50) | - | Gammapapillomavirus 3 |
| Human papilloma virus 53 (HPV53) | HPV30, HPV56, HPV66 | Alphapapillomavirus 6 |
| Human papilloma virus 54 (HPV54) | - | Alphapapillomavirus 13 |
| Human papilloma virus 60 (HPV60) | - | Gammapapillomavirus 4 |
| Human papilloma virus 61 (HPV61) | HPV72, HPV81, HPV83, HPV84, HPVcand62, HPVcand86, HPVcand87, HPVcand89 | Alphapapillomavirus 3 |
| Human papilloma virus 63 (HPV63) | - | Mupapiloma virus 2 |
| Human papilloma virus 71 (HPV71) | - | deleted |
| Human papilloma virus 88 (HPV88) | - | Gammapapillomavirus 5 |
| Human papilloma virus cand90 (HPVcand90) | - | Alphapapillomavirus 14 |
| Human papilloma virus cand92 (HPVcand92) | - | Betapapillomavirus 4 |
What are the symptoms of human papilloma virus infection?
During the transition to the active form, HPV affects the skin, genital mucosa, anal region, larynx, nasopharynx. This is made easier:
- 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 condyloma. Other symptoms are also noted, depending on the location of the papilloma. For example, if they are located in the larynx on 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 outflow in the urethra.
Warts
Warts are the most common manifestation of human papilloma virus infection on the skin.
These are rounded formations with clear boundaries and a rough surface. Their size usually does not exceed 10 mm.
Human papilloma virus causes the following types of warts:
- Plain or vulgar. Most commonly. They protrude above the skin in the form of dense gray-yellow formations with a keratinized rough surface. It occurs on the back of the hands, on the fingers, between the fingers. They tend to merge with each other;
- Straight or youthful. They usually occur in children and adolescents. These 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, arms in groups of several;
- Plantar. It occurs on the plantar part of the foot in the places of the greatest pressure: on the heels, under the toes. Unlike other warts, their growth is inward. They look like blisters, but have a rough, not smooth surface, destroying the skin pattern. Plantar warts are painful under pressure and painful to walk;
- Thread. These are elongated growths, soft to the touch, on the leg up to 4 mm long. Their color ranges from flesh to dark brown. It occurs on the neck, eyelid skin, armpits, groin, under the mammary glands.
Warts
Condylomata are papillomas that form on the lining of the reproductive system, oral cavity and upper respiratory tract.
There are pointed and straight:
- Specified. They are soft conical growths of papillary shape of flesh or pink color. It occurs in the genital area, on the mucous membrane of the external and internal genital organs, the anus, less often in the oral cavity. It can appear as a rash of many warts that merge with each other, forming something similar to the appearance of a ridge. Genital warts are easily injured during intercourse, gynecological examination, rinsing;
- Straight. They look like small protrusions, located in the deep layers of the mucosa. It is almost impossible to detect them with a simple examination. Straight nipples 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 papilloma virus infection in women
The human papilloma virus is especially dangerous in the field of gynecology, because it causes cervical cancer in women.
In 99% of cases, with the development of the tumor process, one of the types of highly oncogenic HPV was found.
The biggest threat is HPV types 16 and 18. These pathogens make up 70% of cancers and precancerous conditions of the cervix.
The first step towards a malignant tumor is structural changes in the cells, thickening and 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 go its course.
According to the size and depth of the affected area, there are 3 degrees of dysplasia:
- light;
- medium;
- difficult.
The higher the degree of dysplasia, the higher the risk of degeneration of altered cells into a tumor. A mild degree often goes away on its own, and a severe one, if left untreated, is more likely to transform into cancer.
In the early stages of cervical dysplasia in women, caused by the human papilloma virus, there are no symptoms. No menstrual disorders, lower abdominal pain, discomfort, bleeding. The diagnosis can be made only after examination. With a severe degree of dysplasia, it is possible to attach a secondary infection, develop an inflammatory process in the vagina (colpitis) and cervix (cervicitis).
Signs of inflammation include:
- itching, stinging;
- pain, stains during intercourse;
- vaginal discharge with an unpleasant odor;
- painful pains in the lower abdomen.
Cervical dysplasia due to the papilloma virus, if left untreated, turns into a malignant tumor within 10 to 12 years. But these are average figures. The behavior of altered cells is unpredictable and largely depends on the state of the immune system and the presence of risk factors.
Human papilloma virus in men
Human papillomavirus infection is rare in men. However, a man infected with HPV primarily poses a danger to the woman with whom he is in an intimate relationship. It is very likely that he will infect his 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 caused by a strong weakening of the immune system, hypothermia, chronic nervous stress, overwork. Condyloma often causes pain during sexual intercourse, causing 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, and immunocompromised men.
Diagnostics
When warts or genital warts appear, you need to see a doctor and get tested for human papilloma virus. Only an expert will be able to determine the nature of the formations and determine their cause. Depending on the location of the papilloma, you may need to consult a dermatologist, podiatrist, venereologist, urologist, gynecologist, otolaryngologist.
Given the risk of cervical cancer, women are advised to undergo regular gynecological examinations to detect the pathogen in time and cure the slightest changes caused by the early cervix.
The following tests are used to confirm HPV:
- Problem area inspection;
- Examination on a gynecological chair on mirrors (for women);
- Smear of oncocytology. It is taken during gynecological and urological examination from the surface of the mucosa with a special brush (Papanicolaou test or PAP test). The test allows you to assess the shape, size and nature of the cell placement under a microscope. Identify changes, damage, dysplasia or tumor transformation of epithelial cells;
- Smear for PCR analysis. This analysis of human papilloma virus 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 in oncocytology are detected. In this study, the doctor examines the surface of the cervix in detail for multiple enlargements;
- 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 a microscope.
How is the treatment carried out?
The fight against human papilloma virus infection is carried out only with the participation of doctors. The use of alternative methods, such as treatment of papillomas with celandine, iodine, treatment of papillomas with oil, treatment with laundry soap, is usually not effective. In addition, such methods of destroying warts can worsen the condition, cause complications and injure 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 complication prevention. Unfortunately, there are no specific drugs that destroy HPV today.
Treatment is carried out in a comprehensive manner in three areas:
- surgical;
- strengthening the immune system;
- use of local and systemic antiviral drugs.
Papilloma removal is performed by hardware and operative methods:
- laser technologies;
- cryotherapy (freezing with liquid nitrogen);
- scalpel removal;
- radio wave operation (radio knife removal);
- electrocoagulation (electric moxibustion);
- damping with aggressive chemicals.
A specific method is selected taking into account the type, location and size of the formation. Papilloma removal does not remove the virus 100%, it does not guarantee that later formations will not reappear.
Immunostimulatory and antiviral agents are prescribed from systemic drugs for papilloma virus infection. They are used for different localization of papillomas, they help to activate the body's defenses in the fight against infection. All HPV medications should be prescribed by a doctor. During therapy, repeated studies are performed to evaluate its effectiveness.
Peculiarities of papilloma treatment by location
Treatment of oral papillomas involves the removal of growths and supportive drug therapy. The need to remove growths in the oral cavity is associated with constant discomfort, high sensitivity of the mucosa, ease of injury in the process of chewing food, speech impairment and the risk of oncological transformation.
Systemic immunostimulants, topical ointments and gels, and surgical methods are used to treat eyelid papillomas. Eye growths must be removed if they are prone to overgrowth, reduced visual vision, and impaired vision. Human papillomavirus infection in the eyes is often accompanied by other infectious lesions of bacterial origin, which leads 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 generally harmless. Treatment of papillomas on the face and body is carried out mainly for cosmetic purposes to get rid of imperfections. In addition, convex formations are inconvenient. They are easy to touch with clothes, jewelry, hurt. In some cases, treatment of skin papillomas is not necessary because they disappear spontaneously.
The most dangerous papillomas in the genital area. Treatment of manifestations of human papilloma virus 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. 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 papillomas need to be removed, cryodestruction and laser are used as the safest methods that do not cause complications.
How to prevent HPV infection?
A large number of virus carriers are dangerous to 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 start of sexual activity, because sexual contact is the main route of infection. The human papillomavirus vaccine can be made later up to 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 successfully developed in practice:
- 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;
- delaying the onset of sexual activity in adolescents;
- one regular sexual partner;
- regular check-ups and check-ups at the gynecologist.
To prevent plantar warts, closed shoes should be worn in public pools, showers, 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 your feet and hands, remove painful blisters, blisters 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 problem, find out the ways in which they can be removed.