Human papillomavirus (HPV or HPV) is a group of viruses from 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 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 scared in advance. Our immune system is able to destroy the pathogen, and not bring the case to disease.
How is human papillomavirus transmitted?
Source of infection - carriers of 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.
The infection enters the body in three ways:
- Contact and household. Infection occurs through touching the skin and mucous membrane 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 remain viable for some time in the external environment, therefore, infection is possible in a public shower, pool, bath, through clothes, dishes, hygiene items;
- Sexual. This is the main route of infection. Infection occurs with any type of intercourse: genital, anal, oral-genital. The likelihood 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 until a certain point. 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 from 6 months to 2 years, depending on the characteristics of the organism. But if the immune system is weak, then the virus goes into 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 may appear after a few weeks or after decades. It all depends on the body's resistance and the type of papilloma virus with which it is infected.
HPV types
About 200 types 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 designated by a number that was assigned to it in the order of opening.
Identify HPV types 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 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 most common.
HPV accounts for 7 - 8% of all cancers. It is the reason:
- 99% of cervical cancer cases in women;
- 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.
| Species name 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?
During the transition to the active form, HPV affects the skin, mucous membranes of the genitals, anal region, 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 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 hoarseness of the voice is observed, if in the nose, breathing difficulties are possible, 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 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 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 pale brown color, slightly rising above the level of the skin. They usually appear on the face, neck, shoulders, hands in groups of several;
- Plantar. They are 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 resemble calluses, but they have a rough rather than smooth surface, they destroy the skin pattern. Plantar warts are painful to pressure, painful when walking;
- Threaded. These are elongated growths, soft to the touch, on a leg up to 4 mm long. Their color is from flesh 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, oral cavity, and upper respiratory tract.
There are pointed and flat:
- Pointed. They are soft cone-shaped growths of a papillary shape 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 merging with each other, forming something similar in appearance to a ridge. Genital warts are easily injured during intercourse, gynecological 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 breadth, and tend to degenerate into a cancerous tumor.
Human papillomavirus infection in women
The 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 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 on the way to a malignant tumor is structural changes in cells, thickening, 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 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 untreated, is highly likely to transform 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, develop an inflammatory process in the vagina (colpitis) 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 papilloma virus, if untreated, transforms into a malignant tumor within 10 to 12 years. But this is 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 in an intimate relationship. He is highly likely to infect his 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. 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: the 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 immunocompromised men.
Diagnostics
When warts or genital warts appear, you need to 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 papillomas, you may need to consult a dermatologist, podologist, 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 smallest changes caused by it in the early stages.
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 from the surface of the mucous membrane with a special brush (Papanicolaou test or PAP test). The test allows you to evaluate the shape, size, nature of the 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 amount;
- 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 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 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 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 must 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.
Treatment is carried out in a comprehensive manner in three areas:
- surgical;
- strengthening the immune system;
- the use of local and systemic antiviral drugs.
Removal of papillomas is carried out 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 by 100%, does not guarantee that later the formations will not appear again.
Of the systemic drugs for human papillomavirus infection, immunostimulating, antiviral agents are prescribed. They are used for different localization of papillomas, help to activate the body's defenses in the fight against infection. Any medications for HPV should be prescribed by a doctor. In the course of therapy, repeated studies are carried out to assess its effectiveness.
Peculiarities of treatment of papillomas by location
Treatment for papillomas in the mouth includes the 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 in the process of chewing food, speech impairment, 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. The growths on the eyes must be removed if they are prone to overgrowth, reduce the view available to the eye, and impair vision. Human papillomavirus infection in the eyes is often accompanied by other infectious lesions of bacterial origin, leading to inflammation of the eyelids and mucous membranes. To remove papillomas, laser therapy, cryodestruction, electrocoagulation are used.
HPV types that cause skin lesions are generally harmless. Treatment of papillomas on the face and body is carried out mainly for cosmetic purposes in order to get rid of imperfections. In addition, convex formations are inconvenient. They can be easily touched by clothes, jewelry, or injured. 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 the human papillomavirus 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 enhance the defenses. Often this step is enough for the formation to disappear 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 HPV infection?
A 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 advisable to carry it out in adolescence (11 - 12 years) before the onset of sexual activity, since it is sexual contact that is the main route of infection. The human papillomavirus vaccine can be done later up to the age of 45, but it will only work if there is no HPV in the body.
Papilloma virus vaccines give almost 100% protection against infection and cancer.
Three vaccines have been developed and are successfully applied in practice:
- protects against HPV 6, 11, 16, 18 types;
- 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 America, Canada, France, Australia, Germany, Switzerland, Norway.
In addition to vaccination, HPV prevention methods include:
- quitting bad habits (smoking, alcohol);
- healthy nutrition balanced with vitamins;
- delaying the onset of sexual activity in adolescents;
- one regular sexual partner;
- regular check-ups and examination by a gynecologist.
To prevent plantar warts, closed shoes should be worn 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 cure plantar warts caused by HPV and other types of warts on the feet and hands, remove painful calluses, calluses, 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 of 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 eliminated.