Human papillomavirus: symptoms, in women, in men, treatment

Papillomavirus infections are currently a hot topic around the world. It turned out that the virus, which causes the appearance of warts and smaller formations on the skin (papilloma), can cause the development of cancer of the genital organs in women and men, as well as cancer of the rectum and pharynx. Vaccines, designed to protect a person from the most dangerous strains of the virus, can cause severe reactions themselves.

Types of papillomavirus infections

Warts and cervical cancer are caused by two different types of the same virus (called strains). Just finding out that papillomavirus infection has occurred does not mean that a person will develop papillomavirus cancer: this is possible if a strain from the oncogenic group got into the body. At the same time, infection with one of the strains increases the risk of another type of virus entering the body.

A total of around 600 strains of the papillomatosis virus are isolated, which differ from one another in the quantity and sequence of the proteins found on their envelope. Scientists divide them into 27 species and 5 genera.

Depending on the ability to cause cancer, the following types of human papillomavirus are distinguished:

1. Have a low oncogenic risk (their entry into the body is unlikely to cause cancer). These are viruses numbered 3, 11, 32, 34, 40-44, 6, 51, 61, 13, 72 and 73.
2. With an average oncogenic risk. These are strains 35, 53, 30, 52, 45, 56, 58. They cause formations on the skin and mucous membranes, the likelihood of malignancy of which is higher than in the first case.
3. Strains with high oncogenicity. First of all, these are the type 16 papillomavirus, which causes cervical cancer in every second woman (41-54%), as well as the type 18 virus, which provokes this disease in every tenth of its carriers. Strongly oncogenic strains also include strains numbered 31, 33, 39, 50, 59, 64, 68, 70, 82.

The risk of papillomavirus infection

The properties of the papillomatosis virus are such that it settles either in the skin or in the mucous membrane of various organs: reproductive organs (both male and female), esophagus, bronchi, oral cavity, rectum. It can also be localized in the conjunctiva of the eyes.

Each strain of the virus has its own "favorite location". Thus, the most dangerous types 16 and 18, when hit, immediately "go" to the genitals, and the low-oncogenic viruses 6 and 11 infect the vulva and perineum, causing the development of genital warts there. The same strains can in a childCausing papillomatosis in the respiratory tract when born naturally to a mother with genital warts.

After an infection, a disease with severe symptoms does not always develop. On the contrary, the disease most often goes unnoticed and does not lead to serious consequences.

The most dangerous complications of human papillomavirus infection are:

• Cervical cancer. It occurs in women as a result of infection with human papillomavirus type 16 or 18. It has been proven that this disease does not occur in the absence of papillomaviruses. And when they used to talk about the development of cervical carcinoma by erosion or ectropion, this has now been revised and denied;
• rectal cancer. Unlike the first disease, it can have other causes;
• throat cancer. It is also caused by a type 16 virus;
• Lung cancer, which can occur when infected with 16, 18, 11, 2, 6, 30 types of the virus;
• respiratory failure, which develops with the growth of malignant papillomas in the respiratory tract (larynx, trachea);
• Contact bleeding from warts. If they are on the vulva, perineum or in the vagina, they are provoked by sex. With a different localization (in the nose, in the mouth), bleeding can be provoked by mechanical injuries with other objects.

According to official figures, almost half a million (470, 000) new cases of cervical cancer caused by this virus are registered worldwide every year. 233, 000 women die from this disease every year. Thus, this oncological disease ranks 2nd in the frequency of all cancers in gynecology (1st in breast cancer) and 5th among all causes of death in women. Most women under the age of 40 die from cervical cancer.

transmission paths

The papillomavirus is very common. According to modern data, it can be found in 90% of the world's population.

How is human papillomavirus transmitted:

• sexual (having any kind of sex). Condoms reduce the possibility of entering the body (infection with a condom was 37. 8, and without a condom - 89. 3%), but they do not completely prevent infection: the diameter of the pores in the latex is designed to prevent spermatozoa. while the size of the virus is too small;
• Household, when the virus penetrates through damaged skin. This happens in the pool, bath, when using common towels, manicure tools, dishes;
• from mother to child, during childbirth: more often - with independent childbirth, but also with caesarean section, there is also a chance of getting the virus on the membranes of the larynx;
• with saliva - with kisses;
• Contact - when rubbing or cutting papillomas, warts or condylomas through the skin or mucous membrane, where the integrity is broken. This is how self-infection usually occurs.

If a person's immunity is strong at the time of virus penetration, then the probability of developing a disease is low: most likely, the microbe will remain in an inactive state. The risk of disease increases when:

• earlier (before 16 years) starting sexual activity or at least petting;
• frequent (more than once in 3 years) change of sexual partners;
• genital infections such asB. recurrent thrush, chlamydia, gonorrhea, ureaplasmosis;
• had abortions;
• Diseases of the cervix: erosion, ectropion;
• constant stress;
• bad habits: smoking, alcoholism;
• long-term use of contraceptive pills for;
• violations of metabolic processes;
• avitaminosis.

The presence of genital warts in a pregnant woman is an indication for a cesarean section - to avoid infection of the child's respiratory tract. Therefore, the child is unlikely to "get" the microbe from the mother. Oncogenic types of viruses are not transmitted by household means, since the virus-carrying formations are not on the skin. Therefore, the first "acquaintance" with these microbes usually occurs during sexual intercourse, and this usually happens during puberty. This justifies measures (especially vaccinations) just before the first sexual experience.

How does papillomavirus infection manifest itself?

The symptoms of the human papillomavirus depend on which strain got into the body and what clinical form it caused. So it could be:

1. papilloma- single or multiple. These are mushroom-shaped outgrowths on a skin-colored stem or with a yellowish, brownish, or blackish tint. They are located on the skin under the mammary glands, on the neck, in the armpits, on the face, as well as on the mucous membranes of the mouth, nose or genitals. Papillomas are more common in women. Most of the time they are just a blemish, they can cause discomfort or pain. Rarely papillomas become malignant.
2. warts, including plantar. These are brownish mushroom-shaped formations. In the area of \u200b\u200bthe palms and soles, they appear in places of greatest friction and cause pain when pressed. Plantar warts can have a shaft that extends into healthy tissue. They can become inflamed and injured.
3. genital warts. These are papillary outgrowths that merge together and resemble cauliflower. Condylomas are formed on the mucous membranes: on the genitals, in the perineum. If they arose as a result of anal sex, they occupy a localization around the anus. Also, condylomas can be located on the mucous membranes of internal organs: bladder, intestines. This causes such symptoms as painful urination or defecation, a violation of physiological functions.
4. Precancerous disease of the cervix - dysplasia, caused by human papillomavirus - is not clinically manifested. This disease can be suspected during colposcopy; detected by cytological examination of a smear from the cervical canal.
5. cervical cancerdoes not appear immediately. In the early stages there are no symptoms. A woman should be alerted by itching in the genital area, a change in the nature of discharge from the genital tract (they can become more frequent, streaks of blood can appear in them, they can have an unpleasant odor), menstrual irregularities, bleeding after sex or in the middle of the cycle. In the later stages, this disease is characterized by swelling of the legs (usually on one side), pain in the spine or lower back.
6. Bowenoid papulosis. This is the name of a precancerous condition that is more common in men. It is characterized by the appearance on the skin of a varying number of spots and plaques ranging in color from pink or yellowish to reddish brown or purple. The surface of such plaques can be smooth or warty; they are painful to the touch.
7. Bowen's disease- This is a skin and mucous membrane cancer that develops from the cells of the surface layer. It looks like a bright red skin defect with uneven contours, covered with scales and warty growths.

In men, human papillomavirus causes a particular disease - squamous cell carcinoma of the penis. It is caused by a type 16 virus. The latter changes the cells of the male genital tract under the influence of cigarette smoke, while the malignant character is acquired under the influence of herpes simplex virus type 2, when the male DNA contains the Ras gene when PUVA therapy was performedundergone chemotherapy, or the man has HIV. Squamous cell carcinoma looks different. This can be the appearance of a patch rising above the skin with wart growths on top, it can also look like an ulcer destroying the penis. The tumor is localized on the head or foreskin.

Rectal cancer caused by the human papillomavirus is also more common in men. It occurs mainly in people of non-traditional orientation. It is characterized by painful bowel movements, discharge of blood or secretions from the rectum.

Any form of papillomavirus infection does not develop immediately after infection: it must take 14 days to several years (depending on immunity and favorable factors) before the first symptoms appear.

diagnosis

To make a diagnosis in the presence of external papillomas or warts, it is not necessary to conduct an analysis for the papilloma virus. For other clinical forms of infection you will need:

1. Physical examination:for women - a gynecologist, for men - a urologist.
2. colposcopy(for women) - examination of the cervix under a microscope. During the study, tests will be performed with Lugol's solution, a Papanicolaou test (swabs from the cervical canal and cervix), a biopsy of the cervix, a swab for examination by the PCR method and the Digene test.
3. Urethroscopy and rectoscopy(for men). When examining the urethra or rectum, a biopsy of precancerous changes or changes suspected of being cancerous is also performed, swabs are also taken for examination by the PCR method and the Digene test.

Therefore, it is possible to be tested for the virus only in the practice of a gynecologist (for women) or a urologist (for men). This is a PCR test of a swab from the cervical canal or urethra, or a Digene test performed on material obtained from a biopsy or scraping of epithelial cells.

treatment

How to treat human papillomavirus depends on the type of infection. So, if we are talking about warts, papillomas or condylomas, the treatment is carried out in two stages:

1. The formation is removed by various methods. This can be surgical removal with a scalpel, burn with a laser or electric current, which is more effective in papillomas and condylomas. For the treatment of warts, the method of cryodestruction is successfully used - the necrosis of pathological tissue with the help of liquid nitrogen, which has a very low temperature.
2. The appointment of immunomodulators, the task of which is to activate one's own immunity, which should no longer allow the virus to "raise its head" (drugs that would completely destroy the virus have not yet been invented).

In addition, it is important to ensure the prevention of re-infection: stop sexual contact with an infected partner (optimal - get treatment with him), exclude frequent changes of sexual partners, avoid visiting baths, saunas andswimming pools.

Treatment for human papillomavirus cancer depends on the stage at which the cancer is discovered. It usually consists of three components: surgical removal of the tumor, chemotherapy and radiation therapy. When to use the last 2 types of treatment - only after the operation, instead of the operation or both before and after - the oncologist decides after the examination.

A vaccine that could cure human papillomavirus infection is under development.

prevention

In view of the danger of human papillomavirus infection and its significant prevalence, several human papillomavirus vaccines have been synthesized.

All vaccines are certified and have passed the relevant tests. They do not contain the viruses themselves, but individual proteins contained on the capsule of the specified strains of viruses and therefore cannot cause disease. It is recommended to do them even before puberty - from 9 to 14 years of age, that is, until the child is said to be unfamiliar with the virus. So far, clear recommendations only apply to girls, since cervical cancer only occurs as a result of infection with this virus and is characterized by an extremely high mortality rate. At the same age, boys are also vaccinated.

It seems that you cannot find money to save a child from such serious oncological diseases. In addition, in some countries of the world, as well as in 18 US states, the introduction of one of the vaccines has been included in the national vaccination schedules. But there are many "buts":

• Studies show that vaccines reduce, but do not completely prevent, the risk of developing cervical cancer;
• According to official data, 8% of all side effects (or 0. 003% of all vaccinated people) observed during vaccination were due to serious side effects: death, disability, diseases threatening life and health. Deaths were also reported in 56 vaccinated adult women, but no association with the vaccinations themselves was found;
• In response to the vaccine, some teenagers responded with a rise in body temperature in large numbers, causing convulsions, some with respiratory failure, which is fatal. The opinion is expressed that such a reaction could be observed in carriers of a particular gene. At the same time, before vaccination, there is no study of the human genome, so it is not possible to determine whether the child is a carrier of this gene.
• after vaccination, Guillain-Barré syndrome was registered - a disease in which there are paralysis (often reversible) of the legs and arms, muscle weakness and their complete "shutdown" can affect all muscles, including respiratory muscles;
• Cases with an increased risk of thromboembolism have been identified. This complication was noted in 56 people, 19 of whom had pulmonary embolism from which 4 people died;
• How the vaccination affects fertility and pregnancy is not known: too little time has passed since the vaccination of the first groups of girls.

On the one hand, there is still evidence that vaccinated women maintain a normal (according to the Pap test) state of the cells of the cervix for at least 5 years. On the other hand, it is still too early to talk about the long-term results of vaccination. If a girl is taught "from an early age" that preventive medical check-ups, including those by a gynecologist, are good for her, it can be expected that any illness can be detected at an early stage.

It is therefore up to the parents to decide whether they want their own child to be vaccinated or not.