Human papilloma virus: symptoms, in women, in men, treatment

Papilloma virus infection is what is now on the lips of the whole world. It has been shown that the virus, which causes the appearance of warts and small formations on the skin (papilloma), can cause genital cancer in women and men, as well as rectal and throat cancer. Vaccines designed to protect a person from the most dangerous strains of the virus can themselves cause serious reactions.

Types of papilloma virus infection

Warts and cervical cancer are caused by two different types of the same virus (called strains). Determining just the fact that a papilloma virus infection has occurred does not mean that a person will develop papilloma virus cancer: this is possible if a strain from the oncogenic group has entered the body. At the same time, infection with any of the strains increases the risk of other viruses entering the body.

In total, about 600 strains of papillomatosis virus were isolated, which differ in the set and order of proteins found on their shell. Scientists divide them into 27 species and 5 genera.

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

1. They have a low oncogenic risk (it is unlikely that their entry into the body will cause cancer). These are viruses with numbers 3, 11, 32, 34, 40-44, 6, 51, 61, 13. 72 and 73.
2. Have an average oncogenic risk. These are strains 35, 53, 30, 52, 45, 56, 58. They cause formations on the skin and mucous membranes whose probability of malignancy is higher than in the first case.
3. High oncogenicity strains. It is, first of all, papilloma virus type 16, which causes cervical cancer in every other woman (41-54%), as well as type 18 virus, which causes this disease in every tenth carrier. Highly oncogenic include strains with numbers 31, 33, 39, 50, 59, 64, 68, 70, 82.

Risk of papilloma virus infection

The properties of the papillomatosis virus are such that it is deposited either in the skin or in the mucosa of various organs: reproductive (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 "favorite" localization. Thus, the most dangerous types 16 and 18, when affected, immediately "go" to the genitals, and low-oncogenic viruses 6 and 11 affect the vulva and perineum, causing the development of genital warts there. These same strains can cause papillomatosis in the respiratory tract of a child if it is born naturally from a mother with genital warts.

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

The most dangerous complications of human papilloma virus infection are:

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

Every year, according to official sources, slightly less than half a million (470, 000) new cases of cervical cancer caused by this virus are registered in the world. 233, 000 women die each year from this disease. This puts cancer on the 2nd place in frequency among all cancerous pathologies in gynecology (first place on breast cancer) and on the 5th place among all causes of death in women. Most women under the age of 40 die from cervical cancer.

Transmission routes

Papilloma virus is extremely common. According to modern data, it can be found in 90% of the world's population.

How is the human papilloma virus transmitted:

• sexually (with any type of sex). Condoms reduce the possibility of its penetration into the body (infection with the use of condoms was 37. 8, and without it - 89. 3%), but do not completely prevent infection: the pore diameter in latex is designed to prevent sperm, while the size of the virus is too small;
• home mode, when the virus penetrates damaged skin. It happens in the pool, bathtub, when you use shared towels, manicure tools, dishes;
• from mother to child, during childbirth: more often - in independent delivery, but also in caesarean section, there is a possibility that the virus can reach the membranes of the larynx;
• with saliva - with kisses;
• contact - when rubbing or cutting papillomas, warts or condyloma with skin or mucous membranes, where integrity is compromised. This is how self-infection usually occurs.

If a person's immunity is strong at the time of entry of the virus, then the probability that the disease will develop is small: the microbe will most likely remain inactive. The risk of developing the disease increases if:

• early (16 years ago) onset of sexual activity or at least cuddling;
• frequent (more than once in 3 years) change of sexual partners;
• genital infections, such as recurrent thrush, chlamydia, gonorrhea, ureaplasmosis;
• had abortions;
• cervical diseases: erosion, ectropion;
• constant stress;
• bad habits: smoking, alcoholism;
• long-term use of birth control pills for;
• violation of metabolic processes;
• avitaminosis.

The presence of genital warts in a pregnant woman is an indication for a caesarean section - to avoid infection of the child's respiratory tract. Therefore, it is unlikely that the child will "get" the microbe from the mother. Oncogenic types of the virus are not transmitted at home because the virus-bearing formations are not found on the skin. Therefore, the first "introduction" to these microbes usually happens during sexual intercourse, and it most often happens in adolescence. This justifies the need to take measures (especially vaccinations) just before the first sexual experience.

How does a papilloma virus infection manifest itself?

The symptoms of human papilloma virus depend on which strain entered the body and which clinical form it caused. So, it could be:

1. Papilloma- single or multiple. These are mushroom-shaped growths on the skin-colored stem or have a yellowish, brownish or blackish tinge. They are found 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. They are usually just a cosmetic defect, they can cause discomfort or pain. Rarely, papillomas become malignant.
2. Warts, including plantar. These are brownish mushroom-shaped formations. In the area of the palms and soles, they occur at the places of greatest friction and cause pain when pressed. Plantar warts may have an axis that extends into healthy tissue. They can become inflamed and injured.
3. Genital warts. These are papillary growths, which, merging with each other, resemble cauliflower. Condyloma is formed on the mucous membranes: on the genitals, in the perineum. If they are the result of anal sex, they are localized around the anus. Condyloma can also be found on the mucous membranes of internal organs: bladder, intestines. This causes symptoms such as painful urination or defecation, violation of physiological functions.
4. Precancerous disease of the cervix - dysplasia, caused by human papilloma virus - does not manifest clinically. This disease may be suspected during colposcopy; detected by cytological examination of swabs from the cervical canal.
5. Cervical cancerdoes not appear immediately. There are no symptoms in the early stages. The woman should be warned about itching in the genital area, changing the nature of the discharge from the genital tract (they may become more abundant, blood stains may appear, may 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. Bovenoid 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 different number of spots and plaques in the color from pink or yellowish to reddish-brown or purple. The surface of such plaques may be smooth or warty; they are painful to the touch.
7. Bowen's disease- This is a cancer of the skin and mucous membranes, which develops from the cells of the surface layer. It looks like a bright red skin defect of uneven contours, covered with scales and warty growths.

In men, the human papilloma virus causes a special disease - squamous cell carcinoma of the penis. It is caused by virus type 16. 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, if male DNA contains Ras gene, if PUVA therapy is chemotherapy, or a man is sick. HIV. Squamous cell carcinoma looks different. This can be the appearance of a spot that rises above the skin with warty growths on top, it can also look like an ulcer that destroys the penis. The tumor is localized on the head or foreskin.

Rectal cancer caused by the human papilloma virus is also more common in men. It occurs mainly in people of non-traditional orientation. It is characterized by painful defecation, discharge of blood or bile from the rectum.

Any form of papilloma virus infection does not occur immediately after infection: it takes 14 days to several years (depending on immunity and favorable factors) before the first symptoms appear.

Diagnosis

It is not necessary to take a test for papilloma virus to make a diagnosis in the presence of external papillomas or warts. In the presence of other clinical forms of infection it is necessary:

1. Medical examination:for women - gynecologist, for men - urologist.
2. Colposcopy(for women) - examination of the cervix under a microscope. During the study, tests are performed with Lugol's solution, Papanicolaou test (swabs from the cervical canal and cervix), cervical biopsy, swab is taken for examination by PCR method and Digene test.
3. Urethroscopy and rectoscopy(for men). During the examination of the urethra or rectum, a biopsy of changes suspected of precancer or cancer is performed, and swabs are taken for examination by PCR and Digene test.

Therefore, testing for the virus is possible only in the office of a gynecologist (for women) or urologist (for men). This is a PCR study of a swab from the cervical canal or urethra, or the Digene test, which is performed with material taken from a biopsy or scraping of epithelial cells.

Treatment

The treatment for human papilloma virus depends on the form of the infection. So, if it is warts, papillomas or condyloma, the treatment is carried out in 2 stages:

1. The formation is removed by various methods. It can be surgical excision with a scalpel, laser burning or electric current, which is more effective in the case of papillomas and condyloma. For the treatment of warts, the method of cryodestruction is successfully used - necrosis of pathological tissue with the help of liquid nitrogen, which has a very low temperature.
2. The appointment of immunomodulators, whose task is to activate their 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 (optimally - be treated with him), exclude frequent changes of sexual partners, avoid visits to baths, saunas, swimming pools.

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

A vaccine that could cure human papilloma virus infection is under development.

Prevention

Given the risk of human papillomavirus infection and its significant prevalence, several vaccines against human papillomavirus have been synthesized.

All vaccines are certified and have passed the relevant tests. They do not contain the viruses themselves, but the individual proteins contained in the capsule of these strains of the virus, so they cannot cause disease. It is recommended that they be performed before puberty - at the age of 9-14, ie until the child is not yet familiar with the virus. For now, clear recommendations apply only to girls, because cervical cancer occurs only as a consequence of infection with this virus, and it is characterized by an extremely high mortality rate. Boys are vaccinated at the same age.

It seems that you can't find the money to save your child from such serious oncological diseases. Moreover, in some countries of the world, as well as in 18 American states, the introduction of one of the vaccines has been introduced in national immunization schemes. 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) observed during vaccination were due to severe side effects: death, disability, life-threatening diseases. Deaths have also been reported in 56 vaccinated adult women, but no association has been found with the vaccinations themselves;
• in response to the vaccine, some teenagers reacted by raising the temperature to high numbers, which caused convulsions, some with respiratory failure, which is fatal. It is thought that such a reaction could be observed in carriers of a particular gene. At the same time, the human genome is not studied before vaccination, so it is impossible to know whether a child is a carrier of this gene;
• after vaccination, Guillain-Barré syndrome has been registered - a disease in which paralysis (often reversible) of the legs and arms, muscle weakness and their complete "quenching" can affect all muscles, including respiratory;
• cases of increased risk of thromboembolism have been reported. This complication was reported in 56 individuals, of whom 19 had pulmonary embolism, resulting in 4 deaths;
• it is not known how vaccination affects fertility and pregnancy: 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) condition of cervical cells for at least 5 years. On the other hand, it is too early to talk about the long-term results of vaccination. In any case, if a girl is taught "from an early age" that preventive examinations, even by a gynecologist, are for her good, we can expect that any disease can be detected at an early stage.

So, it is up to the parents to decide whether to vaccinate their child or not.