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

Papillomavirus infection is what is now on the lips of the whole world. It has been shown that the virus, which causes warts and smaller growths on the skin (papillomas), can cause the development of genital cancer in women and men, as well as cancer of the rectum and throat. Vaccines designed to protect against the most dangerous strains of the virus can themselves cause severe reactions.

Types of papillomavirus infection

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

In total, about 600 strains of papillomatosis virus have been isolated, which differ from each other in the set and sequence of proteins located 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. They have a low oncogenic risk (getting into the body is unlikely to cause cancer). These are viruses with numbers 3, 11, 32, 34, 40-44, 6, 51, 61, 13. 72 and 73.
2. With moderate oncogenic risk. These are strains 35, 53, 30, 52, 45, 56, 58. They cause formations on the skin and mucous membranes, the probability of malignancy of which is higher than in the first case.
3. Strains with high oncogenicity. It is primarily papillomavirus type 16, which causes cervical cancer in every second woman (41-54%), as well as virus type 18, which causes this disease in every tenth of its carriers. Highly oncogenic ones also include strains numbered 31, 33, 39, 50, 59, 64, 68, 70, 82.

The danger of papillomavirus infection

The properties of the papillomatosis virus are such that it is found either in the skin or in the mucous membranes of various organs: reproductive (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 "favorite" location. Thus, the most dangerous types 16 and 18, when struck, 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 tractin a child if born naturally by a mother with genital warts.

After infection, a disease with severe symptoms does not always develop. On the contrary, the disease 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 shown that this disease does not occur in the absence of papillomavirus. And if earlier we talked about the development of cervical cancer from erosion or ectropion, now it is reviewed and denied;
• rectal carcinoma. It, unlike the first disease, 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 virus;
• respiratory failure, which develops with the growth of malignant papillomas in the airways (larynx, trachea);
• contact bleeding from warts. If they are on the vulva, perineum or vagina, then they are provoked by sex. With different localization (nose, mouth), bleeding can be provoked by mechanical injury with other objects.

According to official sources, just under half a million (470, 000) new cases of cervical cancer caused by the virus are reported worldwide each year. 233, 000 women die each year from the disease. This puts this cancer in 2nd place among the most common cancers in gynecology (first place in breast cancer) and 5th among all causes of death in women. Most often, women under the age of 40 die from cervical cancer.

Transmission routes

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

How human papillomavirus is transmitted:

• sexual (with all kinds of sex). Condoms reduce the possibility of penetration into the body (infection with a condom is 37, 8, and without it - 89, 3%), but do not completely prevent infection: the diameter of the pores in the latex is designed to prevent sperm formation, while the size ofthe virus is too small;
• household way when the virus penetrates damaged skin. This happens in the pool, bath, when using shared towels, manicure tools, utensils;
• from mother to child, during childbirth: more often - in single birth, but also by cesarean section, there is a possibility that the virus will get on the membranes of the larynx;
• with saliva - with kisses;
• contact - when rubbing or cutting papillomas, warts or warts from the skin or mucous membranes, in which the integrity is violated. This is how self-infection usually happens.

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

• early (16 years ago) onset of sexual activity or the slightest caress;
• frequent (more than once every 3 years) change of sexual partners;
• genital infections such as recurrent thrush, chlamydia, gonorrhea, ureaplasmosis;
• had abortions;
• diseases of the cervix: erosion, ectropion;
• constant stress;
• bad habits: smoking, alcoholism;
• long-term use of birth control pills for;
• disorders 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. Thus, it is unlikely that the child will "get" the germ from the mother. Oncogenic types of virus are not transmitted by home remedies, as the virus-bearing formations are not located on the skin. Therefore, the first "acquaintance" with these microbes usually occurs during sexual intercourse, and this usually happens in adolescence. This justifies the need to take measures (especially vaccination) just before the first sexual experience.

How does a papillomavirus infection manifest itself?

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

1. papilloma- single or multiple. These are spongy growths on a stalk of skin color or with 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. Usually they are 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 appear in places with the greatest friction and cause pain when pressed. Plantar warts may have a trunk that extends into healthy tissue. They can become inflamed and injured.
3. Genital warts. These are papillary growths that, when fused with each other, look like cauliflower. Warts form on the mucous membranes: on the genitals, in the perineum. If they occur as a result of anal sex, they are located around the anus. Warts can also be located on the mucous membranes of internal organs: bladder, intestines. This causes symptoms such as painful urination or defecation, impaired physiological functions.
4. Precancerous disease of the cervix - dysplasiacaused by human papillomavirus - not clinically evident. This disease may be suspected during colposcopy; detected by cytological examination of a smear from the cervical canal.
5. Cervical cancerdoes not appear immediately. There are no symptoms in the early stages. The woman should be warned of itching in the genital area, a change in the nature of the discharge from the genital tract (they may become more abundant, they may appear streaks of blood, may have an unpleasant odor), menstrual disorders, 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 develops more often in men. It is characterized by the appearance on the skin of a different number of spots and plaques in 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, developing from the cells of the surface layer. It looks like a bright red skin defect with uneven contours, covered with scales and warts.

In men, the human papillomavirus 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, chemotherapy, or the man has HIV. Squamous cell carcinoma looks different. This may be the appearance of a spot rising above the skin with warts on top, it may also look like an ulcer that destroys the penis. The tumor is located on the head or foreskin.

Rectal cancer caused by the human papillomavirus is also more common in men. It occurs mainly in people with non-traditional orientation. It is characterized by painful defecation, bleeding or rectal discharge.

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

Diagnosis

It is not necessary to test for papillomavirus to diagnose external papillomas or warts. In the presence of other clinical forms of infection you need:

1. Medical examination:for women - gynecologist, for men - urologist.
2. Colposcopy(for women) - examination of the cervix under a microscope. During the examination, tests are performed with Lugol's solution, Papanicolaou test (smears from the cervical canal and cervix), biopsy of the cervix, cytosmear is taken for PCR and Digene test.
3. Urethroscopy and rectoscopy(for man). When examining the urethra or rectum, a biopsy of suspected precancerous or cancerous lesions is performed, and cytosmears are taken for examination by PCR and Digene test.

Thus, it is possible to take virus tests only in the office of a gynecologist (for women) or urologist (for men). This is a PCR test of a smear from the cervical canal or urethra, or a Digene test, which is performed with material taken from a biopsy or scraping of epithelial cells.

Treatment

How to treat human papillomavirus depends on the form of the infection. So, if we talk about warts, papillomas or warts, the treatment is carried out in 2 stages:

1. The formation is removed by various methods. This can be a surgical scalpel cut, laser burn or electric shock, which is more effective for papillomas and warts. For the treatment of warts successfully used the method of cryodestruction - 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 destroy the virus completely, have not yet been invented).

In addition, it is important to ensure the prevention of re-infection: to stop sexual contact with an infected partner (optimally - to undergo treatment with him), to exclude frequent changes of sexual partners, to avoid visiting 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 both before and after - the oncologist decides after the examination.

A vaccine is currently being developed that can cure human papillomavirus infection.

Prevention

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

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 these strains of viruses, so they can not cause disease. It is recommended to be performed before puberty - at 9-14 years, ie until the time when the child is not yet familiar with the virus. So far, clear recommendations apply only to girls, as cervical cancer occurs only as a result of infection with this virus and is characterized by extremely high mortality. The boys are also vaccinated at the same age.

It seems that you can not find money to save a child from such serious cancers. In addition, in some countries around the world, as well as in 18 US states, the introduction of one of the vaccines is introduced in the national immunization 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 adverse reactions (or 0, 003% of all vaccinated) observed during vaccination are 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 established with the vaccinations themselves;
• in response to the vaccine, some teenagers react by raising the temperature to high numbers, which provokes convulsions, some with respiratory failure, which is fatal. It has been suggested that a similar reaction may occur in carriers of a particular gene. At the same time, before vaccination, the study of the human genome is not performed, so it is impossible to know whether the child is a carrier of this gene;
• Guillain-Barré syndrome has been reported after vaccination, a disease in which paralysis (often reversible) of the legs and arms, muscle weakness and complete "shutdown" can affect all muscles, including the respiratory system.
• cases of increased risk of thromboembolism have been reported. This complication was noted in 56 people, of whom 19 people had pulmonary embolism, which killed 4 people;
• 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 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 learns "from an early age" that preventive examinations, including with a gynecologist, are for her good, we can expect that any disease can be detected at an early stage.

So parents decide whether to vaccinate their own child or not.