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

Papillomavirus infection is what is now on the lips of the whole world. It turned out that the virus, which causes the appearance of warts and small formations on the skin (papillomas), can provoke the development of cancer of the genital organs in women and men, as well as acarcinoma of the rectum and throat. Vaccines designed to protect a person against the most dangerous strains of the virus can themselves cause serious reactions.

Types of papillomavirus infection

Warts and cervical cancer are caused by two different types of the same virus (called strains). Determining only the fact 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 the papillomatosis virus are isolated, differing from each other in the set and sequence of proteins located on their shells. Scientists divide them into 27 species and 5 genera.

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

1. Presenting a low oncogenic risk (it is unlikely that their entry into the body will cause cancer). These are the viruses with the numbers 3, 11, 32, 34, 40-44, 6, 51, 61, 13, 72 and 73.
2. Have a medium 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. These are, first of all, type 16 papillomavirus, which causes cancer of the cervix in one out of two women (41-54%), as well as type 18 virus, which causes this disease in onetenth of its carriers. Highly oncogenic strains also include strains with numbers 31, 33, 39, 50, 59, 64, 68, 70, 82.

The danger 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 (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 "preferred" location. So, the most dangerous types 16 and 18, when affected, immediately "go" to the genitals, and weakly oncogenic viruses 6 and 11 affect the vulva and perineum, causing the development of genital warts. These same strains can cause respiratory tract papillomatosis in a child if born naturally to a mother with genital warts.

After 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 types 16 or 18. It has been proven that this disease does not occur in the absence of papillomavirus. And if earlier they talked about the development of cervical carcinoma from erosion or ectropion, now this has been revised 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 viruses;
• 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 caused by sex. With a different localization (in the nose, in the mouth), bleeding can be provoked by mechanically injuring them with other objects.

Every year, according to official sources, just under half a million (470, 000) new cases of cervical cancer caused by this virus are recorded worldwide. 233, 000 women die each year from this disease. This places this oncological disease in 2nd place in frequency among all cancerous pathologies in gynecology (1st place in breast cancer) and 5th place among all causes of death in women. Most often, women under 40 die of cervical cancer.

Transmission routes

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

How is the human papillomavirus transmitted:

• sexually (with any type of sex). Condoms reduce the possibility of its penetration into the body (infection with the use of a condom was 37. 8, and without it - 89. 3%), but does not completely prevent infection: thelatex pore diameter is designed to prevent sperm, while the size of the virus is too small;
• domestic way, when the virus penetrates through damaged skin. This happens in the pool, bath, when using shared towels, manicure tools, dishes;
• from mother to child, during childbirth: more often - with independent childbirth, but also with cesarean section, it is also possible for the virus to penetrate the membranes of the larynx;
• with saliva - with kisses;
• contact - by rubbing or cutting papillomas, warts or condyloma through the skin or mucous membrane, where the integrity is broken. This is how auto-infection usually occurs.

If a person's immunity is strong at the time the virus enters, the likelihood that a disease will develop is low: most likely, the microbe will remain in an inactive state. The risk of developing the disease increases if:

• early onset (before age 16) of sexual activity or at least fondling;
• frequent change (more than once in 3 years) 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;
• violations of metabolic processes;
• avitaminosis.

The presence of genital warts in a pregnant woman is an indication for a cesarean section - in order to avoid infection of the child's respiratory tract. Thus, it is unlikely that the child will "catch" the germ from the mother. Oncogenic types of the virus are not transmitted domestically, since the virus-carrying formations are not located on the skin. Therefore, the first "acquaintance" with these microbes usually occurs during sexual intercourse, and this usually occurs in adolescence. This justifies the need to take measures (including vaccination) just before the first sexual intercourse.

How does a papillomavirus infection manifest?

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

1. Papilloma- single or multiple. These are mushroom-shaped growths on a stem that are flesh-colored or have a yellowish, brownish or blackish tint. 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. More often, papillomas occur 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 occur in places of greatest friction and cause pain when pressed. Plantar warts may have a stem extending into healthy tissue. They can become inflamed and injured.
3. Genital warts. These are papillary growths that, merging, look like cauliflower. Condyloma forms on the mucous membranes: on the genitals, in the perineum. If they appeared as a result of anal intercourse, they occupy localization around the anus. Condyloma can also be located on the mucous membranes of internal organs: the bladder, the intestines. This causes symptoms such as painful urination or defecation, a violation of physiological functions.
4. Precancerous disease of the cervix - dysplasia, caused by the human papillomavirus - does not manifest clinically. This disease can be suspected during a 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 secretions from the genital tract (they may become more abundant, streaks of blood may appear there, they may have an unpleasant smell), menstrual irregularities, bleeding after intercourse or in the middle of the cycle. In 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 develops more often in men. It is characterized by the appearance on the skin of a different number of spots and patches of color ranging from pink or yellowish to red-brown or purple. The surface of such plaques can be smooth or warty; they are painful to the touch.
7. Bowen's disease- It is a cancer of the skin and mucous membranes, developing from the cells of the superficial layer. It looks like a bright red skin defect with irregular contours, covered with scales and warty growths.

In men, the human papillomavirus causes a special disease - squamous cell carcinoma of the penis. Its cause is a type 16 virus. The latter changes the cells of the male genital tract under the influence of cigarette smoke, while malignancy is acquired under the influence of the type herpes simplex virus. 2, if the male DNA contains the Ras gene, if PUVA therapy, chemotherapy has been performed, or the male is sick with HIV. Squamous cell carcinoma looks different. It can be the appearance of a spot rising above the skin with warty growths on top, it can 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 mainly occurs in people of non-traditional orientation. It is characterized by painful defecation, discharge of blood or ichor from the rectum.

Not every form of papillomavirus infection develops immediately after infection: you have to wait from 14 days to several years (depending on immunity and favorable factors) before the first symptoms appear.

Diagnostic

To make a diagnosis in the presence of external papillomas or warts, it is not necessary to do an analysis for the papillomavirus. In the presence of other clinical forms of infection, you need:

1. Medical exam:for women - a gynecologist, for men - a urologist.
2. Colposcopy(for women) - examination of the cervix under a microscope. During the study, tests are carried out with Lugol's solution, a Papanicolaou test (smear from the cervical canal and the cervix), a biopsy from the cervix, a smear is taken for examinationby the PCR method and the Digene test.
3. Urethroscopy and rectoscopy(for men). When examining the urethra or rectum, a biopsy of suspicious precancer or cancerous changes is also performed, smears are also taken for examination by the PCR method and the Digene test.

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

Treatment

How to treat human papillomavirus depends on the form of infection. Thus, if it is warts, papillomas or condyloma, the treatment is carried out in 2 stages:

1. The formation is eliminated by various methods. It can be a surgical excision with a scalpel, a burn with a laser or with an 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 - the necrosis of pathological tissues using liquid nitrogen, which has a very low temperature.
2. The appointment of immunomodulators, whose task is to activate its 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 reinfection: stop sexual contact with an infected partner (optimally - undergo treatment with him), exclude frequent changes of sexual partners, avoid visiting baths, saunas, swimming pools.

Treatment for 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 that could cure human papillomavirus infection is under development.

Prevention

Considering the danger 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 in the capsule of the indicated virus strains, so they cannot cause disease. They are recommended to be carried out even before puberty - at the age of 9-14, that is, until the time when the child is still not supposed to know about the virus. So far, clear recommendations only apply to girls, because cervical cancer only occurs as a result of infection with this virus and is characterized by an extremely high mortality rate. Boys are also vaccinated at the same age.

It would seem 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 American states, the introduction of one of the vaccines has been introduced into the national immunization schedules. But there are a lot of "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 (i. e. 0. 003% of all vaccinated) observed during vaccination were due to serious side effects: death, disability, life-threatening and health-threatening diseases. Deaths were also reported in 56 vaccinated adult women, but no association was found with the vaccinations themselves;
• in response to the vaccine, some teenagers reacted with a rise in temperature to high numbers, which caused convulsions, some with respiratory failure, which is fatal. An opinion is expressed that such a reaction could be observed in carriers of a certain gene. At the same time, before vaccination, the study of the human genome is not carried out, therefore it is impossible to know whether the child is a carrier of this gene;
• after vaccination, Guillain-Barré syndrome was recorded - a disease characterized by paralysis (often reversible) of the legs and arms, muscle weakness and their complete "shutdown" that can affect all muscles, including respiratory muscles;
• cases of increased risk of thromboembolism have been noted. This complication was noted in 56 people, of whom 19 people had a pulmonary embolism, from which 4 people died;
• it is not known how vaccination affects fertility and pregnancy: too little time has elapsed since the vaccination of the first groups of girls.

On the one hand, there is still evidence that vaccinated women maintain a normal state (according to the Pap test) of the cells of the cervix for at least 5 years. On the other hand, it is too early to speak of the long-term results of vaccination. In any case, if a girl is taught "from an early age" that preventive examinations, including those carried out by a gynecologist, are for her good, one can expect that any disease can be detected atan early stage.

Thus, it is up to the parents to decide whether or not to have their own child vaccinated.