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

Papillomavirus infection is what is now on the lips of the entire world. The virus, which causes warts and smaller skin formations (papillomas), has been found to cause cancer of Organs genital organs in women and men, as well as carcinoma of the rectum and throat. Vaccines designed to protect a person from the most dangerous strains of the virus can cause serious reactions.

Types of papillomavirus infection

Warts and cervical cancer are caused by two different types of the same virus (called strains). Determining just the fact that papillomavirus infection has occurred does not mean that a person will develop papillomavirus cancer: this is possible if a strain of the oncogenic group enters the body. At the same time, infection with either strain 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 in its shell. 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 (its entry into the body is unlikely to cause cancer). They are viruses with 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, whose probability of malignancy is greater than in the first case.
3. High oncogenic strains. This is, first of all, the type 16 papillomavirus, which causes cervical cancer in every two women (41-54%), as well as the type 18 virus, which causes this disease in every tenth of its carriers. Highly oncogenic also includes 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 on the skin or mucous membrane of various organs: reproductive (male and female), esophagus, bronchi, oral cavity, rectum. It can also be located on 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 affect the vulva and perineum, causing the development of genital warts there. These same strains can cause respiratory tract papillomatosis in a child if they are 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 is proven that this disease does not occur in the absence of papillomavirus. And if before they talked about the development of cervical carcinoma by 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 the virus;
• respiratory failure, which develops with the growth of malignant papillomas in the respiratory tract (larynx, trachea);
• contact bleeding from warts. Whether they are on the vulva, perineum, or vagina, they are caused by sex. With a different location (in the nose, in the mouth), bleeding can be provoked by mechanically hurting 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 every year from this disease. This places this oncological disease in 2nd place in frequency among all cancerous pathologies in gynecology (first place in breast cancer) and in 5th place among all causes of death in women. Most of the time, women under the age of 40 die from cervical carcinoma.

transmission routes

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

How the human papillomavirus is transmitted:

• sexually (with any type of sex). Condoms reduce the possibility of their penetration into the body (infection with condom use was 37. 8 and without it - 89. 3%), but they do not completely prevent infection: the diameter of the pores in latex is designed to prevent sperm, while the size of the virus is very small;
• domestic way, when the virus penetrates through damaged skin. This happens in the pool, in the bath, when using shared towels, manicure utensils, dishes;
• from mother to child, during childbirth: more often - with independent delivery, but also with cesarean section, there is also a possibility that the virus enters the membranes of the larynx;
• with saliva - with kisses;
• contact - when rubbing or cutting papillomas, warts or condylomas through the skin or mucosa, where integrity is broken. This is how auto-infection usually occurs.

If a person's immunity is strong at the time the virus enters, the probability of a disease developing is small: 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;
• prolonged use of birth control pills for;
• disturbances 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, the child is unlikely to "catch" the microbe from the mother. The oncogenic types of the virus are not transmitted by domestic means because the virus-bearing formations are not located in 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 (in particular, vaccination) immediately before the first sexual experience.

How does papillomavirus infection manifest itself?

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

1. papilloma- single or multiple. They are mushroom-shaped outgrowths on a skin-colored stalk or with a yellowish, brownish, or blackish tinge. They are found on the skin under the mammary glands, on the neck, under the armpits, on the face, as well as on the mucous membranes of the mouth, nose, or genitals. More often, papillomas occur in women. They are usually just a cosmetic defect, they can cause discomfort or pain. Rarely, papillomas become malignant.
2. warts, including planting. These are brownish mushroom-shaped formations. In the region of the palms and soles of the feet, they occur in places of greater friction and cause pain when pressed. Plantar warts can have an axis that extends into healthy tissue. They can become inflamed and bruised.
3. genital warts. They are papillary protuberances that, merging with each other, 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 location around the anus. Condylomas can also be located on the mucous membranes of internal organs: bladder, intestines. This causes symptoms such as pain when urinating or defecating, a violation of physiological functions.
4. Pre-cancerous disease of the cervix - dysplasia, caused by the human papillomavirus - does not manifest clinically. This disease can be suspected during colposcopy; detected by cytological examination of a cervical canal smear.
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 the discharge from the genital tract (they may become more abundant, streaks of blood may appear on them, they may have an unpleasant odor), menstrual irregularities, bleeding after sex 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 of a different number of pink or yellowish to reddish-brown or purple spots and plaques on the skin. 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 blemish with irregular contours, covered in scales and warts.

In men, the human papillomavirus causes a special disease - squamous cell carcinoma of the penis. Its cause is a type 16 virus. The latter alters the cells of the male genital tract under the influence of cigarette smoke, while the malignant character is acquired under the influence of the herpes simplex virus type 2, if the male DNA contains the Ras gene, if PUVA therapy, chemotherapy was performed, or the man is ill with HIV. Squamous cell carcinoma looks different. This can look like a spot that rises above the skin with warts on top, it can also look like an ulcer that destroys the penis. The tumor is located in the head or foreskin.

Rectal cancer caused by the human papillomavirus is also more common in men. It mainly occurs in people of nontraditional orientation. It is characterized by painful defecation, bloody discharge, or itching from the rectum.

Any form of papillomavirus infection does not develop immediately after infection: it may take anywhere from 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 papillomas or external warts, it is not necessary to perform a test 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, examinations with Lugol's solution, Pap smear (smears of the cervical canal and cervix), cervical biopsy, smear collection for examination by the PCR method and Digene test are performed.
3. Urethroscopy and Rectoscopy(for men). During the examination of the urethra or rectum, a biopsy of suspicious changes of pre-cancer or cancer is also performed, smears are also taken for examination by the PCR method and the Digene test.

Thus, testing for the virus can only be done in the office of a gynecologist (for women) or a urologist (for men). This is a PCR study of a smear of 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 are talking about warts, papillomas or condylomas, the treatment is carried out in 2 stages:

1. Formation is removed by various methods. It can be surgical excision with a scalpel, burning with a laser or electric current, which is more effective in the case of papillomas and condylomas. 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, the task of which is to activate the immunity itself, 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 - get 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 before and after - the oncologist decides after the examination.

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

Prevention

Given the danger of human papillomavirus infection and its significant 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, therefore, cannot cause a disease. They are recommended to be performed even before puberty - at age 9-14, that is, until the time when the child is still supposedly unfamiliar with the virus. So far, clear recommendations apply only to girls, since cervical cancer occurs only as a result of infection with this virus and is distinguished by an extremely high mortality rate. Boys are also vaccinated at the same age.

You can't seem to find the money to save a child from such serious oncological diseases. Furthermore, in some countries of the world, as well as 18 US states, the introduction of one of the vaccines has been introduced into 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 side effects (or 0. 003% of all vaccinates) observed during vaccination were due to serious side effects: death, disability, life and health threatening diseases. Deaths were also reported in 56 adult women vaccinated, but no association was found with the vaccines themselves;
• in response to the vaccine, some teenagers reacted with temperature rise to high numbers, which provoked convulsions, some with respiratory failure, which is deadly. An opinion is expressed that such a reaction can be observed in carriers of a particular gene. At the same time, before vaccination, the study of the human genome is not carried out, so it is impossible to know if the child is a carrier of this gene;
• after vaccination, Guillain-Barré syndrome was recorded - a disease in which paralysis (often reversible) of the legs and arms occurs, muscle weakness and their complete "shutdown" can affect all muscles, including the respiratory ones;
• cases of increased risk of thromboembolism have been observed. This complication was observed in 56 people, of which 19 people had pulmonary embolism, due to which 4 people died;
• it is not known how vaccination affects fertility and pregnancy: very 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 state (according to the Pap smear) 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, including those by a gynecologist, are for her own good, we can expect that any disease can be detected early.

Thus, it is up to parents to decide whether or not to vaccinate their own child.