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

Papillomavirus infection is one that is now on the lips of the whole 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 genital cancer in women and men, as well as cancer of the rectum and throat. Vaccines designed to protect a person from the most dangerous strains of the virus can cause serious reactions of their own.

Types of papillomavirus infection

Warts and cervical cancer are caused by two different types of the same virus (called strains). Determining the mere fact 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 has entered the body. At the same time, infection with any of the strains increases the risk of another type of virus penetrating the body.

In total, about 600 strains of the papillomatosis virus have been isolated, which differ from each other in the group and sequence of proteins located in their 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. They have a low oncogenic risk (their entry 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. Having a moderate oncogenic risk. These are strains 35, 53, 30, 52, 45, 56, 58. They cause formations in the skin and mucous membranes, the probability of malignancy of which is higher than in the first case.
3. High oncogenicity species. This is, first of all, 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 the carriers ofhis. Many oncogenes also include strains numbered 31, 33, 39, 50, 59, 64, 68, 70, 82.

Risk of papillomavirus infection

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

Each type of virus has its "favorite" localization. So the most dangerous types 16 and 18, when struck, "go" immediately to the genitals, and viruses with low oncogenes 6 and 11 affect the vulva and perineum, causing the development of genital warts there. The same strains can cause papillomatosis in the respiratory tract in a baby if it is born naturally from 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. Occurs in women as a result of infection with human papillomavirus 16 or 18. It has been proven that this disease does not occur in the absence of papillomavirus. And if earlier there was talk of developing cervical carcinoma from erosion or ectropion, now this has been 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 respiratory tract (larynx, trachea);
• contact bleeding from warts. If they are in the vulva, perineum or vagina, then they are provoked by sex. With a different localization (in the nose, in the mouth), bleeding can be provoked by mechanically damaging them with other objects.

Every year, according to official sources, a little 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 this oncological disease in second place in terms of frequency among all cancerous pathologies in gynecology (first place in breast cancer) and in 5th place among all causes of death in women. Most often, women under 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 human papillomavirus transmitted:

• sexually (with any kind of sex). Condoms reduce the chance of it penetrating the body (infection with the use of a condom was 37. 8, and without it - 89. 3%), but do not completely prevent infection: the diameter of the pores in the latex is created to prevent sperm, whilethe size of the virus is very small;
• home way, when the virus penetrates through the damaged skin. This happens in the pool, bath, when using shared towels, manicure tools, dishes;
• from mother to child, during birth: most often - by independent birth, but also by cesarean section, there is a possibility that the virus enters the laryngeal membranes;
• with saliva - with kisses;
• contact - when rubbing or cutting papillomas, warts or condylomas from the skin or mucous membranes, where the integrity is broken. This is how self-infection usually occurs.

If a person's immunity is strong at the time the virus enters, then the likelihood of a disease developing is small: most likely, the germ 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 petting;
• frequent change (more than once in 3 years) of sexual partners;
• genital infections, such as recurrent thrush, chlamydia, gonorrhea, ureaplasmosis;
• had an abortion;
• 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 cesarean section - in order to avoid infection of the baby's respiratory tract. Thus, the baby is unlikely to "get" the germ from the mother. Oncogenic strains of the virus are not transmitted by home remedies because the formations that carry the virus are not located in the skin. Therefore, the first "acquaintance" with these microbes usually occurs during sexual intercourse and it usually occurs in adolescence. This justifies the need to take measures (in particular, vaccination) shortly before the first sexual experience.

How is papillomavirus infection manifested?

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

1. Papilloma- single or multiple. These are fungal formations on a skin-colored stalk or that have a yellow, brown, or black tinge. They are found on the skin under the mammary glands, in the neck, in the armpits, on the face, as well as in the mucous membranes of the mouth, nose or genitals. Most often, papillomas appear in women. Usually they are just a cosmetic defect, they can cause discomfort or pain. Rarely, papillomas become malignant.
2. wen, including the toe. These are brown mushroom formations. In the area of the palms and soles, they occur at the sites of greatest friction and cause pain when pressed. Plantar warts can have an axis that extends into healthy tissue. They can become inflamed and injured.
3. Genital warts. These are papillary outgrowths, which, when joined together, resemble cauliflower. Condylomas form in the mucosa: in the genitals, in the perineum. If they arise as a result of anal sex, they occupy a localization around the anus. Condylomas can also be localized in the mucosa of internal organs: bladder, intestines. This causes symptoms such as painful urination or defecation, a violation of physiological functions.
4. Precancerous disease of the cervix - dysplasia, caused by human papillomavirus - not clinically manifested. This disease can be suspected during colposcopy; detected by cytological examination of a stain from the cervical canal.
5. Cervical cancerdoes not appear immediately. In the early stages, there are no symptoms. A woman should be alarmed by itching in the genital area, a change in the nature of discharge from the genital tract (they may become more abundant, blood streaks may appear in them, 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 back or lower back.
6. Bowenoid papules. This is the name of a precancerous condition that most often develops in men. It is characterized by the appearance on the skin of a different number of spots and plaques in color from pink or yellow to reddish-brown or purple. The surface of such tiles may be smooth or delightful; 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 reddish-brown skin defect with uneven contours, scaly coverage, and growing lesions.

In men, 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 the malignant character is acquired under the influence of the herpes simplex virus type 2, if the male DNA contains the Ras gene, ifPUVA therapy chemotherapy is performed. , or the husband is infected with HIV. Squamous cell carcinoma looks different. This may be the appearance of a spot that rises on the skin with growing warts on top, it may also look like an ulcer that destroys the penis. The tumor is localized to the head or forehead.

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

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

Diagnosing

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

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

Thus, tests 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 stain from the cervical canal or urethra, or a Digene test, which is performed with material obtained from a biopsy or scraping of epithelial cells.

Treatment

How human papillomavirus is treated depends on the form of the infection. So, if we are talking about warts, papillomas or condyloma, the treatment is performed in 2 stages:

1. The formation is removed by various methods. This can be surgical removal with a scalpel, laser burn or electric shock, which is most effective in the case of papillomas and condyloma. For the treatment of warts is 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 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 - undergo treatment with him), exclude frequent changes of sexual partners, avoid visits to baths, saunas, swimming pool.

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 the last 2 types of treatment are applied - only after surgery, instead of surgery or both before and after - the oncologist decides after the examination.

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

prevention

Given the risk of human papillomavirus infection and its significant spread, 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 the individual proteins contained in the capsule of the indicated virus strains, therefore they can not cause disease. They are recommended to be performed even before puberty - at the age of 9-14 years, ie until the time when the child is assumed to be unfamiliar with the virus. So far clear recommendations apply only to girls, as cervical cancer appears only as a result of infection with this virus and is distinguished by extremely high mortality. Boys are vaccinated at the same age.

It seems you can not find money to save a child from such serious oncological diseases. Moreover, in some countries of the world, as well as in 18 US states, the introduction of one of the vaccines has been 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 side effects (or 0. 003% of all vaccinated) observed during vaccination were due to severe side effects: death, disability, life-threatening and health 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 adolescents reacted with fever in high figures, which provoked convulsions, some with respiratory failure, which is fatal. An opinion is expressed that such a reaction can be observed in carriers of a certain gene. At the same time, before vaccination, the study of the human genome is not performed, 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 "closure" can affect all muscles, including those of the respiratory tract;
• 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 condition (according to the Pap test) 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 benefit, we can expect any disease to be detected at an early stage.

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