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

Papillomavirus infection is what is now on the mouth around the world. It turned out that the virus, which causes warts and smaller formations on the skin (papillomas), can cause the development of cancer of the genital organs in women and men, as well as carcinoma of the rectum and throat. Vaccines designed to protect a person from the more dangerous strains of the virus can cause severe reactions.

Types of papillomavirus infection

Warts and cervical cancer are caused by two different types of the same virus (called strains). Just determining the fact that a 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 entering the body.

In total, about 600 strains of the papillomatosis virus are isolated, which differ from each other in the set and sequence of proteins located on 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. 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. 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 greater than in the first case.
3. Strains of high oncogenicity. This is, first of all, the type 16 papillomavirus, which causes cervical cancer in one in two women (41-54%), as well as the type 18 virus, which causes this disease in every tenth of its carriers. Highly oncogenic 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 in the skin or mucous membrane of various organs: reproductive (both male and female), esophagus, bronchi, oral cavity, rectum. It can also be located 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 low oncogenic viruses 6 and 11 affect the vulva and perineum, causing genital warts to develop there. These same strains can cause respiratory papillomatosis in a baby if it is 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 due to human papillomavirus infection of type 16 or 18. It has been shown that this disease does not occur in the absence of papillomavirus. And if earlier there was talk of the development of cervical cancer due to erosion or ectropion, now this has been revised and denied;
• rectal carcinoma. Unlike the first disease, it can have other causes;
• throat cancer. It is also caused by a type 16 virus;
• lung cancer, which can occur if 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, on the 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, there are just under half a million (470, 000) new cases of cervical cancer caused by this virus worldwide. 233, 000 women die each year from this disease. This places this oncological disease in 2nd place for 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.

Routes of transmission

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

How human papillomavirus is transmitted:

• sexually (with any type of sex). Condoms reduce the possibility of its penetration into the body (the infection with the use of a condom was 37. 8, and without it - 89. 3%), but they do not completely prevent infection: the diameter of the pores in the latex is designed to prevent spermatozoa, while the size of the virus is too small;
• home way, when the virus penetrates through damaged skin. This happens in the pool, in the bathroom, when using shared towels, manicure tools, dishes;
• from mother to child, during childbirth: more often - with independent childbirth, but also with caesarean section, there is also a possibility that the virus will penetrate the membranes of the larynx;
• with saliva - with kisses;
• contact - when rubbing or cutting papillomas, warts or warts 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 by the time the virus enters, the likelihood 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 stroking;
• frequent (more than once in 3 years) change of sexual partners;
• genital infections, such as recurrent thrush, chlamydia, gonorrhea, ureaplasmosis;
• had an abortion;
• diseases of the cervix: erosion, ectropion;
• constant stress;
• bad habits: smoking, alcoholism;
• long-term use of contraceptive pills;
• violations of metabolic processes;
• avitaminosis.

The presence of genital warts in a pregnant woman is an indication for a caesarean section, in order to avoid infection of the baby's respiratory tract. Therefore, the baby is unlikely to "get" the microbe from the mother. Oncogenic types of the virus are not transmitted by domestic means because the virus-carrying formations are not found 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 (especially vaccination) shortly before the first sexual experience.

How does papillomavirus infection manifest itself?

Symptoms of human papillomavirus 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 a skin-colored stem 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, and on the mucous membranes of the mouth, nose or genitals. Most 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 the footbed. These are brownish mushroom-shaped formations. In the area of the palms and soles of the feet, they occur at the points of greatest friction and cause pain when pressed. Plantar warts can have a shaft that extends into healthy tissue. They can become inflamed and injured.
3. Genital warts. These are papillary growths that, merging with each other, resemble cauliflower. Condylomas form on the mucous membranes: on the genitals, in the perineum. If they arose due to anal sex, they occupy a localization around the anus. Condylomas can also be localized on the mucous membranes 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 the human papillomavirus - does not manifest itself clinically. This disease can be suspected during colposcopy; detected by cytological examination of a smear from the cervical canal.
5. Cervical cancerit does 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 in them, they may have an unpleasant smell), 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. Bowenoid papulosis. 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 ranging in color from pink or yellowish to red-brown or purple. The surface of these plaques can be smooth or warty; they are painful to 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 appears as 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 modifies 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 DNA male contains the Ras gene, if PUVA therapy was performed chemotherapy or the man is HIV-positive. Squamous cell carcinoma looks different. This could 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 localized on the head or foreskin.

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

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

Diagnostics

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

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, a Papanicolaou test (smears from the cervical canal and cervix), a biopsy of the cervix, a smear is taken for examination by the PCR method and the Digene test.
3. Urethroscopy and rectoscopy(for men). During the examination of the urethra or rectum, a biopsy of suspected precancerous or cancer changes is also performed, smears are also taken for examination by the PCR method and the Digene test.

Therefore, 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 from the cervical canal or urethra, or a Digene test, which is performed with material taken from a biopsy or skin scraping.

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. Training is removed by various methods. This can be surgical excision with a scalpel, burning with a laser or an electric current, which is more effective in the case of papillomas and warts. 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 one's 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: 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.

Human papillomavirus cancer treatment 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

Given the danger of human papillomavirus infection and its significant prevalence, 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 individual proteins contained in the capsule of the indicated virus strains, so they cannot cause disease. It is recommended to carry them out even before puberty - at 9-14 years old, that is, until the moment when the child is allegedly not yet familiar with the virus. So far, clear recommendations apply only to girls, since cervical cancer occurs only due to infection with this virus and is distinguished by an extremely high mortality rate. Boys are also vaccinated at the same age.

It would seem that no money can be found to save a child from such severe oncological diseases. In addition, in some countries of the world, as well as in 18 states of the United States, the introduction of one of the vaccines was 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 diseases and health. Deaths were also reported in 56 vaccinated adult women, but no association with the vaccinations was found;
• in response to the vaccine, some adolescents reacted with a rise in temperature in large numbers, which resulted in seizures, 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, so it is impossible to know whether the child is a carrier of this gene;
• Guillain-Barré syndrome was recorded after vaccination - a disease in which paralysis (often reversible) of the legs and arms occurs, muscle weakness and their complete "shutdown" can affect all muscles, including respiratory ones ;
• cases of increased risk of thromboembolism have been observed. This complication was noted in 56 people, of which 19 people had pulmonary embolism, as a result of which 4 people died;
• it is not known how vaccination affects fertility and pregnancy: too little time has passed since 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 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 of a gynecologist, are for her sake, we can expect any disease to be detected at an early stage.

It is therefore up to the parents to decide whether or not to vaccinate their child.