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

17 June 2022

Papilloma virus infection is what is now on everyone's lips. It turned out that the virus, which provokes the appearance of warts and smaller formations on the skin (papillomas), can provoke 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 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 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 any of the strains increases the risk of penetration into the body of another type of virus.

In total, about 600 strains of papillomatosis virus are isolated, which differ from each other by the set and sequence of proteins located on their coat. Scientists divide them into 27 species and 5 genera.

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

Have a low oncogenic risk (it is unlikely that its entry into the body will cause cancer). These are viruses with the numbers 3, 11, 32, 34, 40-44, 6, 51, 61, 13, 72 and 73.
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.
Highly oncogenic strains. This is, first of all, the type 16 papillomavirus, which causes cervical cancer in one out of two women (41-54%), as well as the type 18 virus, which causes this disease in one in ten women. their carriers. Highly oncogenic 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 settles on 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 "favorite" location. So, the most dangerous types 16 and 18, when hit, immediately "go" to the genitals, and low-oncogenesis 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 tract of a child if he 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 often goes unnoticed and does not have serious consequences.

The most dangerous complications of human papillomavirus infection are:

cervical cancer. It occurs in women as a result of infection with types 16 or 18 of the human papillomavirus. It has been proven that this disease does not occur in the absence of papillomavirus. And if before there was talk of the development of cervical carcinoma due to erosion or ectropion, now it has been revised and denied;
rectal carcinomaUnlike the first disease, it 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. If they are on the vulva, perineum, or vagina, then they are triggered 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, slightly 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 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 often, women under the age of 40 die from carcinoma of the cervix.

transmission routes

Papillomavirus 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 kind of sex). Condoms reduce the possibility of their 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 sperm, while the size of the virus is too small;
homemade way, when the virus penetrates through damaged skin. This happens in the pool, bathroom, when using shared towels, manicure tools, dishes;
from mother to child, during childbirth: more often, with independent delivery, but also with cesarean section, there is also a chance that the virus will enter the membranes of the larynx;
with saliva - with kisses;
contact - when rubbing or cutting papillomas, warts or condylomas through the skin or mucous membrane, where the integrity is broken. This is how autoinfection usually occurs.

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

early onset (before age 16) of sexual activity or at least petting;
frequent (more than once in 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;
violations 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. Therefore, the child 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 (particularly vaccination) just before the first sexual experience.

How does papillomavirus infection manifest itself?

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

Papilloma- single or multiple. These are fungus-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. Most often, papillomas occur in women. They are usually just a cosmetic defect, they can cause discomfort or pain. Rarely, papillomas become malignant.
wartsincluding plantar. These are mushroom-shaped formations of brown color. In the area of the palms of the hands and the soles of the feet, they appear in the places of greatest friction and cause pain when pressed. Plantar warts may have a shaft that extends into healthy tissue. They can become inflamed and sore.
Genital warts. These are papillary growths that, merging with each other, resemble cauliflower. Condylomas are formed on the mucous membranes: on the genitals, on the perineum. If they arose as a result of anal sex, they occupy a localization around the anus. Condylomas can also be located on the mucous membranes of internal organs - the bladder, intestines. This provokes symptoms such as pain during urination or defecation, a violation of physiological functions.
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.
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 the later stages, this disease is characterized by swelling of the legs (usually on one side), pain in the spine or lower back.
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 colored plaques ranging 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.
Bowen's disease- This is a cancer of the skin and mucous membranes, which develops 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 the malignant character is acquired under the influence of herpes simplex virus type 2, if the male DNA contains the gene Ras, if PUVA therapy, chemotherapy was performed. , or the man is sick with HIV. Squamous cell carcinoma looks different. This can be the appearance of a spot that rises 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 occurs mainly in people of non-traditional orientation. It is characterized by painful defecation, discharge 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.

Diagnosis

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

Medical exam:for women, a gynecologist, for men, a urologist.
colposcopy(for women) - examination of the cervix under a microscope. During the study, tests are carried out with Lugol's solution, a Pap smear (smear 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.
Urethroscopy and rectoscopy(for men). During the examination of the urethra or rectum, a biopsy of changes suspicious for precancer or cancer is also performed, smears are also taken for examination by the PCR method and the Digene test.

Therefore, 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 performed on material taken from a biopsy or scraping of epithelial cells.

Treatment

The way to treat the 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:

The formation is removed by various methods. This can be surgical excision with a scalpel, burning with a laser or with an electric current, which is more effective in the case of papillomas and condylomas. For the treatment of warts, the cryodestruction method is successfully used - necrosis of pathological tissue with the help of liquid nitrogen, which has a very low temperature.
The appointment of immunomodulators, whose task is to activate one's 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 found. 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 examination.

A vaccine is being developed that could cure human papillomavirus infection.

Prevention

Given the danger of human papillomavirus infection and its significant prevalence, several vaccines against human papillomavirus 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 cannot cause a disease. It is recommended that they be carried out even before puberty, between the ages of 9 and 14, that is, until the time when the child is supposedly not yet familiar with the virus. Until now, 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. Children are also vaccinated at the same age.

It would seem that you can not find money to save a child from such serious oncological diseases. In addition, in some countries of the world, as well as in 18 US states, the introduction of one of the vaccines in the National Immunization Calendars has been introduced. 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 vaccinees) observed during vaccination were due to serious side effects: death, disability, life-threatening diseases and health. Deaths were also reported in 56 vaccinated adult women, but no association was found with the vaccines themselves;
in response to the vaccine, some adolescents reacted with a rise in temperature to high numbers, leading to seizures, some with respiratory failure, which is fatal. The 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 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 respiratory;
Cases of increased risk of thromboembolism have been reported. This complication was observed in 56 people, of whom 19 people had pulmonary embolism, for which 4 people died;
it is not known how vaccination affects fertility and pregnancy: very little time has passed since the first groups of girls were vaccinated.

On the one hand, there is still evidence that vaccinated women maintain a normal state (according to the Pap smear) 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 the gynecologist, are for her good, we can hope that any disease can be detected at an early stage.

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