HPV is often practically invisible in any way. The main symptom of human papillomavirus is, of course, warts, which can appear in the most unexpected places: on the genitals, palms, arms, neck and other parts of the body. Read more about the hidden manifestations of this virus and its treatment methods in the following article.
What is human papillomavirus?
Human papillomavirus (HPV) is the common name for more than 70 different viruses that can cause disease in various human organs: some HPV viruses cause skin diseases, others cause genital warts (genital warts) and other diseases of the genital organs. Each virus of the HPV group has its own sequence number and differs from other viruses in its unique DNA composition.
Currently, the role of several types of human papillomavirus in the development of malignant tumors of various organs has been proven: for example, cervical cancer, penile cancer, throat cancer, etc. Different types of human papillomavirus are divided into groups, depending on their ability to cause malignant neoplasms. So, it is customary to distinguish between viruses with high, medium and low oncogenicity (oncogenicity is the ability of a virus to cause cancer). Viruses with high oncogenicity include HPV 16 and 18, tk. they are more often found in cervical cancer.
How HPV enters the body
The most common way of transmission of the human papilloma virus (HPV) is sexual contact, so this infection is classified as a sexually transmitted disease (STD). In addition, human papillomavirus (HPV) infection is possible through contact of damaged skin or mucous membranes with the secretions of a sick person (for example, underwear, towels, etc. ). Transmission of human papillomavirus from mother to child during childbirth is possible. .
Review
Human papillomavirus (HPV) is the most common viral infection of the genital tract. Most sexually active women and men are infected at some point in their lives, and some may become infected again.
The peak period for getting the infection for both women and men begins immediately after they become sexually active. HPV is sexually transmitted, but penetrative sex is not necessary to transmit the virus. Skin-to-genital contact is an established route of transmission.
Many types of HPV do not cause problems. HPV infection usually clears up on its own without any intervention within a few months of acquiring it, and about 90% are cured within 2 years. A small number of infections with certain types of HPV can persist and develop into cancer.
Cervical cancer is by far the most common HPV-related disease. Almost all cases of cervical cancer can be caused by HPV infection.
Although data are limited on anogenital cancers other than cervical cancer, growing evidence links HPV to anal, vulva, vaginal and penile cancers. Although this cancer is less common than cervical cancer, its association with HPV makes it potentially preventable using the same primary prevention strategies as cervical cancer.
Non-cancer types of HPV (especially types 6 and 11) can cause genital warts and respiratory papillomatosis (a disease in which tumors grow in the airways that lead from the nose and mouth to the lungs). And although these conditions very rarely lead to death, they can often lead to illness. Genital warts are widespread and highly contagious.
How HPV is transmitted and manifested
In modern medical science, more than 150 types of viruses have been identified. Depending on the type, it affects the work of all organs and systems of the human body. For example, infected people see various neoplasms on the skin and mucous membranes in the form of genital warts and wart-like growths.
The main route of transmission is physical contact with the carrier, including sexual contact without a condom. But it is also quite common to be infected by household means. Usually, after entering the body, the infection does not show itself in any way, so people do not know that they are carriers.
How does papillomavirus infection manifest itself?
The most common manifestations of human papillomavirus infection are:
- Pointy warts. The development of genital warts and papillomas is more often caused by low oncogenic risk HPV. Condylomas are single and focal, usually occurring in places injured during sexual intercourse. The size of the elements is from 1 millimeter to several centimeters, they resemble the shape of a "cocktail" or "cauliflower" and are located on a narrow base (foot). Often, women find warts to the touch during washing, which are perceived as uneven. With a large number or size of genital warts, they can injure and bleed, interfere with normal sexual life and childbirth, and cause psychological discomfort. Itching rarely accompanies the manifestation of human papillomavirus infection.
- Papilloma (wart). Unlike papillomas that are tumors, viral papillomas appear, disappear and reappear, because their severity depends on the current state of the body's defenses. Viral papilloma does not differ in color from normal skin and can grow anywhere.
- Flat condyloma of the cervix. Flat condyloma is a manifestation of a long-standing chronic viral infection that causes changes in the cervical epithelial cells. It can be combined with genital warts on the external genitalia. Changes in the cervix, characteristic of HPV, always alert doctors, because women who have this virus for a long time are 65 times more likely to get cervical cancer than those who do not have it. However, the presence of a high-risk virus in the body does not mean that a woman will definitely get cancer. It needs to have additional factors so that cells can degenerate into malignancy. The fact of detecting a high-risk type of virus gives the patient an important head start in the fight against the disease; here the formula "informed is armed in front" is the most appropriate. Therefore, the average age of women with the first signs of malignant transformation in the cervix is 30 years, and the average age of patients with cervical cancer is 50 years.
Symptoms of HPV in women
In women, human papillomavirus infection can cause the appearance of genital warts - genital warts, which in many cases are only discovered during a gynecological examination.
They grow about three months after infection. Often it is formed on the labia minora, in the vagina, on the cervix, cervical canal, on the skin around the anus.
Externally, they are small formations that are located on wide "legs" and have uneven edges. At the same time, the type of HPV that causes genital warts is not the one that causes cancer.
Symptoms of the disease in women also include cervical intraepithelial neoplasia - a precancerous condition of the uterine mucosa, which causes a violation of cell maturation. Currently, doctors know three stages of this disease, two of which are not very dangerous, and the third is the first stage of cervical cancer. The same symptoms are caused by viruses of types 16 and 18. Also, cancer is provoked by types 31, 33, 35 and 39.
Symptoms of HPV in both women and men may include the presence of small tumors not only on the genitals, but also in other places - under the mammary glands, in the armpits, on the neck and on the eyelids.
For men, this disease is less dangerous than for women. And if some types of carcinogenic viruses that cause the development of tumors on the skin in a man rarely trigger tumors in the stronger sex, then a woman, after being infected from a man, faces the risk of developing cervical cancer.
Pregnancy journey
During pregnancy, visible warts often recur, tend to increase significantly, become loose, large formations can cause difficulties during childbirth. There is evidence that primary infection with HPV during pregnancy can lead to threatened termination, but whether such infection causes birth defects is debatable.
The frequency of transmission of HPV from mother to fetus, according to different researchers, varies significantly - from 4 to 80%. How the virus is transmitted is still not known exactly. Most likely through the cervical canal and the fetal membranes upwards or through contact when the child passes through the mother's birth canal.
Recently, the development of papillomatosis of the larynx, trachea and bronchus and anogenital warts in infants has been associated with HPV infection during childbirth. This disease is quite rare, in addition, cases of this disease in children born by caesarean section are described, so the presence of HPV and its manifestations in pregnant women is not an indication for caesarean section.
Indications for surgery can only be the presence of giant condyloma, which makes it difficult to give birth through the natural birth canal. But such condylomas only occur in women with severe immune deficiency, such as AIDS.
After delivery, HPV detected during pregnancy is most often not detected, and clinical manifestations in the form of massive growths are significantly reduced or disappear. It should be noted that HPV is first detected during pregnancy, as a rule, is not detected after delivery.
Cervical Cancer Risk Factors
- first sexual intercourse at an early age;
- multiple sexual partners;
- tobacco use;
- immunosuppression (for example, people infected with HIV face an increased risk of HPV infection and are infected with a wider variety of HPV types).
Diagnostics
The main method for diagnosing PVI is routine clinical examination. To confirm this diagnosis, colposcopy is used (examination of the mucous membrane of the cervix and vagina using a special magnifying device) and cytological examination (for this, scrapings are taken from the cervical canal and from the surface of the cervix).
Cytological examination does not reveal the virus itself, but changes in the cervical epithelial cells that are characteristic of this infection. Histological examination helps clarify the cytological diagnosis: in this case, not a scraping of surface cells is taken, as for cytology, but a piece of tissue, and not only the structure of the cells is studied, but also the correct arrangement of their layers. During pregnancy, biopsy is usually not performed.
To determine the type of virus and its oncogenic risk, the polymerase chain reaction (PCR) is used, which determines the DNA fragment of the pathogen. It allows you to accurately determine the presence of the HPV virus in the cervix. This is important for the prognosis of the development of cervical disease.
HPV treatment
Since it is currently impossible to achieve a complete cure for human papillomavirus infection (along with this, spontaneous and spontaneous recovery is often observed), HPV manifestations are treated, and not the presence of the virus in the body. At the same time, the effectiveness of various treatment methods is 50-70%, and in a quarter of cases the disease reappears a few months after the end of treatment.
Given the possibility of self-resolving genital warts, it is sometimes advisable not to carry out any treatment. The question of appropriateness of treatment for each pregnant patient is decided individually.
In this case, it is necessary to avoid factors that reduce immunity (hypothermia, severe emotional stress, chronic overwork, beriberi). There are studies showing the preventive effect of retinoids (beta-carotene and vitamin A), vitamin C, and micronutrients such as folate against HPV infection.
The most common treatments used for genital warts are:
Destruction Method
The extermination method is a local treatment aimed at getting rid of genital warts. There are physical (cryodestruction, laser therapy, diathermocoagulation, electrosurgical isolation) and chemical (trichloroacetic acid) destruction methods, as well as genital wart removal surgery.
In pregnant women, physical destruction methods and trichloroacetic acid preparations can be used. Treatment with destructive methods should be carried out only in the early stages of pregnancy, with caution. At the same time, it is necessary to take into account the risk of side effects that may occur during treatment (bleeding and secondary infections due to altered blood circulation, toxic complications), and the possibility of the reappearance of genital warts after their removal.
Cytotoxic drugs
Cytotoxic drugs are ABSOLUTELY CONTRAINDICATED during pregnancy. For women of childbearing age, reliable contraception or abstinence from sexual activity is recommended for the duration of treatment.
Immunological methods
Interferon is most commonly used to treat HPV infections. They are a family of proteins produced by cells of the immune system in response to viral stimuli. Immunoglobulin preparations are used together with the topical use of drugs. These drugs are actively used at the end of pregnancy. However, in 60% of cases, even long-term interferon therapy does not lead to clinical improvement and does not prevent fetal HPV infection.
Specific antiviral drugs
certain antiviral drugs. These drugs are not used in pregnant women with papillomavirus infection, because the effects on the fetus have not been studied. By the way, well-known antiviral drugs have no effect on HPV.
Summary
- Itching can be caused by PVI, but to confirm this cause, all other possible causes of itching transmitted by contact must be excluded. This is not an STD, and the infection may not necessarily come from a sexual partner and not necessarily from a sexual life at all. Condoms, virginity, regular sexual partners, abstinence - do not mean the impossibility of contracting PVI.
- HPV is widespread, its detection in the body is more of a pattern than an oddity.
- PVI is diagnosed "by eye", according to clinical manifestations, and not by PCR.
- If PVI is detected, colposcopy is required, if necessary, biopsy and treatment. If you can give up on the OK of the external genital organs and do not treat, then the cervix must be examined and treated without fail. PVI is the most common cause of cervical cancer.
- If HPV is detected, partner screening is necessary, because penile cancer is the same consequence of PVI as cervical cancer. Exams are also points, not PCR.
- Manifestations of PVI - OK or flat condyloma - and not the presence of the virus in the body are subject to treatment.
- The first step of treatment is conservative. The basis of therapy is antiviral drugs, incl. - local. Immunomodulators are additional components and treatment options.
- Itching can be caused by PVI, but all other possible causes of itching must be excluded to confirm this cause.
- PVI recurs with decreased immunity. This does not indicate ineffectiveness of previous treatment. No treatment can completely remove the virus from the body and does not guarantee complete removal of OK.
- PVI can be transmitted during childbirth from mother to child, causing laryngeal papillomatosis. This is easily treated. Condylomatosis is not an indication for cesarean section.
Human papillomavirus (HPV) can be in a woman's body for years and not manifest itself in any way, while always affecting the risk of developing cancer and precancerous diseases of its "mistress".