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

Papillomavirus infection is what is now on the lips of the whole world. It turns out that the virus, which causes the appearance of warts and smaller formations on the skin (papillomas), can lead to the development of genital cancer in women and men, as well as carcinomas of the rectum and throat. Vaccines designed to protect a person from the most dangerous viruses can cause severe reactions.

Types of papillomavirus infection

Warts and cervical cancer are caused by two similar types of viruses (called strains). Determining just the fact that a papillomavirus infection has occurred does not mean 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 strain increases the risk of penetration into the body of other types of viruses.

In total, about 600 strains of the papillomatosis virus were isolated, differing from each other in the set and sequence of proteins located on 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 (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. Has an average oncogenic risk. These are strains 35, 53, 30, 52, 45, 56, 58. They cause formation on the skin and mucous membranes, the probability of malignancy being higher than in the first case.
3. High oncogenicity strains. This is, first of all, papillomavirus type 16, which causes cervical cancer in every second woman (41-54%), as well as type 18 virus, which causes the disease in every tenth of its carriers. Highly oncogenic also includes strains with numbers 31, 33, 39, 50, 59, 64, 68, 70, 82.

Dangers of papillomavirus infection

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

Each virus strain has its own "favorite" localization. So, the most dangerous types 16 and 18, when exposed, immediately "go" to the genitals, and low -oncogenic viruses 6 and 11 affect the vulva and perineum, causing the development of genital warts there. This same strain can cause papillomatosis in the respiratory tract in a child if he or she is born naturally from a mother who has genital warts.

After infection, diseases with severe symptoms do not always develop. On the other hand, the disease is most often 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 human papillomavirus infection type 16 or 18. It has been shown that the disease does not occur in the absence of papillomavirus. And if before they spoke of the development of cervical carcinoma from erosion or ectropion, now this has been reviewed and denied;
• rectal carcinoma. It, unlike the first disease, may 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 viruses;
• respiratory failure, which develops with the growth of malignant papillomas in the respiratory tract (larynx, trachea);
• tactile bleeding from warts. If they are in the vulva, perineum or in the vagina, then they are provoked by sex. With different localizations (in the nose, in the mouth), bleeding can be provoked by injuring them mechanically 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 registered in the world. 233, 000 women die each year from the disease. This places this oncological disease in 2nd place in frequency among all cancer pathologies in gynecology (first place in breast cancer) and in 5th place among all causes of death in women. Often, women under the age of 40 die from cervical carcinoma.

Delivery route

Papilloma viruses are very common. According to modern data, it can be found in 90% of the world's population.

How human papillomavirus is transmitted:

• sexually (with any kind of sex). Condoms reduce the likelihood of its penetration into the body (infection with condom use is 37. 8, and without it - 89. 3%), but do not completely prevent infection: the diameter of the pores in latex is designed to prevent spermatozoa, while the size of the virus is too small;
• way home, when the virus penetrates the damaged skin. This happens in swimming pools, showers, when using shared towels, manicure tools, crockery;
• from mother to child, during childbirth: more often - with free birth, but also with cesarean section, there is also the possibility of the virus getting on the laryngeal membrane;
• with saliva - with a kiss;
• contact - when rubbing or cutting a papilloma, wart or condyloma by the skin or mucous membranes, where its 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 chances of the disease developing is small: most likely, the microbes will remain inactive. The risk of getting the disease increases if:

• early (before 16 years) onset of sexual activity or at least caressing;
• frequent (more than once in 3 years) exchange of sexual partners;
• genital infections, such as recurrent thrush, chlamydia, gonorrhea, ureaplasmosis;
• has aborted;
• cervical disease: erosion, ectopion;
• 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 pregnant women is an indication for caesarean section - to prevent infection in the respiratory tract of children. Therefore, the child is unlikely to "get" the microbes from the mother. The oncogenic type of virus is not spread by home means because the formation of the virus carrier is not located on the skin. Therefore, the first "introduction" with these microbes usually occurs during sexual intercourse, and this usually occurs during adolescence. This justifies the need to take measures (in particular, vaccination) immediately before the first sexual experience.

How does a papillomavirus infection manifest itself?

The symptoms of human papillomavirus depend on the strain that enters the body and the clinical form it causes. So, it could be:

1. Papilloma- single or multiple. These are mushroom-shaped plants on bark-colored stalks or have a yellowish, brownish or blackish color. They are found on the skin under the mammary glands, in the neck, in the armpits, on the face, as well as on the mucous membranes of the mouth, nose, or genitals. More often papillomas occur in women. Usually they are just cosmetic blemishes, they can cause discomfort or pain. Rarely, papillomas become malignant.
2. Warts, including plantar. This is a brown mushroom -shaped formation. In the area of the palms and soles of the feet, it occurs in the most frictional places and causes pain when pressed. Plantar warts may have a stem that extends into healthy tissue. They can become inflamed and painful.
3. Genital warts. This is a papillary growth, which, joined to each other, resembles cauliflower. Condylomas form on the mucous membranes: on 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 located on the mucous membranes of internal organs: bladder, intestines. This causes symptoms such as pain in urination or defecation, violation of physiological functions.
4. Cervical precancerous disease - dysplasia, caused by human papillomavirus - not clinically manifested. The disease may be suspected during colposcopy; detected through smear cytological examination of the cervical canal.
5. Cervical cancerdoes not appear immediately. In the early stages, there are no symptoms. A woman should be informed of itching in the genital area, changes in the nature of the discharge from the genital tract (it may be more, blood lines may appear in it, they may have an unpleasant odor), irregular menstruation, bleeding. after sex or in the middle of a cycle. At a later stage, the 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 frequently in men. It is characterized by the appearance on the skin of a number of spots and plaques that differ in color from pink or yellowish to reddish-brown or purple. The surface of the plaque may be slippery or warty; they are painful to the touch.
7. Bowen's disease- This is a cancer of the skin and mucous membranes, growing from the cells of the surface layer. It looks like a bright red skin blemish with an uneven contour, covered with scales and warty tumors.

In men, human papillomavirus causes a special disease - squamous cell carcinoma of the penis. The cause is a virus type 16. 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 herpes simplex virus type 2, if male DNA contains Ras gene, if PUVA therapy, chemotherapy is performed. , or the man has HIV. Squamous cell carcinomas look different. This may be the appearance of spots that arise on the skin with warty tumors on top, it may also look like an ulcer that destroys the penis. The tumor is located in the head or foreskin.

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

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

Diagnostics

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

1. Health screening:for women - gynecologists, for men - urologists.
2. Colposcopy(for women) - examination of the cervix under a microscope. During the study, tests were performed with Lugol’s solution, Papanicolaou test (smears from the cervical and cervical canals), cervical biopsy, smears were taken for examination by PCR method and Digene test.
3. Urethroscopy and rectoscopy(for men). During examination of the urethra or rectum, biopsies of suspicious precancerous or cancerous changes are also performed, smears are also taken for examination by PCR method and Digene test.

Therefore, it is possible to take a test for the virus only in the office of a gynecologist (for women) or urologist (for men). This is a PCR study of a swab from the cervical or urethral canal, or a Digene test, performed with material taken from a biopsy or scraping of epithelial cells.

Treatment

How to treat human papillomavirus depends on the form of infection. So, if we talk about warts, papillomas or condylomas, treatment is carried out in 2 stages:

1. The formation is removed by various methods. This can be surgical isolation 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. Appointing an immunomodulator, its job is to activate its own immunity, which should no longer allow the virus to "raise its head" (a drug that will completely destroy the virus has not yet been invented).

In addition, it is important to ensure the prevention of re -infection: stop sexual intercourse with an infected partner (optimally - undergo treatment with him), exclude frequent changes of sexual partners, avoid visiting the 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: tumor removal surgery, chemotherapy, and radiation therapy. When to apply the last 2 types of treatment - only after surgery, not surgery or both before and after - the oncologist decides after the examination.

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

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 virus itself, but individual proteins contained in the capsules of the virus strain indicated, therefore they cannot cause disease. They are recommended to do even before puberty-at the age of 9-14 years, that is, until the time the child is still supposedly unfamiliar with the virus. So far, clear recommendations apply only to girls, because cervical cancer occurs only as a result of this viral infection, and it is distinguished by a very high mortality rate. Boys were also vaccinated at the same age.

It seems that you can’t find the money to save a child from a serious oncological disease. In addition, in several countries of the world, as well as in 18 U. S. states, the introduction of one of the vaccines has been introduced into the National Immunization Schedule. But there are many "buts":

• studies show that vaccines reduce, but do not completely prevent, the risk of getting cervical cancer;
• according to official data, 8% of all side effects (or 0. 003% of all vaccinated) observed during vaccination are due to severe side effects: death, disability, life -threatening illness and health. Deaths were also reported in 56 adult women who were vaccinated, but no association was found with the vaccine itself;
• In response to the vaccine, some teens respond with a rise in temperature to a high volume, which provokes seizures, some suffer respiratory failure, which is fatal. Opinions are expressed that such a response can be observed in certain gene carriers. At the same time, prior to vaccination, human genome studies were not conducted, so it was impossible to know whether the child was a carrier of this gene;
• after vaccination, Guillain -Barré syndrome has been registered - a disease in which paralysis occurs (often reversible) in the legs and arms, muscle weakness and its complete "closure" can affect all muscles, including the respiratory ones;
• cases of increased risk of thromboembolism have been observed. This complication was noted in 56 people, of whom 19 had pulmonary embolism, which resulted in 4 deaths;
• it is not known how vaccination affects fertility and pregnancy: too little time has passed since the vaccination of the first group of girls.

On the one hand, there is still evidence that vaccinated women maintain a normal state (according to Pap tests) of cervical cells for at least 5 years. On the other hand, it is still 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 checkups, including by gynecologists, are for her good, we can expect that any disease can be detected at an early stage.

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