HPV (human papillomavirus)

Human Papilloma Virus (HPV virus) are a group of common pathogens that can infect the skin and mucous membranes. Most often, the disease is diagnosed in patients aged 20 to 30 years and in children under 5 years old. According to statistics, about 22% of the world's residents are HPV carriers. Many patients are affected by multiple strains of the disease simultaneously.Currently, more than 190 genotypes of this pathogen are known. They differ in DNA structure, disease course, and potential complications. 30 pathogens can infect the epithelium of internal and external reproductive organs. Of note, many HPV strains have significant oncogenic activity. Therefore, the virus often causes life-threatening complications: malignant tumors of the vagina, vulva, anus, penis.

Causes of HPV

The only cause of infectionhuman papilloma virusis contact with the causative agent of disease. However, certain factors can significantly increase your chances of becoming infected. Exactly:

1. Refuse to use barrier contraception. Only male or female condoms and special latex wipes can prevent infection.
2. Change sexual partners frequently. If you don’t take your safety seriously enough, your risk of infection increases significantly.
3. Initiate sex early. Sexual relationships during adolescence often lead to HPV infection due to an irresponsible attitude toward preventing the spread of the pathogen.
4. Failure to observe hygiene rules. Insufficient self-care can lead to the growth of pathogenic microbiota on the skin and mucous membranes, which negatively affects susceptibility to viruses.
5. bad habits. The body's immune defenses are significantly affected by addiction: alcohol abuse, smoking, and the use of psychoactive substances.
6. decrease in immunity. The reasons for this can be vitamin and mineral deficiencies, pre-existing illnesses, and psycho-emotional overload.
7. Long-term medication. The effect of long-term use of hormone drugs is particularly obvious.
8. trauma. Mucosal and skin lesions become "gateways" to infection.
9. Chronic stress. They also affect the patient's immune system and hormonal background.
10. Gynecological intervention. Risk factors for HPV include spontaneous miscarriage or abortion.
11. Pregnant. Usually the disease first appears during pregnancy. Pregnancy increases stress on the body, which increases susceptibility to pathogenic flora.

Risks include certain conditions, such as uterine dysplasia. Regular preventive visits to your gynecologist and urologist can help significantly reduce your risk.

symptom

Only 5-10% of total pathogen carriers develop clinical manifestations of papillomavirus. The first symptoms may appear months or years after infection. However, in this state, a person poses a threat to others. It can infect other people through contact. Symptoms can be divided into subjective symptoms that indirectly indicate pathology and objective characteristics of HPV. Subjective symptoms include:

1. Papules. These are single or multiple structures that protrude from the skin or resemble spots. They appear on the skin and mucous membranes of the genitourinary area.
2. Itchy skin. Patients often complain of itching in the genital area or other areas of the skin.
3. feeling abnormal. This is a sensitivity disorder in the affected area. Often the opposite manifestation occurs - dyspareunia. In this case, any contact will cause pain.
4. Urinary dysfunction. Burning, itching, and pain when emptying the bladder. If the urethra is affected, urinating may be very difficult.
5. crack. Bleeding cracks appear in the skin and mucous membranes, causing severe pain.

These clinical manifestations may indicate various diseases of the genitourinary system. Objective symptoms of HPV aid in accurate diagnosis. These signs include:

1. Genital warts. This is a height above the surface of the skin that is characterized by an elongated, finger-like shape. Localized in the genital area. They differ by a specific pattern: variegated or ringed.
2. Papular warts. Occurs in the keratinized areas of the genitals. Can be flat or regular.
3. Stains. The nature of spots varies. Available in bright red, brown with red undertones, pink, and white with gray.
4. Bowen disease. These papules or spots are characterized by a shiny or soft surface. Color varies from red to almost black.
5. Giant genital warts. It was a small formation that gradually grew in size and merged into one.
6. Respiratory papillomatosis. In this case, these structures are localized to the mouth, respiratory tract, and lungs.

In addition, late-stage HPV infection in women can manifest as uterine cancer. In 2008, this particular virus was discovered to be the cause of malignant tumors. Cervical cancer does not occur as a separate disease. Pathological manifestations include severe bleeding, abdominal and waist pain, discomfort during intimacy, etc.

transmission route

Doctors and scientists still debate how contagious human papillomavirus is. Many experts believe that without the use of barrier contraception, there is a 70% chance that a single contact with an asymptomatic carrier is enough to transmit the pathogen to a healthy partner. Other doctors say the risk only makes sense if you are in contact with someone who is a papilloma carrier. Statistics show that the virus can spread to healthy people for up to 6 months if they are in frequent close contact.Infection can occur in a variety of ways. How papillomavirus is spread:

1. Sexually transmitted. The main route of infection is sexual contact. When condoms are used, the risk is reduced to 10%. However, pathogens can also penetrate during other intimate procedures, such as during kissing.
2. From mother to baby. Newborns can become infected with HPV from their mothers as they pass through the reproductive tract. Typical results of this condition are laryngeal papillomas and anogenital warts.
3. Contact details and family paths. The virus is also spread through ordinary household contact. Most often this happens in public areas. The risk of infection is particularly high in bathrooms, saunas, gyms and swimming pools. Public restroom.
4. Autoinfection. This is the transfer of viruses from affected areas to healthy areas, and occurs during shaving and hair removal.

onset

Key capabilities of HPV have significant effects on pathogenesis. This is the only virus that does not penetrate the blood and therefore does not cause an inflammatory process. The pathogenesis of human papillomavirus is simplified as follows:

1. Infect. The source of the viral agent can be another person or a commonly used object. Microtrauma (wounds, cuts, cracks, acne) on the skin and mucous membranes significantly increases the risk of transmission.
2. incubation period. Lesions caused by HPV invasion into the body are often latent. There is no exact length of the incubation period for this disease. This stage takes 1-3 months or reaches 2-3 years.
3. Chronic presence The disease continues to progress despite the absence of clinical manifestations. One person becomes a source of viruses for others.
4. Visual manifestations on the skin. The result of infection is the development of benign or malignant structures at the site of viral entry.

In the early stage, the pathogen invades the basal epithelial layer and is mainly distributed in the mucosa of the reproductive organs, oral cavity and conjunctiva. Viral agents are able to replicate only within the basal epidermis without penetrating into the bloodstream. Due to this characteristic, the body's immune system cannot fight the pathology to the maximum extent, but its effect is extremely limited.The main cause of tumor pathology in the context of HPV is the increased release of specific proteins that influence the process of cell division. First, proteins responsible for preventing tumor changes, controlling the life cycle, and preventing replication in the event of DNA damage are affected.

Classification

Because of the variety of strains, there are significant differences in HPV types. Many experts use multiple classifications of pathogens simultaneously. Therefore, based on clinical presentation, all HPV cases can be divided into asymptomatic and characteristic phenotypes. There is a subclinical course in which periods of exacerbation are documented. According to different locations, it can be divided into:

1. skin. This type of human papillomavirus forms on the skin of an infected person.
2. Anogenital. In this case, papillomas appear mainly in the mucous membranes of the reproductive organs and the anal area.

Often, the main cause of patient discomfort is the external symptoms of HPV. When evaluating pathogens, doctors focus more on the carcinogenicity of strains. Exactly:

1. HPV types that cannot cause malignancy. These include strains 1-5, 10, 28, and 49.
2. Types of pathogens with reduced carcinogenic activity. They can cause cancer, but in rare cases. Such strains include 6. 7, 32, 40-44, etc.
3. It is characterized by moderate carcinogenicity. The rate of degeneration of affected cells into cancer cells is quite high. This group includes strains 52-58, 30, 26, etc.
4. Dangerous forms of human papillomavirus. It is these strains that primarily trigger the formation of malignant tumors. This includes 16, 18, 64, 73, etc.

Diagnosis of human papillomavirus

Various diagnostic techniques help identify papillomas in men and women. Therefore, to diagnose latent patients, only molecular biology studies are effective. The most common and well-known method is PCR. Its purpose is to determine the genetic properties of material obtained from patients. PCR helps identify not only the fact of infection but also the specific strain of HPV. Subclinical and clinical forms can be diagnosed by:

1. Simple colposcopy. Papillomas, warts, and spots can also be discovered during routine visual examination. Colposcopy involves the use of a special binocular device to examine the vaginal opening. The examination may be accompanied by the collection of biological material for research.
2. Extended colposcopy. During the inspection, additional tests are used. Testing with 3% acetic acid is indicative, causing narrowing of unchanged blood vessels. Additionally, an epinephrine test and a Chrobak test may be recommended (if cancer is suspected).
3. Cytological examination. To perform a diagnostic procedure, you will need material from epithelial or skin cells. The sample is used to determine the DNA of the virus and rule out cancerous tumors. Typically, cytology detects only the most oncogenic virus types.

It is best to plan to collect female papillomavirus biomaterials during the first half of the menstrual cycle, but no earlier than day five. As a last resort, you can donate biological material later if your period is more than 5 days away. You should not douche your vagina before surgery. It is worth excluding sexual activity two days before collection. Similar rules apply to intravaginal ultrasound and colposcopy.When diagnosing HPV in men, material is collected from the urethra. It should have been at least two hours since you last urinated. It is important to avoid intimacy for 48 hours before the test. Otherwise, the study may show erroneous results.

complication

Pathologic complications include overgrowth of warts and papillomas. In rare cases, a purulent septic process occurs with damage to the formation. Typical consequences of infection with cancer-causing strains include:

1. Anal cancer. Eighty percent of detected cases of this malignancy are associated with HPV infection. In addition, negative factors that influence the development of anal cancer include anal sex, smoking, and genetic predisposition. The disease may not manifest itself for a long time. Typical symptoms of the disease are rectal bleeding, itching, and a foreign body sensation.
2. Vaginal cancer. Seventy percent of patients with this diagnosis have human papillomavirus. This condition usually occurs in women over the age of 40. Female representatives over the age of 70 are more likely to develop pathologies. In the first stage, symptoms may be confused with menstruation. Additionally, pain in the pelvic area, constipation, and vaginal tightness can occur.
3. Cancers of the Mouth and Pharynx. One-third of diagnoses are the result of HPV infection. The patient complained of pain when swallowing and eating food. In a calm state, there is a feeling of a foreign body in the throat. In later stages, general weakness, nausea, and decreased performance occur.
4. Penile cancer. Fifty percent of cases are caused by viruses. It is a rare malignant tumor involving neoplastic processes located in the male reproductive organs. This pathology is typical in men over 60 years of age.

HPV treatment

There is currently no effective treatment for HPV. Treatment strategies for papillomavirus can be developed in two ways:

1. Infection warning. Unfortunately, even regular use of birth control and good hygiene cannot protect a person from infection. Of course, this greatly reduces the chances. However, most cases of pathogen transmission occur in adolescence, at 15-16 years of age. By the age of 25, the first symptoms have appeared. In order to obtain obvious results, prevention must be carried out from an early age.
2. Treats diseases caused by the human papillomavirus. If the strain leads to malignant or benign formation, treatment will need to be directed at the established pathology. Papillomas are removed in a cosmetic or medical clinic. Cancerous tumors require complex multi-stage treatments depending on the stage.

Of course, there's good news. Therefore, people with a functioning immune system can cope with HPV on their own within two years. Patients infected during adolescence no longer have the virus by age 30. Unfortunately, those who recover do not gain lifelong immunity.

forecast

A large proportion of strains are of low or moderate carcinogenicity. Only certain types of viruses are associated with an increased risk of cancer. This statistic allows us to provide many patients with a positive prognosis regarding HPV. Early detection of malignant tumors significantly increases the chances of recovery. The discovery of a virus that causes cell damage has three potential consequences:

1. There is a virus, but it has not yet changed the structure of the cell. In this case, the patient will be classified into a risk group. If the carcinogenic type is found, regular monitoring by a gynecologist or urologist is required. Additionally, you should get tested regularly.
2. Changes in CIN-1 cells were detected early. In most cases, this condition also does not require medical intervention. Typically, follow-up exams are performed annually to ensure the pathology is not progressing.
3. Significant changes in CIN-1 were recorded. To rule out dangerous conditions, a biopsy is required. The study will determine whether the formation is neoplastic in nature.

prevention

You can prevent HPV infection by following important prevention rules. important:

1. Seek medical attention promptly. It is recommended that women visit their gynecologist 1-2 times a year. Men should follow a similar schedule to see their urologist. If you have risk factors (frequent changes of sexual partners, refusal of birth control), you should see your doctor more often.
2. Minimize visits to public places - swimming pools, saunas, bathrooms. If this is not possible, it is important to use your own towel, not to take someone else's razor, and not to sit naked on the surface.
3. Use birth control. Only barrier methods are effective. Using oral contraceptives does not affect the strain.
4. Say no to bad habits. Quitting smoking and drinking moderate amounts of alcohol can have modest effects on physical condition.
5. Increase the body's immune defense capabilities. Proper nutrition, regular physical activity, consistent daily routine, and exercise all have beneficial effects.
6. Avoid stress. Psycho-emotional overload can have a negative impact on the immune system, so it is best to exclude them.

It is important to test regularly. If there is a possibility of infection, it is best to get tested for HPV. There are also people at risk. so:

• Patients aged 21 to 30 need a PAP test (preferably with liquid cytology) at least every five years;
• People aged 30 to 65 years need to undergo an HPV Pap test every three years, with mandatory PCR for the cancer-causing form (16, 18).

HPV in pregnant women

Generally speaking, human papillomas in women do not pose any special risks to having children. Anogenital warts deserve special attention. They are located not only on the outer labia, but also on the vagina. In some cases, they are accompanied by bacterial components. Anogenital warts significantly increase the baby's risk of infection during delivery. This is filled with:

1. Recurrent juvenile laryngeal papillomatosis. Four strains of HPV cause similar conditions. Often the pathology is the result of anogenital warts or genital HPV.
2. The risk of cancer increases in adulthood. Infection with the virus at such a young age can significantly affect future susceptibility to cancer.

Let’s discuss laryngeal papillomatosis in more detail. At this time, it is not entirely clear when the spread of viral agents occurs. Infection can occur through the placental barrier or directly during birth. The first symptom of pathology is hoarseness. In difficult cases, the baby's voice completely disappears and breathing difficulties occur.The disease can progress rapidly. Soon after, the patient developed a cough and persistent shortness of breath. In cases of HPV infection, children may suffocate due to airway obstruction. Most commonly, this occurs when there are papillomas on the thin legs.In order to diagnose this disease, a special medical device called a laryngoscope is used. It can be replaced with a bronchoscope. These devices allow us to identify the main pathological sign - growths in the throat (genital warts). Surgery is often recommended for children. Genital warts are removed by destruction (freezing) or excision. However, the aggressive nature of the disease often leads to recurrence.Expectant mothers who are infected with highly carcinogenic HPV should inform their obstetrician at the antenatal clinic. In this case, the doctor will take all measures to ensure that the virus does not affect the child's health.