HPV doesn't usually show itself in any way. The main symptom of HPV 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 how to deal with it in the following article.
What is Human Papillomavirus
Human papillomavirus (HPV) is the generic name for more than 70 different viruses that can cause disease in a variety of organs in the body: some HPV viruses cause skin diseases, others cause genital warts (genital warts) and other genital disorders. Each virus of the HPV group has its own sequence number and differs from other viruses in its unique DNA composition.
At present, the role of certain types of human papillomaviruses in the development of malignant tumors in various organs has been confirmed: such as cervical cancer, penile cancer, and throat cancer. The different types of HPV are divided into groups based on their ability to cause malignancies. Therefore, it is customary to distinguish viruses with high, medium and low carcinogenicity (carcinogenicity is the ability of a virus to cause cancer). Viruses with high oncogenicity include HPV 16 and 18, tk. They are more common in cervical cancer.
How HPV Enters the Body
Human papillomavirus (HPV) is most commonly spread through sexual contact, so the infection is classified as a group of sexually transmitted diseases (STDs). In addition, damaged skin or mucous membranes may be infected with human papillomavirus (HPV) when they come into contact with patient secretions (such as underwear, towels, etc. ). Mother-to-child transmission of human papillomavirus is possible during childbirth.
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Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. Most sexually active women and men will become infected at some point in their lives, and some may become reinfected.
The peak period of infection acquisition for both women and men begins immediately after becoming sexually active. HPV is transmitted sexually, but penetrative sex is not required to transmit the virus. Skin-to-genital contact is a recognized route of transmission.
Many types of HPV do not cause problems. HPV infections usually clear up on their own within a few months of infection without any intervention, and about 90% clear up within 2 years. A small percentage of certain types of HPV infections 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 on anogenital cancers other than cervical cancer are limited, there is growing evidence that HPV is associated with cancers of the anus, vulva, vagina, and penis. Although these cancers are less common than cervical cancer, their association with HPV makes them potentially preventable with the same primary prevention strategies as cervical cancer.
HPV types that don't cause cancer (especially types 6 and 11) can cause genital warts and respiratory papillomatosis (a disease in which tumors grow in the airways from the nose and mouth to the lungs). Although these conditions rarely result in death, they often result in illness. Genital warts are widely distributed and highly contagious.
How HPV Spreads and Manifests
In modern medicine, more than 150 viruses have been identified. Depending on its type, it affects the work of all organs and systems of the body. For example, infected individuals notice various tumors 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 a carrier, including sexual intercourse without the use of a condom. But infection through the family route is also common. Usually, after entering the body, the infection does not manifest itself in any way, so people don't even know they are carriers.
How does papillomavirus infection manifest?
The most common manifestations of HPV infection are:
- acute warts. The development of genital warts and papillomas is usually caused by HPV with low cancer risk. Condyloma acuminatum is solitary and focal, and is prone to occur in the injured part during sexual intercourse. The size of the elements varies from 1 mm to a few centimeters, their shape resembles a "cockscomb" or "cauliflower", resting on narrow bases (legs). Most often, women feel the wart during washing and it feels uneven. Condyloma acuminatum is large in number, large in size, easy to be injured and bleeds, affects normal sex life and fertility, and causes psychological discomfort. Human papillomavirus infection is rarely accompanied by itching symptoms.
- Papillomas (warts). Unlike papillomas of a neoplastic nature, viral papillomas can appear, disappear and reappear, as their severity depends on the state of the body's defenses at the time. Viral papillomas are no different in color from normal skin and can grow anywhere.
- Cervical flat warts. Condyloma plana is a manifestation of a chronic, long-standing viral infection that causes changes in the epithelium of the cervix. Condyloma acuminata on the external genitalia can be combined. Changes in the cervix, the hallmark of HPV, always alert doctors because women chronically infected with the virus are 65 times more likely to develop cervical cancer than women who are not infected. However, the presence of high-risk viruses in the body does not mean that women will definitely get cancer. There must be additional factors for the cells to degenerate into malignant cells. The fact that a high-risk virus is detected gives patients an important head start in the fight against the disease; the formula "forewarned is forewarned" is most appropriate here. It can be seen that the average age of women with the first signs of cervical malignant transformation is 30 years old, and the average age of cervical cancer patients is 50 years old.
Signs of HPV in women
In women, HPV infection can lead to the appearance of genital warts - which in many cases are detected only during a gynecological examination.
They grow about three months after infection. Most often, they form on the labia minora, vagina, cervix, endocervical canal, and skin around the anus.
On the surface, they appear to be small structures with ragged edges sitting on broad "legs". Also, the types of HPV that cause genital warts do not cause cancer.
Symptoms of the disease in women also include cervical intraepithelial neoplasia - a precancerous lesion of the lining of the uterus that causes a disorder in cell maturation. Currently, doctors know of three stages of the disease, two of which are not particularly dangerous and the third is the first stage of cervical cancer. Similar symptoms are caused by types 16 and 18. Also, cancers are caused by types 31, 33, 35, and 39.
Symptoms of HPV infection in both women and men can include small growths not only on the genitals, but elsewhere—under the breasts, armpits, neck, and eyelids.
For men, the risk of the disease is lower than for women. If certain types of cancer-causing viruses that cause growths on men's skin rarely cause tumors during vigorous sex, then women who contract these viruses from men are at risk of developing cervical cancer.
pregnancy process
During pregnancy, visible warts often recur and tend to increase significantly, becoming loose, large formations that can cause labor difficulties. There is some evidence that primary infection with HPV during pregnancy poses a threat of pregnancy termination, but whether this infection causes fetal malformations is inconclusive.
According to different researchers, the frequency with which HPV is transmitted from mother to fetus varies widely - from 4% to 80%. It's unclear how the virus spreads. Most likely as the child passes through the mother's birth canal, either ascending or by touching through the endocervix and membranes.
More recently, the development of infantile larynx, tracheal, and bronchial papillomatosis and anogenital warts has been associated with HPV infection during childbirth. The disease is very rare and, moreover, cases of babies born by caesarean section have been described, so the presence of HPV and its manifestation in pregnant women is not an indication for caesarean delivery.
The indication for surgery can only be the presence of huge genital warts, which make delivery through the natural birth canal difficult. But this type of genital warts only occurs in women with severe immune deficiencies such as AIDS.
After delivery, HPV detected during pregnancy is usually undetectable, and the clinical manifestations of the massive growth form are significantly reduced or disappeared. It should be noted that usually HPV that is first detected during pregnancy will not be detected after delivery.
Risk Factors for Cervical Cancer
- early sexual intercourse for the first time;
- multiple sexual partners;
- tobacco use;
- Immunosuppression (for example, HIV-infected individuals are at increased risk of HPV infection and infection with a wider range of HPV types).
diagnosis
The main method of diagnosing PVI is routine clinical examination. To confirm this diagnosis, colposcopy (examination of the cervix and mucous membrane of the vagina with a special magnifying device) and cytology (for this, a scraping from the endocervical canal and surface of the cervix) are used.
Cytology does not reveal the virus itself, but changes in the cervical epithelium that are characteristic of this infection. Histological examination helps to clarify the cytological diagnosis: in this case, instead of scraping the superficial cells as in cytology, a piece of tissue is studied not only for the structure of the cells, but also for the correct arrangement of the cells in their layers. During pregnancy, a biopsy is usually not done.
To determine the type of virus and its cancer risk, using the polymerase chain reaction (PCR), the DNA fragment of the pathogen is determined. It allows you to accurately determine whether the HPV virus is present on the cervix. This is important for the prognosis of cervical disease development.
HPV treatment
Since it is currently not possible to completely cure HPV infection (while spontaneous, spontaneous recovery is often observed), it is the manifestations of HPV that are treated, not the presence of the virus in the body. Meanwhile, the effectiveness of various treatments is 50-70%, and in a quarter of cases the disease reappears a few months after the treatment ends.
Given the potential for genital warts to resolve on their own, it is sometimes advised against any treatment. The question of whether treatment is appropriate for each pregnant patient is determined individually.
In this case, it is necessary to avoid factors that reduce immunity (hypothermia, severe emotional stress, chronic overexertion, beriberi). Micronutrients such as retinoids (beta-carotene and vitamin A), vitamin C, and folic acid have been shown to be protective against HPV infection.
The most common treatments for genital warts are:
destructive method
Destructive methods are topical treatments aimed at removing genital warts. There are physical (cryodestructive, laser therapy, diathermy coagulation, electrosurgical excision) and chemical (trichloroacetic acid) methods of destruction, as well as surgical excision of genital warts.
In pregnant women, physical disruption methods and preparations of trichloroacetic acid can be used. Destructive methods of treatment are best performed only in the early stages of pregnancy and with special care. At the same time, it is necessary to take into account the risk of side effects that may occur during treatment (secondary infection caused by bleeding and changes in blood circulation, toxic complications), and the possibility of reappearance of genital warts after removal.
cytotoxic drugs
Cytotoxic drugs are strictly contraindicated during pregnancy. For women of childbearing age, it is recommended to use reliable contraception or avoid sexual activity during treatment.
immunological method
Interferon is most commonly used to treat HPV infection. They are a family of proteins produced by immune system cells in response to viral stimuli. Immunoglobulin preparations are used in conjunction with topical application of the drug. These drugs are actively used in the third trimester of pregnancy. However, even long-term interferon therapy does not lead to clinical improvement and does not prevent fetal HPV infection in 60% of cases.
specific antiviral drugs
Specific antiviral drugs. These drugs are not used in pregnant women with papillomavirus infection because of insufficient research on the effects on the fetus. By the way, well-known antiviral drugs have no effect on HPV.
summarize
- Pruritus may be caused by PVI, but to confirm this cause all other possible contact-transmissible causes of itching must be ruled out. This is not an STD and the infection doesn't have to come from a sexual partner or have sex. Condoms, virginity, regular sex partners, abstinence—doesn't mean getting PVI is impossible.
- HPV is so common that its detection in the body is more of a pattern than a weird phenomenon.
- PVI is diagnosed "by the eye" clinically, not by PCR.
- If PVI is detected, a colposcopy, biopsy and treatment is required if necessary. If the external genitalia is OK and no treatment can be given up, then the cervix must be checked and treated without failure. PVI is the most common cause of cervical cancer.
- If HPV is detected, it is necessary to test the partner, as cancer of the penis is a consequence of PVI, as is cancer of the cervix. The inspection is also eye, not PCR.
- Manifestations of PVI - OK or flat warts - rather than the presence of the virus in the body require treatment.
- The first step in treatment is conservative treatment. The basis of treatment is antiviral drugs, incl. - local. Immunomodulators are adjunct and optional components of therapy.
- Pruritus can be caused by PVI, but all other possible causes of pruritus must be ruled out to confirm this cause.
- PVI recurs as immunity declines. This does not mean that previous treatments have not worked. No treatment can completely clear the virus from the body, and there is no guarantee that it will be OK.
- PVI can be passed from mother to child during childbirth, causing laryngeal papillomatosis. It's easy to treat. Condyloma acuminatum is not an indication for caesarean section.
Human papillomavirus (HPV) can exist in a woman for years without expressing itself in any way, while constantly endangering her "mistress"'s risk of cancer and pre-cancer.