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

Papillomavirus infection is what is now on the lips of the whole world. It turned out that the virus, which causes the appearance of warts and smaller formations on the skin (papillomas), can cause 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 themselves cause severe 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 papillomavirus infection has occurred does not mean that 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 of the strains increases the risk of penetration into the body of another type of virus.

In total, about 600 strains of the papillomatosis virus are isolated, differing from each other in the set and sequence of proteins located on their 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. Having 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. Having an average 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.
3. Strains of high oncogenicity. 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 provokes this disease in every tenth of its carriers. Highly oncogenic also include strains with numbers 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 either in the skin or in the mucous membrane of various organs: reproductive (both male and female), esophagus, bronchi, oral cavity, rectum. It can also be localized in the conjunctiva of the eyes.

Each strain of the virus has its own "favorite" localization. So, the most dangerous types 16 and 18, when hit, immediately "go" to the genitals, and low-oncogenic 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 in a child if he is born naturally from a mother with genital warts.

After infection, a disease with severe symptoms does not always develop. On the contrary, the disease most often goes 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 infection with the human papillomavirus types 16 or 18. It has been proven that this disease does not occur in the absence of papillomavirus. And if earlier they talked about the development of cervical carcinoma from erosion or ectropion, now this has been revised 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 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 in the vagina, then they are provoked 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, a little less than half a million (470 thousand) new cases of cervical cancer caused by this virus are registered in the world. 233, 000 women die every year from this disease. This puts 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 40 die from cervical carcinoma.

Transmission routes

The papilloma virus is extremely common. According to modern data, it can be found in 90% of the world's population.

How is the human papillomavirus transmitted:

• sexually (with any kind of sex). Condoms reduce the possibility of its penetration into the body (infection with the use of a condom was 37. 8, and without it - 89. 3%), but do not completely prevent infection: the diameter of the pores in the latex is designed to prevent spermatozoa, while the size of the virus is too small;
• household way, when the virus penetrates through damaged skin. This happens in the pool, bath, when using shared towels, manicure tools, dishes;
• from mother to child, during childbirth: more often - with independent childbirth, but also with caesarean section, the likelihood of the virus getting on the membranes of the larynx also exists;
• with saliva - with kisses;
• contact - when rubbing or cutting papillomas, warts or condylomas by the skin or mucous membrane, where the 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 likelihood that a disease will develop is small: most likely, the microbe will remain in an inactive state. The risk of developing the disease increases if:

• early (before 16 years) onset 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 contraceptive pills for;
• violations of metabolic processes;
• avitaminosis.

The presence of genital warts in a pregnant woman is an indication for a caesarean section - in order to avoid infection of the child's respiratory tract. Thus, the child is unlikely to "get" the microbe from the mother. Oncogenic types of the virus are not transmitted by household means because the virus-bearing formations are not located on the skin. Therefore, the first "acquaintance" with these microbes usually occurs during sexual intercourse, and this usually happens in adolescence. This justifies the need to take measures (in particular, vaccination) just before the first sexual experience.

How does papillomavirus infection manifest itself?

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

1. Papilloma- single or multiple. These are mushroom-shaped outgrowths on a skin-colored stalk or having 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. More often papillomas occur in women. Usually they are only a cosmetic defect, they can cause discomfort or pain. Rarely, papillomas become malignant.
2. warts, including plantar. These are brownish mushroom-shaped formations. In the area of the palms and soles, they occur in places of greatest friction and cause pain when pressed. Plantar warts may have a shaft extending into healthy tissue. They can become inflamed and hurt.
3. Genital warts. These are papillary outgrowths, which, merging with each other, resemble cauliflower. Condylomas are formed on the mucous membranes: on the genitals, in the perineum. If they arose as a result of anal sex, they occupy localization around the anus. Condylomas can also be located on the mucous membranes of internal organs: the bladder, intestines. This causes symptoms such as painful urination or defecation, a violation of physiological functions.
4. Precancerous disease of the cervix - dysplasia, caused by human papillomavirus - is not clinically manifested. This disease may be suspected during colposcopy; detected by cytological examination of a smear from the cervical canal.
5. 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 discharge from the genital tract (they may become more abundant, streaks of blood may appear in 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.
6. 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 plaques in color from pink or yellowish to red-brown or purple. The surface of such plaques may be smooth or warty; they are painful to touch.
7. Bowen's disease- This is a cancer of the skin and mucous membranes, developing from the cells of the surface layer. It looks like a bright red defect of the skin, having uneven 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 the herpes simplex virus type 2, if the male DNA contains the Ras gene, if PUVA therapy, chemotherapy was performed, or the man is sick with HIV. Squamous cell carcinoma looks different. This may be the appearance of a spot rising above the skin with warty growths on top, it may also look like an ulcer that destroys the penis. The tumor is localized 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 must take from 14 days to several years (depending on immunity and favorable factors) before the first symptoms appear.

Diagnostics

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

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

Thus, it is possible to take tests 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 with material taken from a biopsy or scraping of epithelial cells.

Treatment

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

1. The formation is removed by various methods. This can be surgical excision 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 - the necrosis of pathological tissue with the help of liquid nitrogen, which has a very low temperature.
2. The appointment of immunomodulators, the task of which is to activate one's own immunity, which should no longer allow the virus to "raise its head" (drugs that would destroy the virus completely have not yet been invented).

In addition, it is important to ensure the prevention of re-infection: 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 detected. It usually consists of three components: surgical removal of the neoplasm, chemotherapy, and radiation therapy. When to apply the last 2 types of treatment - only after surgery, instead of surgery or both before and after - the oncologist decides after the examination.

A vaccine that could cure human papillomavirus infection is under development.

Prevention

Given the danger of human papillomavirus infection and its significant prevalence, several vaccines have been synthesized against the human papillomavirus.

All vaccines are certified and have passed the relevant tests. They do not contain the viruses themselves, but individual proteins contained on the capsule of the indicated strains of viruses, therefore they cannot cause a disease. They are recommended to be performed even before puberty - at 9-14 years old, that is, until the time when the child is still supposedly not familiar with the virus. So far, clear recommendations apply only to girls, since cervical cancer occurs only as a result of infection with this virus, and it is distinguished by an extremely high mortality rate. Boys are also vaccinated at the same age.

It would seem that you can’t find any kind of money to save a child from such serious oncological diseases. Moreover, in some countries of the world, as well as in 18 US states, the introduction of one of the vaccines has been introduced into the National Immunization Schedules. 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 vaccinated) observed during vaccination were due to severe side effects: death, disability, diseases that threaten life and health. Deaths were also reported in 56 vaccinated adult women, but no association was found with the vaccinations themselves;
• in response to the vaccine, some teenagers reacted with a rise in temperature to high numbers, which provoked convulsions, some with respiratory failure, which is deadly. An opinion is expressed that such a reaction could be observed in carriers of a certain gene. At the same time, the study of the human genome is not carried out before vaccination, so it is impossible to know whether the child is a carrier of this gene;
• after vaccination, Guillain-Barré syndrome was registered - a disease in which paralysis occurs (often reversible) of the legs and arms, muscle weakness and their complete "shutdown" can affect all muscles, including respiratory ones;
• cases of increased risk of thromboembolism have been noted. This complication was noted in 56 people, of which 19 people had pulmonary embolism, due to which 4 people died;
• it is not known how vaccination affects fertility and pregnancy: too little time has passed since the vaccination of the first groups of girls.

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

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