Human papillomavirus: symptoms, in women, men, treatment

Papillomavirus infection is now spreading all over the world. The virus, which causes warts and smaller papillomas on the skin, has been shown to cause genital cancer in women and men, as well as colorectal cancer. Vaccines designed to protect a person from the most dangerous strains of the virus can cause serious reactions.

Types of papillomavirus infection

Warts and cervical cancer are caused by two different types of the same virus (called strains). Just because a papillomavirus infection has been diagnosed does not mean that a person will develop papillomavirus cancer: it is possible if a strain from the oncogenic group enters the body. At the same time, infection with any of the strains increases the risk of another type of virus entering the body.

In total, about 600 strains of papillomatosis virus are isolated, differing from each other by the set and sequence of proteins located in the shell. Scientists divide them into 27 species and 5 genera.

The following types of human papillomavirus are distinguished depending on their ability to cause cancer:

1. Have a low oncogenic risk (their entry into the body is less likely to cause cancer). These are viruses 3, 11, 32, 34, 40-44, 6, 51, 61, 13. 72 and 73.
2. Have a moderate oncogenic risk. These are strains 35, 53, 30, 52, 45, 56, 58. They cause formations in the skin and mucous membranes, they are more likely to be malignant than in the first case.
3. High oncogenic strains. It is primarily 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 carrier. High oncogenicity includes strains 31, 33, 39, 50, 59, 64, 68, 70, 82.

Danger of papillomavirus infection

Papillomatosis virus is characterized by the fact that it is located either on the skin or in the mucous membranes of various organs: the 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. Thus, the most dangerous species 16 and 18, when injected, 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 respiratory papillomatosis in a child born naturally with genital warts.

A disease with severe symptoms does not always develop after infection. On the contrary, the disease is often overlooked and does not cause serious consequences.

The most dangerous complications of human papillomavirus infection:

• cervical cancer. Occurs in women as a result of infection with human papillomavirus type 16 or 18. It has been proven that this disease does not occur in the absence of papillomavirus. If earlier there was talk of the development of cervical carcinoma from erosion or ectropion, now it has been reworked and refuted;
• rectal carcinoma. Unlike the first disease, there may be other causes;
• throat cancer. It is also caused by a type 16 virus;
• Lung cancer that can occur when infected with 16, 18, 11, 2, 6, 30 virus types;
• respiratory failure, which develops with the growth of malignant papillomas in the respiratory tract (larynx, trachea);
• contact bleeding from warts. If they are in the vulva, perineum or vagina, then they are having sex. Bleeding with a different localization (nose, mouth) can cause mechanical damage to other objects.

According to official sources, slightly less than half a million (470, 000) new cases of cervical cancer caused by the virus are registered worldwide each year. Each year, 233, 000 women die from the disease. This puts this oncological disease in the second place in gynecology among all cancerous pathologies in terms of frequency (first place in breast cancer) and in the fifth place among all causes of death in women. Women under the age of 40 often die from cervical carcinoma.

Transmission paths

Papilloma virus is very common. According to modern data, it is found in 90% of the world's population.

How is human papillomavirus transmitted:

• sexual (with all kinds of sexual intercourse). Condoms reduce the chances of it entering the body (infection with a condom is 37, 8, without it 89, 3%), but do not completely prevent infection: the diameter of the pores in the latex is designed to prevent sperm, although the size of the virus is very small;
• In the household, when the virus penetrates through the damaged skin. This happens in the pool, in the bath, when using common towels, manicure tools, utensils;
• to the newborn, at birth: more often - by independent birth, but also by caesarean section, there is a possibility of the virus entering the laryngeal membranes;
• with saliva - with kisses;
• contact - when rubbing or cutting papillomas, warts or condylomas with damaged skin or mucous membranes. This is usually the case with self-infection.

If a person's immunity is strong at the time of entry of the virus, the disease is less likely to develop: it is likely that the microbe will remain inactive. If the risk of developing the disease increases:

• early (before the age of 16) onset of sexual activity or at least pampering;
• frequent (more than once every 3 years) change of sexual partners;
• genital infections, such as recurrent hepatitis, chlamydia, gonorrhea, ureaplasmosis;
• had an abortion;
• cervical diseases: erosion, ectropion;
• constant stress;
• bad habits: smoking, alcoholism;
• long-term use of contraceptive pills;
• disruption of metabolic processes;
• avitaminosis.

The presence of genital warts in a pregnant woman is an indication for caesarean section - to prevent infection of the baby's respiratory tract. Thus, the child is less likely to "get" the born germs. Oncogenic strains of the virus are not transmitted domestically because the virus-carrying formations are not located on the skin. Therefore, the first "acquaintance" with these microbes usually occurs during sexual intercourse, and this usually happens during adolescence. This justifies the need to take action (especially vaccination) immediately before the first sexual experience.

How does a papillomavirus infection manifest itself?

The symptoms of human papillomavirus depend on which strain enters the body and what clinical form it causes. So it can be:

1. Papilloma- single or multiple. These are mushroom-shaped protrusions on a leathery stalk or yellowish, brown or dark in color. They occur in the skin under the mammary glands, neck, armpits, face, as well as in the mucous membranes of the mouth, nose or genitals. Papillomas are more common in women. They are usually just a cosmetic defect and can cause discomfort or pain. Rarely, papillomas are malignant.
2. Warts, including plantar. These are brown mushroom-shaped compounds. Occurs in the palms and heels, where there is the most friction, and causes pain when pressed. Plantar warts can be a shaft extending to healthy tissue. They can become inflamed and damaged.
3. Genital warts. These are papillary protrusions that combine with each other to resemble cauliflower. Condyloma occurs in the mucous membranes: in the genitals, in the perineum. If they occur as a result of anal sex, they occupy a localization around the anus. Condylomata can also be located in the mucous membranes of internal organs: bladder, intestines. It causes symptoms such as painful urination or defecation and impaired physiological functions.
4. Precancerous disease of the cervix - dysplasia, caused by human papillomavirus - does not manifest itself clinically. This disease can be suspected during colposcopy; detected by cytological examination of a smear from the cervical canal.
5. Cervical cancernot immediately visible. There are no symptoms in the early stages. Women should be warned of itching in the genital area, changes in the nature of discharge from the genitals (there may be more, they may show streaks of blood, there may be an unpleasant odor), menstrual irregularities, bleeding. after sexual intercourse or in the middle of the period. In later stages, the disease is characterized by swelling of the legs (usually on one side), pain in the spine or back.
6. Bowenoid papulosis. This is the name of a pre-cancerous condition that develops more often in men. It is characterized by the appearance of a number of spots and plaques on the skin, ranging from pink or yellowish to reddish-brown or purple. The surface of such boards may be smooth or warty; it is painful to touch them.
7. Bowen's disease- It is a cancer of the skin and mucous membranes that develops from the cells of the surface layer. Looks like a bright red skin defect with uneven contours, covered with scales and warts.

In men, human papillomavirus causes a special disease - squamous cell carcinoma of the penis. The cause is a type 16 virus. The latter changes the cells of the male genitals under the influence of cigarette smoke, and the malignant character is acquired under the influence of herpes simplex virus type 2, if the male DNA contains the Ras gene, if there is PUVA therapy, chemotherapy. , or the man is sick with HIV. Squamous cell carcinoma looks different. This can be the appearance of a spot with warty growths above the skin, but it can also look like an ulcer that destroys the penis. The tumor is localized on the scalp or foreskin.

Rectal cancer caused by human papillomavirus is also more common in men. Occurs mainly in people of non-traditional orientation. Painful defecation is characterized by bleeding from the rectum or bowel.

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

Diagnostics

In the presence of external papillomas or warts, testing for papillomavirus is not necessary to diagnose. If you have other clinical forms of infection, you need:

1. Medical examination:for women - gynecologist, for men - urologist.
2. Colposcopy(for women) - examination of the cervix under a microscope. During the study, tests are performed with Lugol's solution, Papanicolaou test (smear from the cervical canal and cervix), cervical biopsy, PCR and Digene test.
3. Urethroscopy and rectoscopy(For men). Examination of the urethra or rectum also includes biopsy of pre-cancerous or suspected cancer changes, as well as swabs for examination by PCR and Digene test.

Thus, it is possible to perform tests for the virus only in the office of a gynecologist (for women) or urologist (for men). This is a Digene test performed on material from a cervical canal or urethral swab by PCR or a biopsy or excavation of epithelial cells.

Treatment

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

1. The form is removed in different ways. This can be a surgical incision with a laser or an electric scalpel, which is more effective in papillomas and condylomata. Cryodestruction method is successfully used for the treatment of warts - necrosis of pathological tissue with the help of liquid nitrogen with a very low temperature.
2. The appointment of immunomodulators, whose task is to activate their immunity, should no longer allow the virus to "raise its head" (drugs that will completely destroy the virus have not yet been developed).

In addition, it is important to prevent re-infection: stop having sex with an infected partner (optimally - treat him), exclude frequent changes of sexual partners, avoid visiting baths, saunas, swimming pools.

Treatment of human papillomavirus cancer depends on the stage at which the cancer is detected. It usually consists of three components: surgical removal of the tumor, chemotherapy and radiation therapy. The oncologist decides when the last 2 types of treatment should be applied - only after the operation, at the place of surgery or before and after both - and after the examination.

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

Prevention

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

All vaccines are certified and tested. They do not contain viruses, but they do contain individual proteins in the capsules of these strains of viruses, so they cannot cause disease. It is recommended to take them before puberty - at the age of 9-14, ie until the child is still unfamiliar with the virus. To date, clear recommendations apply only to girls, because cervical cancer occurs only as a result of infection with this virus and is characterized by an extremely high mortality rate. Boys are vaccinated at the same age.

It seems that you can't find the money to save your child from such serious oncological diseases. In addition, in some countries around the world, as well as in 18 US states, the use of one of the vaccines is included in the National Immunization Calendar. But there are many "buts":

• Studies show that vaccines reduce the risk of developing cervical cancer, but do not completely prevent it;
• According to official data, 8% of all side effects observed during vaccination (or 0. 003% of all vaccinated) are related to severe side effects: death, disability, life-threatening and health-threatening diseases. Deaths were also reported in 56 vaccinated adult women, but no association was found with the vaccines themselves;
• In response to vaccinations, some adolescents reacted to elevated temperatures, which led to convulsions, and some to fatal respiratory failure. It is thought that such a reaction can be observed in carriers of a particular gene. At the same time, the human genome is not studied before vaccination, so it is not possible to know if a child is a carrier of this gene;
• Guillain-Barré syndrome was reported after vaccination - a disease in which paralysis of the legs and arms (often recurrent), muscle weakness and their complete "closure" affect all muscles, including the respiratory muscles;
• Increased risk of thromboembolism has been reported. This complication was reported in 56 people, 19 of whom had pulmonary embolism, resulting in 4 deaths;
• It is not known how the vaccine affects fertility and pregnancy: very little time has passed since the first group of girls were vaccinated.

On the one hand, there is evidence that vaccinated women maintain a normal state of cervical cells (according to the Pap test) for at least 5 years. On the other hand, it is too early to talk about the long-term consequences of the vaccine. In any case, if a girl is taught from an "early age" that preventive examinations, including examinations by a gynecologist, are in her favor, one can expect any disease to be detected at an early stage.

Thus, it is up to the parents to decide whether to vaccinate their children.