HPV very often practically does not manifest itself in any way. The main symptoms of the human papillomavirus are, of course, warts, which can appear in the most unexpected places: on the genitals, palms, hands, neck and other parts of the body. Read more about the hidden manifestations of this virus and its treatment methods in the following article.
What is human papillomavirus?
Human papillomavirus (HPV) is the collective name for more than 70 different viruses that can cause diseases in different human organs: some of the HPV viruses cause skin diseases, others cause genital warts (genital warts) and other diseases of the genital organs. Each of the HPV group viruses has its own serial number and differs from other viruses by its unique DNA composition.
Currently, the role of certain types of human papillomaviruses in the development of malignant tumors of various organs has been proven: for example, cervical cancer, penile cancer, throat cancer, etc. Different types of human papillomaviruses are divided into groups, depending on their ability to cause malignant neoplasms. Thus, it is common to distinguish viruses of high, medium and low oncogenicity (oncogenicity is the ability of a virus to cause cancer). Highly oncogenic viruses include HPV 16 and 18, tk. they are more often found in cervical cancer.
How HPV enters the body
The most common way to transmit human papillomavirus (HPV) is sexual contact, so this infection is classified as a sexually transmitted disease (STD). In addition, human papillomavirus (HPV) infection is possible through contact of damaged skin or mucous membranes with the secretions of a sick person (eg underwear, towels, etc. ). It is possible to transmit human papillomavirus from mother to child during childbirth.
Overview
Human papillomavirus (HPV) is the most common viral infection of the genital tract. Most sexually active women and men become infected at some point in their lives, and some may become infected again.
The peak of infection for both men and women begins immediately after they become sexually active. HPV is transmitted sexually, but penetrative sex is not necessary for transmission of the virus. Skin-to-genital contact is a well-established route of transmission.
Many types of HPV do not cause problems. HPV infections usually clear up on their own without any intervention within a few months of getting it, and about 90% clear up within 2 years. A small proportion of infections with certain types of HPV can persist and develop into cancer.
Cervical cancer is by far the most common disease associated with HPV. Almost all cases of cervical cancer can be caused by HPV infection.
Despite limited data on anogenital cancers other than cervical cancer, a growing body of evidence links HPV to cancer of the anus, vulva, vagina, and penis. Although these cancers are less common than cervical cancer, their association with HPV makes them potentially preventable using the same primary prevention strategies as for cervical cancer.
Types of HPV that do not cause cancer (especially types 6 and 11) can cause genital warts and respiratory papillomatosis (a disease in which tumors grow in the airways that lead from the nose and mouth to the lungs). And although these conditions very rarely lead to death, they can often lead to illness. Genital warts are widespread and highly contagious.
How HPV is transmitted and manifested
More than 150 types of viruses have been identified in modern medical science. Depending on the species, it affects the work of all organs and systems of the human body. For example, infected people notice various neoplasms on the skin and mucous membranes in the form of genital warts and warty growths.
The main route of transmission is physical contact with the carrier, including sexual intercourse without a condom. But it's also quite common to get infected at home. Usually, after entering the body, the infection does not manifest itself in any way, so people do not even know that they are carriers.
How is papillomavirus infection manifested?
The most common manifestations of human papillomavirus infection are:
- Pointed nipples. The development of genital warts and papillomas is more often caused by HPV of low oncogenic risk. Condylomas are single and focal, they most often appear in places that were injured during sexual intercourse. The size of the elements is from 1 millimeter to several centimeters, their shape resembles a "rooster" or "cauliflower" and they are located on a narrow base (leg). Most often, women find warts to the touch during washing, which is felt as a bump. With a large number or size of genital warts, they can injure and bleed, interfere with normal sexual life and childbirth, and cause psychological discomfort. Itching rarely accompanies the manifestations of human papillomavirus infection.
- Papillomas (warts). Unlike papillomas of a tumor nature, viral papillomas appear, disappear and reappear, because their severity depends on the current state of the body's defenses. Viral papillomas do not differ in color from normal skin and can grow anywhere.
- Flat condylomas of the cervix. Flat condylomas are a manifestation of a chronic, long-term viral infection that has caused changes in the epithelial cells of the cervix. It can be combined with genital warts on the external genitalia. Changes on the cervix, characteristic of HPV, always alarm the doctor, because women who have this virus for a long time are 65 times more likely to get cervical cancer than those who do not have it. However, the presence of a high-risk virus in the body does not mean that a woman will definitely get cancer. Additional factors are necessary for cells to degenerate into malignancy. The fact of detecting high-risk virus types gives the patient a significant head start in the fight against the disease; here the formula "warned is armed" is the most appropriate. Thus, the average age of women with the first signs of malignant transformation of the cervix is 30 years, and the average age of patients with cervical cancer is 50 years.
Signs of HPV in women
In women, human papillomavirus infection can cause the appearance of genital warts - genital warts, which in many cases are only found during a gynecological examination.
They grow about three months after infection. They are most often formed on the labia minora, in the vagina, on the cervix, cervical canal, on the skin around the anus.
On the outside, there are small formations that are located on a wide "leg" and have uneven edges. At the same time, the types of HPV that cause genital warts are not the ones that cause cancer.
Symptoms of the disease in women include cervical intraepithelial neoplasia - a precancerous condition of the uterine lining, which causes a violation of cell maturation. Doctors currently know three stages of this disease, two of which are not particularly dangerous, and the third is the first stage of cervical cancer. Similar symptoms are caused by viruses of type 16 and 18. Also, cancer provokes types 31, 33, 35 and 39.
Symptoms of HPV in both women and men can include the presence of small growths not only on the genitals, but also in other places - under the mammary glands, in the armpits, on the neck and on the eyelids.
For men, the disease is less dangerous than for women. And if some cancerous types of viruses that cause growths on the skin in men rarely cause tumors in the stronger sex, then a woman, after contracting them from a man, risks developing cervical cancer.
The course of pregnancy
During pregnancy, visible warts often recur, tend to increase significantly, loosen, large formations can cause difficulties during childbirth. There is evidence that primary infection with HPV during pregnancy can lead to threatened termination of pregnancy, but the question is whether such infection causes malformations in the fetus.
The frequency of transmission of HPV from mother to fetus, according to different researchers, varies quite a lot - from 4 to 80%. It is still not known exactly how the virus is transmitted. It is most likely through the cervical canal and fetal membranes by the ascending route or by contact when the child passes through the mother's birth canal.
Recently, the development of papillomatosis of the larynx, trachea and bronchi and anogenital warts in newborns has been associated with HPV infection during childbirth. The disease is quite rare, in addition, cases of this disease have been described in children born by caesarean section, so the presence of HPV and its manifestations in a pregnant woman is not an indication for caesarean section.
The indication for surgery can only be the presence of a huge condyloma, which makes it difficult to give birth through the natural birth canal. But such condylomas occur only in women with severe immunodeficiency, such as AIDS.
After childbirth, HPV detected during pregnancy is usually not detected, and clinical manifestations in the form of massive growths significantly decrease or disappear. It should be noted that HPV detected for the first time during pregnancy, as a rule, is not detected after childbirth.
Risk factors for cervical cancer
- first sexual intercourse at an early age;
- multiple sexual partners;
- tobacco use;
- immunosuppression (for example, people infected with HIV are at increased risk of HPV infection and are infected with a wider range of HPV types).
Diagnostics
The main method for diagnosing PVI is a routine clinical examination. To confirm this diagnosis, colposcopy (examination of the mucous membrane of the cervix and vagina using a special magnifying glass) and cytological examination (for this, scrapings are taken from the cervical canal and the surface of the cervix) are used.
Cytological examination does not reveal the virus itself, but changes in the epithelial cells of the cervix that are characteristic of this infection. Histological examination helps to clarify the cytological diagnosis: in this case, not a scraping of surface cells is taken, as in cytology, but a piece of tissue, and not only the structure of cells, but also the correct arrangement of cells is studied. their layers. During pregnancy, a biopsy is usually not done.
Polymerase chain reaction (PCR) is used to determine the types of viruses and their oncogenic risk, which determines DNA fragments of pathogens. It allows you to accurately determine the presence of the HPV virus in the cervix. This is important for the prognosis of the development of cervical disease.
HPV treatment
Since it is currently impossible to achieve a complete cure of infection with the human papillomavirus (in addition, spontaneous, spontaneous recovery is often observed), the manifestations of HPV are treated, and not the presence of the virus in the body. At the same time, the effectiveness of various treatment methods is 50-70%, and in a quarter of cases the disease reappears several months after the end of treatment.
Given the possibility of self-resolution of genital warts, it is sometimes advisable not to carry out any treatment. The question of suitability of treatment for each pregnant woman is decided individually.
In that case, it is necessary to avoid factors that reduce immunity (hypothermia, strong emotional stress, chronic overwork, beriberi). There are studies showing the preventive effect of retinoids (beta-carotene and vitamin A), vitamin C and micronutrients such as folate on HPV infections.
The most commonly used treatments for genital warts are:
Destructive methods
Destructive methods are local treatment aimed at removing genital warts. There are physical (cryodestruction, laser therapy, diathermocoagulation, electrosurgical excision) and chemical (trichloroacetic acid) destructive methods, as well as surgical removal of genital warts.
Physically destructive methods and preparations of trichloroacetic acid can be used in pregnant women. Treatment with destructive methods is preferably carried out only in the early stages of pregnancy, with special care. At the same time, it is necessary to take into account the risk of possible side effects during treatment (bleeding and secondary infection due to altered circulation, toxic complications), and the possibility of genital warts reappearing after their removal.
Cytotoxic drugs
Cytotoxic drugs are STRICTLY CONTRAINDICATED during pregnancy. For women of reproductive age, reliable contraception or abstinence from sexual activity during treatment is recommended.
Immunological methods
Interferons are most often used to treat HPV infection. They are a family of proteins produced by cells of the immune system in response to viral stimulation. Immunoglobulin preparations are used in combination with local administration of drugs. These drugs are actively used in late pregnancy. However, in 60% of cases, even long-term interferon therapy does not lead to clinical improvement and does not prevent HPV infection of the fetus.
Specific antiviral drugs
specific antiviral drugs. These drugs are not used in pregnant women with papillomavirus infection, due to insufficiently studied effects on the fetus. Otherwise, the well-known antiviral drug has no effect on HPV.
Summary
- Pruritus may be caused by PVI, but to confirm this cause, all other possible contact-borne causes of pruritus must be ruled out. This is not a sexually transmitted disease, and the infection does not necessarily have to come from a sexual partner and does not necessarily have to come from a sexual life at all. Condom, virginity, regular sexual partner, abstinence - do not mean the impossibility of PVI infection.
- HPV is widespread, its detection in the body is more of a pattern than an oddity.
- PVI is diagnosed "by eye", according to clinical manifestations, not PCR.
- If PVI is detected, colposcopy, if necessary, biopsy and treatment are required. If you can give up OK external genital organs and not treat, then the cervix must be examined and treated without fail. PVI is the most common cause of cervical cancer.
- If HPV is detected, an examination of the partner is necessary, because penile cancer is the same consequence of PVI as cervical cancer. The examination is also about, not PCR.
- Manifestations of PVI - OK or flat condylomas - and not the presence of the virus in the body are subject to treatment.
- The first step of treatment is conservative. The basis of therapy is antiviral drugs, incl. - local. Immunomodulators are an auxiliary and optional component of treatment.
- Itching may be caused by PVI, but all other possible causes of itching must be ruled out to confirm this cause.
- PVI recurs with decreased immunity. This does not indicate the ineffectiveness of the previous treatment. No treatment can completely remove the virus from the body and does not guarantee complete elimination of OK.
- PVI can be transmitted from mother to child during childbirth, causing papillomatosis of the larynx. This is easily treated. Condylomatosis is not an indication for caesarean section.
The human papilloma virus (HPV) can be in a woman's body for years and never manifest itself, while constantly endangering the risk of developing cancerous and precancerous diseases of its "mistress".