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, arms, neck and other parts of the body. Read more about the hidden manifestations of this virus and the methods of its treatment in the following article.
What is the human papilloma virus?
Human papillomavirus (HPV) is the common name for more than 70 different viruses that can cause diseases in various human organs: some of the HPV viruses cause skin diseases, others cause genital warts (genital warts), and other diseases of the Fondling. Each of the HPV group viruses has its own sequence number and differs from other viruses in its unique DNA composition.
At present, the role of certain types of human papillomavirus in the development of malignant tumors of various organs has been demonstrated: for example, cervical cancer, penile cancer, throat cancer, etc. The different types of human papillomaviruses are divided into groups, based on their ability to cause malignancies. Therefore, it is customary to distinguish between viruses with high, medium and low oncogenicity (oncogenicity is the ability of a virus to cause cancer). Viruses with high oncogenicity include HPV 16 and 18, tk. they are most often found in cervical cancer.
How HPV enters the body
The most common route of transmission of the human papillomavirus (HPV) is sexual contact, which is why this infection is classified within a group of sexually transmitted diseases (STDs). In addition, infection with the human papillomavirus (HPV) is possible through contact of damaged skin or mucous membranes with the secretions of a sick person (for example, underwear, towels, etc. ) Transmission is possible of the human papilloma virus from mother to child during childbirth.
Check
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 period for contracting the infection for both women and men begins immediately after they become sexually active. HPV is transmitted sexually, but penetrative sex is not required to transmit 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 them, 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 HPV-associated disease. Almost all cases of cervical cancer can be due to HPV infections.
Despite limited data on anogenital cancers other than cervical cancer, there is increasing evidence linking HPV to 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 using the same primary prevention strategies as for cervical cancer.
HPV types 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 while these conditions rarely lead to death, they can often lead to illness. Genital warts are widespread and highly infectious.
How HPV is transmitted and manifests itself
In modern medical science, more than 150 types of viruses have been identified. Depending on its type, it affects the work of all organs and systems of the human body. For example, infected people note various neoplasms 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 the carrier, including sexual intercourse without a condom. But it is also quite common to get infected by household means. Usually, after entering the body, the infection does not manifest itself in any way, so people do not even know that they are a carrier.
How does papilloma virus infection manifest itself?
The most common manifestations of human papillomavirus infection are:
- Pointy warts. The development of genital warts and papillomas is most often caused by low-risk oncogenic HPV. Warts are single and focal, usually occurring in places that are injured during sexual intercourse. The size of the elements is from 1 millimeter to several centimeters, they resemble a "cockscomb" or "cauliflower" in shape and are located on a narrow base (paw). Most of the time, women find warts to the touch during washing, which is felt as an irregularity. With a large number or size of genital warts, they can be injured 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, since their severity depends on the state of the body's defenses at that time. Viral papillomas do not differ in color from normal skin and can grow anywhere.
- Flat condyloma of the cervix. Genital wart is a manifestation of a long-term chronic viral infection that caused changes in the epithelial cells of the cervix. It can be combined with genital warts on the external genitalia. Changes in the cervix, characteristic of HPV, always alert the doctor, since women who have this virus for a long time are 65 times more likely to contract 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. It is necessary to have additional factors so that the cells can degenerate into malignant. Detecting high-risk virus types gives the patient an important advantage in fighting the disease; here the formula "forewarned is forewarned" is the most appropriate. Thus, the average age of women with the first signs of malignant transformation in the cervix is 30 years, and the average age of cervical cancer patients is 50 years.
HPV signs in women
In women, infection with the human papillomavirus can cause the appearance of genital warts, genital warts, which in many cases are found only during a gynecological examination.
They grow about three months after infection. Most often they are formed on the labia minora, in the vagina, on the cervix, the cervical canal, on the skin around the anus.
Outwardly, they are small formations that are located in a wide "leg" and have jagged edges. At the same time, the types of HPV that cause genital warts are not the types that cause cancer.
Symptoms of the disease in women also include cervical intraepithelial neoplasia - a precancerous condition of the uterine mucosa that provokes a violation of cell maturation. At the moment, doctors know about three stages of this disease, two of which are not particularly dangerous, and the third is the first stage of cervical cancer. Viruses types 16 and 18 cause similar symptoms. Also, cancer is caused by types 31, 33, 35 and 39.
HPV symptoms 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 carcinogenic types of the virus that cause the development of skin growths in a man rarely cause tumors in the stronger sex, then a woman, having contracted them from a man, risks developing cervical cancer.
the course of pregnancy
During pregnancy, visible warts often reappear, they tend to increase significantly, loosen, and large formations can cause difficulties during childbirth. There is evidence that primary HPV infection during pregnancy can lead to threatened termination, but whether such infection causes malformations in the fetus is a moot point.
The frequency of transmission of HPV from mother to fetus, according to different researchers, varies significantly - from 4 to 80%. It is not yet known exactly how the virus is transmitted. Most likely through the cervical canal and fetal membranes ascending or by contact as the infant passes through the mother's birth canal.
Recently, the development of papillomatosis of the larynx, trachea, and bronchi and anogenital warts in infants has been associated with HPV infection during childbirth. The disease is quite rare, in addition, cases of this disease in children born by cesarean section are described, so the presence of HPV and its manifestations in a pregnant woman is not an indication for cesarean section.
An indication for surgery can only be the presence of a giant condyloma, which makes it difficult to deliver through the natural birth canal. But such warts occur only in women with severe immunodeficiency, such as AIDS.
After childbirth, HPV detected during pregnancy is often 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 a young age;
- multiple sexual partners;
- tobacco use;
- immunosuppression (for example, HIV-infected people are at increased risk of HPV infection and are infected with a broader range of HPV types).
Diagnosis
The main method of diagnosing PVI is a routine clinical examination. To confirm this diagnosis, colposcopy (examination of the mucous membrane of the cervix and vagina with a special magnifying device) and cytological examination (for this, a scraping of the cervical canal and the surface of the cervix is taken) is used ).
Cytological examination does not reveal the virus itself, but changes in the epithelial cells of the cervix that are characteristic of this infection. A histological examination helps to clarify the cytological diagnosis: in this case, not a scraping of superficial cells is taken, as in cytology, but a piece of tissue, and not only the structure of the cells is studied, but also the correct arrangement from the same. their layers. During pregnancy, a biopsy is usually not done.
To determine the types of the virus and its oncogenic risk, the polymerase chain reaction (PCR) is used, which determines the DNA fragments of the pathogen. 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 diseases of the cervix.
HPV treatment
Since it is currently impossible to achieve a complete cure for human papillomavirus infection (along with this, spontaneous and 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 recurs a few 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 the adequacy of treatment for each pregnant patient is decided individually.
In this case, it is necessary to avoid factors that reduce immunity (hypothermia, severe emotional stress, chronic overwork, beriberi). There are studies that show the preventive effect of retinoids (beta-carotene and vitamin A), vitamin C and micronutrients such as folate in HPV infections.
The most used treatments for genital warts are:
destructive methods
Destructive methods are local treatments intended to eliminate genital warts. There are physical (freeze destruction, laser therapy, diathermocoagulation, electrosurgical excision) and chemical (trichloroacetic acid) destructive methods, as well as surgical removal of genital warts.
Destructive physical methods and preparations of trichloroacetic acid can be used in pregnant women. It is desirable that treatment with destructive methods be carried out only in the early stages of pregnancy, taking 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 impaired blood circulation, toxic complications), and the possibility of recurrence of genital warts after their removal.
Cytotoxic drugs
Cytotoxic drugs are STRICTLY CONTRAINDICATED during pregnancy. For women of childbearing potential, a reliable method of contraception or abstaining from sexual activity for the duration of treatment is recommended.
immunological methods
Interferons are most commonly used to treat HPV infection. They are a family of proteins that are produced by cells of the immune system in response to viral stimulation. Immunoglobulin preparations are used in conjunction with the topical application of medications. These drugs are actively used at the end of pregnancy. However, in 60% of cases, even long-term interferon therapy does not lead to clinical improvement and does not prevent fetal HPV infection.
Specific antiviral drugs
specific antiviral drugs. These drugs are not used in pregnant women with HPV infection, due to insufficiently studied effects on the fetus. By the way, the well-known antiviral drug has no effect on HPV.
Resume
- Itching can be caused by PVI, but to confirm this cause, all other possible contact-borne causes of itching must be excluded. This is not an STD, and the infection may not necessarily come from a sexual partner and not necessarily from sexual life at all. A condom, virginity, a regular sexual partner, abstinence, do not mean that you cannot get PVI.
- HPV is widespread, its detection in the body more of a pattern than a rarity.
- PVI is diagnosed "by eye", based on clinical manifestations, and not by PCR.
- If PVI is detected, a colposcopy is needed, if necessary - a biopsy and treatment. If you can give up the approval of the 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, since penile cancer is the same consequence of PVI as cervical cancer. The exam is also ocular, not PCR.
- The manifestations of PVI - OK or flat wart - and not the presence of the virus in the body are the subject of treatment.
- The first step of treatment is conservative. The basis of therapy is antiviral drugs, incl. - locally. Immunomodulators are an optional ancillary component of treatment.
- Itching can be caused by PVI, but all other possible causes of itching must be excluded 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 removal of OK.
- PVI can be transmitted during childbirth from mother to child, causing papillomatosis of the larynx. This is easily treatable. Condylomatosis is not an indication for a cesarean section.
The human papillomavirus (HPV) can be in a woman's body for years and not manifest itself in any way, while constantly endangering the risk of developing cancerous and precancerous diseases of her "mistress" from her.