Papilloma virus: signs, types and treatments | Diagnosis, treatment of papillomavirus in St. Petersburg

Human papillomavirus (HPV) is one of the most common viral agents on Earth.

According to medical statistics, from 80% to 90% of all people on the planet are carriers of HPV, many of whom are not even aware of the presence of papillomavirus in their own bodies. This is due to the fact that, penetrating into the patient’s blood, HPV can remain in a latent (inactive) state for a long time, slowly affecting the basal cells of the epidermis, without appearing visually in any way. We will try to consider the mechanisms of infection and symptoms of the disease, and also figure out how to cure the human papillomavirus quickly and effectively.

Why get tested for HPV

Cervical cancer is a disease with a proven viral etiology. Its causative agent is the human papillomavirus (HPV), an infection transmitted primarily through sexual contact. However, the more specialists accumulate knowledge about the nature of this disease, the more myths and misconceptions accumulate among the population. Today we’ll try to figure out what to believe and what not – and at the same time answer the most frequently asked questions about HPV.

Human papillomavirus - what is it?

First of all, it's a virus. Like all other viruses, it penetrates the cell, declares itself the local ruler and sets up a factory from the cell to produce its beloved self. These viral copies penetrate neighboring cells and take control of them in the same way.

Researchers have now identified more than 150 different types of HPV. Some of them cause small, harmless papillomas on the skin, and about 40 varieties prefer the tissue of the genital organs.

HPV is a highly contagious virus, easily jumping from person to person during any form of sexual contact, including petting. Due to its high contagiousness, almost every sexually active woman will be diagnosed with HPV at least once in her life.

What will happen to me if I am diagnosed with HPV?

Since HPV prefers to “settle” in the cells of stratified squamous epithelium, which is constantly renewed and exfoliated, in most cases no disease develops.

But if something goes wrong, HPV manages to integrate into the genome of the host cell and says: “I’m in the house.” From this moment on, the immune system ceases to recognize HPV, and the development of the disease begins. Which one depends on the specific type of HPV.

Some viruses are considered low-oncogenic and cause the development of genital warts (anogenital warts) in the genital area. These growths can appear on the skin and mucous membranes of the genital organs in men and women, around the anus, on the rectal mucosa or on the cervix in women. The most common low-oncogenic types are HPV-6 and HPV-11.

Genital warts can look very ugly, sometimes even scary, but they are easy to remove with the help of medications (not on your own! There may be such a chemical burn that it doesn’t seem like much) or surgical methods (cryotreatment, radio waves, laser or electrosurgery).

Highly oncogenic types of HPV (at least 14 different types) slowly but surely “enslave” all layers of the epithelium and penetrate deeper. This process does not manifest any symptoms at all, develops very slowly, but almost inevitably leads to the development of cancer of the cervix, anus and rectum, vagina, penis, mouth and throat. The most dangerous and “evil” types are HPV-16 and HPV-18.

How is HPV infection treated?

Whether you like it or not, attempts to treat HPV infection with all sorts of magical immunotropic drugs, extracts of potatoes, broccoli and some kind of flies are a waste of money.

You can find hundreds of domestic publications and studies telling how amazingly these medicines “work”. The problem is one thing - no one can claim that the virus is defeated by the pill, and not by the body’s own work. In women under 30 years of age, spontaneous clearance of HPV occurs in most cases.

If the virus has entered the integrative phase (into the “house”) and the development of an HPV-associated disease has begun, treatment can only be surgical. If these are genital warts, they must be excised; if this is a precancerous lesion of the cervix (CIN - cervical epithelial neoplasia) - the entire area of the lesion (the doctor sees this place through a colposcope) must be removed.

What can I do to prevent the disease?

The principles of protection are the same as for other infections transmitted primarily through sexual contact. However, even constant and correct use of condoms does not exclude infection (HPV is highly contagious), although it significantly reduces the risk.

The onset of the disease caused by HPV is possible within 8–10 years from the onset of sexual activity, but in order to identify the initial signs of the disease, it is necessary not only to go to the gynecologist, but to undergo cervical screening: a cytological smear from the cervix from the age of 21 (not less than once every 3 years) and analysis for HPV of high carcinogenic risk from the age of 30 (at least every 5 years)1.

Debate has been going on for many years about at what age it is advisable to start HPV testing. In our country, they decided to add an HPV test to cytological screening from the age of 30, and in some countries, including the USA2, from the age of 25. But experts are unanimous on one thing: in young patients, HPV is detected in 90% of cases and leaves the body as quickly and easily as it is colonized. Therefore, there is no need to start testing too early - there will be a lot of unnecessary movements, tears and pointless attempts at treatment.

Does correct diagnosis guarantee protection against cancer?

It is important to understand: screening is good, but not ideal. Of course, the opportunity to catch cervical cancer in its pre-stages is a magical chance given to humanity by Georgios Papanicolaou, but there are many different “buts”.

The analysis must be taken well, transported carefully, colored correctly, viewed correctly - and at each of these stages, errors can, unfortunately, occur. In any case, the task of screening is to “catch” an already started disease at the stage of early, still precancerous, changes in order to cure it as quickly as possible.

But there is a second strategy - vaccine prevention, the task of which is to prevent infection at all. And we’ll talk about the possibilities of preventing HPV-associated diseases through vaccination next time.

Oksana Bogdashevskaya

Photo istockphoto.com

1 Benign and precancerous diseases of the cervix from the perspective of cancer prevention. Clinical recommendations (treatment protocol). Letter from the Ministry of Health of the Russian Federation dated November 2, 2017.

2 Society of Gynecologic Oncology (SGO) and the American Society for Colposcopy and Cervical Pathology (ASCCP): Interim clinical guidance for primary hrHPV testing 2015

How is human papillomavirus transmitted?

When answering the pressing question of how one can become infected with the human papillomavirus, one should definitely mention three main mechanisms for the penetration of a viral agent into the body:

Contact route - by direct touching the epidermis of the carrier. The risk group includes massage therapists, cosmetologists, dermatologists, etc.;
Indirect (household) mechanism - involves the transmission of the papilloma virus through household items - a towel, comb, public transport handrails, etc.;
Sexual contact - unprotected sexual contact with an infected person - provides an almost 100% chance of the papillomavirus entering the body, while subtypes of the agent such as human papillomavirus type 31 in women can be transmitted even when using a condom.

Symptoms of human papillomavirus in men and women may not appear until certain conditions or conditions occur. Such factors are considered secondary causes of papillomavirus:

Decreased immune function;
Violation of the integrity of the skin - injuries, microcracks, scratches, wounds, etc.;
Stress and neuro-emotional fatigue;
Weakening of the body due to an inflammatory or infectious process;
Hormonal disorders;
Violations of personal hygiene rules.

The only sign of the papilloma virus can be considered the formation of specific skin tumors, which are mostly benign, but require mandatory medical monitoring. If at least one of the above factors is present, skin growths appear within 1-6 months after the patient’s initial infection. This is how long the incubation period of papillomavirus lasts.

Varieties

Doctors have developed several classifications of the virus that help navigate all its diversity.

To date, more than 100 strains are known, differing from each other in oncogenicity and a number of other indicators.

HPV classification makes the doctor's work easier.

First of all, viruses are divided into groups:

low risk, provoking pathological tissue degeneration in exceptional cases
medium risk, which can, under certain circumstances, lead to the development of oncological processes
high risk, differing ability to cause cancer in a significant number of cases

HPV 18 in men, along with strain 18, poses the greatest oncological danger, causing tumors in 85% of cases.

In addition to the risk of oncogenicity, it is customary to classify the disease based on the severity of symptoms.

There are:

latent form, characterized by the presence of the virus in the body, but the absence of symptoms of its manifestation
subclinical form, characterized by vague symptoms
clinical form with typical symptoms, characterized by the ability to greatly reduce the patient’s quality of life

Most often in medical practice, the latent form of the disease occurs.

Vivid clinical symptoms are in most cases a consequence of an exacerbation of the disease, provoked by external factors.

Why are different types of human papillomavirus dangerous?

In order to determine how to get rid of the human papillomavirus and whether it is worth carrying out therapeutic measures at all, let’s figure out why this viral agent can be dangerous and how serious the consequences can be. Often people do not pay due attention to skin growths such as papillomas and warts, considering them harmless defects. The only thing that can push a patient to visit a specialist is a noticeable (facial) localization of the tumor, which brings aesthetic problems. Meanwhile, some types of human papillomavirus are considered precancerous conditions and can transform into malignant tumors.

Modern medicine has about 120 types of papillomavirus, which determine the location, size and oncogenicity of the epidermal growth. Let's try to figure out which types can be considered just an aesthetic defect, and which require immediate treatment:

Papillomavirus types 1, 2, 4. The viral agent leads to the formation of plantar warts, which can grow over time and spread to healthy tissue, making it difficult for the patient to move;
Papillomavirus types 2, 4, 26, 27, 29, 57. It provokes the formation of ordinary or vulgar warts, which most often affect the skin of the hands.
Papillomavirus types 3, 10, 28, 49. It is the main cause of the appearance of flat warts, which most often affect children and adolescents, for which they received the second name - juvenile;
HPV type 7. Forms special papillomas on the hands of an infected person, which are called “butcher’s warts”;
Papillomavirus types 2, 3, 5, 8-10, 12, 14, 15, 17, 19, 20, 36, 37, 46, 47 and 50. A large group of viral agents that provoke veruciform epidermodysplasia, while being exclusively benign formations;
Human papillomavirus types 6 and 11, as well as types 42 and 54. A more dangerous group of HPV that forms genital warts on the genitals and mucous membranes. Such growths can undergo malignant degeneration;
Papillomavirus 16, 18 and most subspecies 30-67 types. This group of viral agents has a high level of oncogenicity, which manifests itself in the internal genital organs. Thus, papillomavirus type 33 in women, as well as papillomavirus type 18, provoke the formation of flat condylomas and cervical dysplasia, which can lead to cervical cancer;
Papillomavirus type 51, as well as types 45, 52, 54, 56, 66, 68. Human papillomavirus type 52 and other aggressive agents of this group can cause cancer of the cervix or vagina, as well as cause cancer of the external genitalia and anus.

It should be understood that these are not all subtypes of HPV known to science, but the varieties listed above can confidently be classified as the most common.

References

Cervical cancer. Clinical guidelines, 2022. - 44 p.
Rakhmatulina, M.R., Sokolovsky, E.V., Perlamutrov, Yu.N. and others. Federal clinical recommendations for the management of patients with anogenital (venereal) warts. Russian Society of Dermatovenereologists and Cosmetologists, 2015. - 27 p.
Folyak, E.V., Sokolova, T.M., Makarov, K.Yu. and others. Papilloma-viral infection of the urogenital tract of women (epidemiology, clinical and pathogenetic features, diagnostic methods, treatment, prevention): information and methodological manual. - Novosibirsk: Vector-Best, 2010. - 88 p.
Piana, A., Sotgiu, G., Cocuzza, C. et al. High HPV-51 prevalence in invasive cervical cancers: results of a pre-immunization survey in North Sardinia, Italy. PLoS One, 2013. - Vol. 8(5).

How to determine the human papillomavirus in women and the stronger sex?

Diagnostics is a mandatory step in visiting a doctor in the event of the formation of papillomas on the skin or mucous membranes. This is dictated by the risk of confusing papilloma with another skin problem. Being asymptomatic in most cases, the human papillomavirus in women is often detected only during a planned or other reason, gynecological examination.

Skin growths can be differentiated by simple examination, confirmed by microscopic analysis of epithelial scrapings. At the same time, the final diagnosis can be made only after PCR diagnostics are carried out, which makes it possible to establish the presence of papilloma virus in the patient’s blood. If a malignant course of genital papillomas is suspected, an additional test is often prescribed - a tissue biopsy.

Human papillomavirus - treatment

When answering the question of how to cure the papilloma virus, it should initially be understood that simply removing the skin tumor does not solve the problem once and for all, since the viral agent remains in the blood. Unfortunately, to date, medicine has not developed an effective method for completely cleansing the human body of the virus, but strengthening the immune system and rational hygienic care do not allow HPV to actively multiply and be accompanied by the formation of skin defects.

There are two main directions for removing papillomas of various locations:

Treatment of human papillomavirus with folk remedies;
Hardware removal of benign tumors.

Why is papillomavirus dangerous?

The potential threat in viruses of this type is primarily the risk of growth of tumors of the urinary tract and genitals.

Slightly less commonly, viruses are responsible for tumor growth in the oropharynx area.

The long-term existence of the virus in epithelial cells sooner or later changes their structure and ability to divide uncontrolledly.

Any episode of infection should be diagnosed, monitored and, if possible, treated.

Errors in immune defense can occur at any stage of life.

In addition to external provoking factors, they can be caused by natural hormonal fluctuations.

Therefore, today there is an urgent question about creating artificial protection against papillomaviruses by vaccinating high-risk groups or children.

Treatment of papillomavirus with folk remedies

Folk recipes suggest the use of fresh celandine juice, as well as solutions of iodine and vinegar as agents that burn out papillomas. Such methods are based on simply applying the product to the tumor and then rejecting it. It should be remembered that this practice has limited effectiveness and may lead to the formation of scars. A more gentle option is to regularly apply a garlic cut to the skin growth, which may not provide the desired result, but certainly will not harm the patient’s health.

The use of decoctions and infusions of herbs such as wormwood, dandelion, tricolor violet, etc., helps strengthen the immune system and provide natural resistance to HPV. Treatment of human papillomavirus at home can also be done using special pharmaceutical ointments, creams and patches.