Human papillomavirus (HPV) affects epithelial cells and has a particle diameter of 55 nm. It is characterized by proliferation of the skin epitheliiam, as well as mucous membranes. At the initial stage, the pathogen usually affects the basal cells of the epitheliiam, entering them through microcrauma. Localized papillomas of the skin of the neck, armpits, groin and genitals (most often), the oral mucosa, and nasopharynx are common.
This virus can be asymptomatic for many years. To detect HPV, electronic or molecular microscopic hybrid methods are used.
Types of human papillomavirus virus
In humans, HPV is distinguished, which affects the mucous membranes and skin. Among the large number of papillomaviruses viruses, there are species with low and high oncogenic risk. Oncogenic properties have been proven to be associated with the ability to integrate DNA into the genome of human cells.
The virus is activated in 10-20% of cases. Depending on its type, this can lead to benign or malignant lesions. Some HPVs are not oncogenic. They lead to warts and genital warts. The most common are HPV 6 and 11.
HPV oncogenes are those at high risk of developing cancerous lesions, especially of the cervix or anus. For skin, HPV 16 and 18 are more common, as are HPV 5 and 8, which can lead to skin cancer. The most well-known type of HPV-induced cancer is cervical cancer. But men can also contract the papilloma virus, which in the worst cases causes cancer of the penis or anus.
Women are often exposed to HPV 16 - this is a form in which introsomal parasitism, that is, outside the (benign) cell chromosome, is observed. HPV 18 is characterized by a high risk of developing oncology - initially, benign tumors are formed, which eventually develop into cancer. Virions in this case are tiny (up to 30 nm).
Different types of HPV infections lead to:
- neoplasms of the cervix;
- invasive or pre-invasive oncology;
- genital warts of the urinary tract and genitals.
Ingestion of the pathogen into the body does not always lead to disease. It all depends on the predictable factors: increased sexual activity, vitamin deficiency, pregnancy, hypothermia, endometriosis, smoking, alcohol abuse, etc. It should be noted that viral infection can occur even in an organism that has a good immune system.
Aspects of infection
Human papillomavirus is highly contagious. It is usually transmitted through direct contact, skin to skin or mucous membrane to the mucous membrane, with an infected person. In genital infections, this often occurs during vaginal or oral sex. A large number of sexual partners or other TSIs (sexually transmitted infections) increase the risk. Indirect transmission can be done through contaminated objects, clothing or bedding, but it rarely occurs.
In 7% of cases, transmission of the virus from mother to child during childbirth is possible when the infection is active. The risk increases to 40% if you are infected with HPV 16 or 18.
Penetrated into the epitheliiam, violating integrity, papillomavirus infection promotes the growth of the lower layer of epithelial cells in the form of warts or warts. This form of the disease is contagious and spreads rapidly to others. Metastases are usually not caused by warts and condylomas and often disappear spontaneously.
HPV symptoms
The incubation period lasts up to 9 months (3 months on average). HPV can be present in the body without obvious symptoms. The virus can be identified that has not been identified for months or years. Even at this point, it is contagious.
Skin warts usually occur in clusters and increase with abrasion. The two most common forms of papilloma are gray, hard, raised with a broken surface (common wart) or flat and brown (flat wart). Spiky warts are found on the soles of the feet or heels, they grow inwards and so are often painful.
The causative agents of genital warts occur on moist and warm parts of the body, thus they are localized in the mucous membranes and membranes. They can cause symptoms like itching or burning. The incubation period, that is, the time between infection and the onset of symptoms, in genital warts is from 3 weeks to 8 months.
There are different types of genital warts caused by different pathogens:
- Genital warts. Pale or reddish nodules that often stand in clusters and occur on the labia, vagina, penis, urethra, anal canal, and rectum. They are highly contagious.
- Flat warts. They appear in the form of flat knots and are found mainly on the organs of the female genitalia. They increase the risk of developing cancer.
- Giant warts (Buschke-Levenshtein tumors). They grow in huge formations, destroying the surrounding tissues. In rare cases, they can degrade and lead to squamous cell carcinoma.
Infection of the mucous membranes in the upper respiratory tract is also possible. The conjunctiva of the eyes may be affected, leading to the growth of a pink stem. It is more difficult to detect an asymptomatic course, which the doctor can only see with the help of aids, such as acetic acid (which colors the warts) or a microscope.
In addition, the virus can reside in cells without any tissue changes. Then they talk about latent infection, that is, the presence of pathogens, but without symptoms. After infection, this stage can last from several weeks to several months.
Potential consequences
Once infected, viruses enter the intervening tissue cells of the skin and mucous membrane, settle in the nuclei of cell structures and then multiply. Such HPV infections are usually not noticed and heal on their own without consequences, since the immune system is able to fight off the pathogen.
However, some types of HPV cause changes in the skin, i. e. growth. Possible forms include genital warts or warts and papillomas, which may affect, for example, the face, arms or legs.
The tissue changes that are made are mostly benign, but they can degrade and lead to cancer. For example, cancer can occur many years after HPV infection. Cancer of the external female genital organs (cancer of the vulva and vagina), anal cancer, cancer of the penis, and cancer of the mouth and throat (tumors of the head and neck) are possible.
Establish a diagnosis
HPV infection is tested in women as part of preventative visits to the gynecologist. During a gynecological examination, a swab is taken from the lining of the cervix, this is called a Papanicolaou test (cytological examination). The resulting material is examined for tissue changes to determine precancerous conditions.
Alternatively, an HPV test can be performed, in which cell material from a mucosal swab or tissue sample is tested in a laboratory for certain viruses. However, this only allows infection of the affected area to be created, but no comment on whether the tissue changes have occurred. Therefore, HPV testing makes sense, especially when combined with Pap testing, and can help detect cancer precursors at an early stage.
If the test is positive, this is still not a cause for concern, because infection does not always lead to cancer. Regular examination of tissue changes at an early stage is recommended. Conversely, a negative test result does not allow us to confirm whether an infection in the past has been successfully fought by the body.
For men, there is no prophylactic examination in which the test is performed regularly. If there is a corresponding cancer, examination of the tumor can determine if there is an HPV infection at the base of the cancer.
Specialized DNA techniques are also used in laboratory diagnostics, such as real-time PCR. Anogenital warts caused by types 6 and 11 HPV are easily detected during pelvic examination.
How to cure the human papillomavirus virus
In most cases, the disease does not require treatment because it disappears on its own and then viruses are no longer detected. However, if this is not the case, the infection can last longer and last for months or years.
To date, there are no methods to systematically influence this virus, as it would be able to completely eradicate it. However, the resulting treatment of warts reduces the number of viruses, so in many cases the immune system can fight other viruses and thus get rid of them. In some cases, pathogens survive and can cause repeated symptoms.
Therapeutic measures depend on the type of HPV and the associated picture of the disease:
- Plantar warts and genitals can be treated with topical formulations of salicylic acid.
- Cryotherapy is also a method often used for HPV. In this case, the wart is burned with cold, using liquid nitrogen.
- Lasers or electrodes are equally applicable methods.
Since the frequency of relapse is quite high, it is recommended that you check yourself regularly and use condoms even several months after the lesions have disappeared, so that the sexual partner does not become infected.
For HPV cancers, treatment is much more difficult. In cervical cancer, it is often recommended to remove the uterus, respectively, the upper part of the vagina and ovaries. This can be supplemented with radiation therapy to rule out the likelihood of relapse occurring. Other cancers caused by HPV are often treated with targeted therapy, such as radiation or chemotherapy.
It should be remembered that the operation is not a cardinal solution, but only solves a cosmetic problem, since after its removal the virus is able to remain in the surrounding tissues and warts may reappear.
Prevention of infection
There are two vaccinations: bivalent HPV 16 and 18 and quadriplegic HPV 6, 11, 16 and 18. Vaccination is recommended for all young girls aged 14 and over.
Vaccination does not protect against all types of HPV. Therefore, all women between the ages of 25 and 65, even if vaccinated, are advised to have regular smear tests.
Timely detection and complete removal of genital warts reduces the risk of disease. The effectiveness of condom use in preventing the transmission of infection can significantly reduce the risk of developing this condition. The most promising method to prevent and treat the early stages of the disease caused by this infection is a specific multilingual vaccine.