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THE HUMAN PAPILLOMA VIRUS

the human papilloma virus

Many infections do not cause symptoms in healthy people. The immune system suppresses the activity of the virus, with the result that the person becomes a carrier of infection. In this case, transmission of the pathogen to other people happens even in case of complete clinical well-being, as the viral particles contained in the biological fluids of the patient. Latent period of infection may be the main reason for significant spread of the disease: patients in a timely manner do not pass the examination and continue to infect other people unknowingly.

The human papillomavirus (HPV) can be called a great example of a latent infectious agent. The majority of people infected at least one type of HPV throughout their life, but clinical manifestations of the disease arise not in all cases. To distant complications of the infection, the doctors will carry an increased risk of developing malignant tumors. In addition, in patients suffering from immunodeficiency, frequently there is a negative consequence of the disease. Topical medications help suppress the symptoms of HPV infection. It is also recommended to timely vaccination.

Read more about the disease

The human papillomavirus is a pathogen that infects the skin and mucous membranes of organs. The main manifestation of the disease is the growth of tumors on the face, genitals mouth and throat. In some cases, genital papillomas are formed in non-specific areas, like the skin of the lower and upper extremities. Localization of warts depends on the type of HPV. In most people the infection leads to carrier state of latent infection, however, reduced immunity, the virus begins to show its virulence. In some cases, immune cells destroy the pathogen independently in 3-6 months after its infestation in the body.

HPV infection is the most common sexually transmitted diseases. This figure can be explained by the high virulence of the virus and asymptomatic disease in most people. The use of condoms does not always prevent infection, so the patient can continue to spread the virus even when protected sexual contact. At the same time, experts have developed effective vaccines to prevent oncogenic forms of HPV. Immunization shown to the girls during adolescence as a defense against the virus is necessary to vaccinate before first sexual contact.

Features of the virus

The human papillomavirus is a DNA pathogen. Unlike bacteria and other microorganisms, viruses can be active only after the introduction into the cell and incorporate their own genetic information in the nucleus. Thereafter, the affected cell begins to synthesize proteins required for the Assembly of viral particles. Almost all members of the family of papillomaviruses attack only one species of organisms, and HPV infection can only occur in humans.

Scientists know more than 600 strains (types) of human papillomavirus, wherein genetic information. 40 types of HPV cause different forms of lesions of the mucous membranes and skin. An important clinical importance is the classification of the degree of oncogenetic strains. So, cancer of the cervix in women most often occurs during the invasion of HPV 16 and 18 types. These infectious agents do not always manifest themselves by skin changes.

HPV affects the basal layer of the epithelium. The pathogen can exist in the form episome not related to the cellular DNA, or an integrated form that is linked to the cell's genome. It is the integrated virus produces the necessary proteins and cause clinical manifestations of the disease. The activity of HPV in the body is not the direct cause of malignant transformation of tissues, but the carriers of the virus increase the risk factors of cancer risk.

Methods of infection

The virus is found in the basal cells of the epithelium, so any microtrauma of the skin and mucous membranes increase the risk of infection. In most cases, HPV is transmitted during vaginal, anal, or oral sexual contact. A condom can protect only a part of the skin surface, however, virus particles can still enter the body through other tissues. Genital warts predispose to transmission of the pathogen, but apparently intact skin of the carrier of the disease is also a source of HPV.

Other ways of transmission

  1. Infection of baby during childbirth. Children often have respiratory tract
  2. Independent transfer of the virus from one body part to another
  3. Shared use of personal hygiene items, including razors, toothbrushes and towels
  4. A blood transfusion. Recent studies have confirmed the possibility of transfusion of infection.
  5. Surgery in unsterile conditions

Despite the variety of causes of viral invasion, only sexual transmission of HPV has clinical significance. Other sources of infection are characterized by a low risk of spread of the pathogen.

Risk factors

In addition to direct modes of transmission of HPV, one must also consider the role of risk factors. We are talking about the features of a person's lifestyle and certain physical conditions.

Key risk factors for infection

  1. A large number of sexual partners. Even with safe sex active sex life sooner or later leads to infection.
  2. Age. Genital warts in most cases are seen in adolescents and young patients, while warts of the oral cavity and respiratory system characteristic of children.
  3. A weakened immune system. Patients suffering from HIV infection or acquired immunodeficiency are at high risk of virus invasion. Also, HPV often manifests itself symptomatically after organ transplantation.
  4. Damage to the skin and mucous membranes. Microtrauma facilitate the penetration of the virus into the basal layer of the epithelium.
  5. Smoking and alcoholism. Bad habits weaken the activity of the immune system.
  6. Genitourinary infection.

In addition, the risk of infection includes pregnant women. It should be remembered that the elimination of factors predisposing to disease is an effective prevention tactic.

the clinical picture of a papilloma

The clinical course

The incubation period preceding symptomatic manifestations of the disease can last for several months or not. Immunocompetent patients during this time, the body can eliminate the infection, however, spontaneous elimination of the pathogen does not always happen. A person can be simultaneously infected with multiple strains of the virus. Signs of HPV infection occur under the influence of unfavorable factors weaken the immune defense of tissues. Because of recurrent condyloma periodically disappear and form again. Cancer infection complications can develop over several decades.

The possible consequences of the disease:

  1. Carcinoma of the cervix – malignant neoplasm of epithelial tissue. This type of cancer only associated with human papillomavirus. With timely vaccination, the risk of oncogenesis is reduced.
  2. Squamous cell carcinoma of the anus. This complication can occur in men and women. Early symptoms of cancer of the anus include bleeding and itching.
  3. Violation of urination due to obstruction of the urethra the warts.
  4. Malignant transformation of warts in the throat and oral cavity.

Cervical cancer is one of the most common causes of death of women. Since this disease is associated with viral invasion, you need to pass regular examinations by a gynecologist. Modern vaccines protect women against the most carcinogenic types of HPV.

Diagnosis

A survey of warts engaged gynecologists, urologists, venereologists and dermatologists. During the initial appointment the doctor will ask the patient about complaints, collect anamnesis data and will examine the skin lesions. The manifestations of HPV identifitseerida easy, but it is necessary to exclude other diseases. To do this, you assign instrumental and laboratory tests.

The necessary methods of diagnostics:

  1. Instrumental examination of the vagina and cervix (colposcopy). Such a study is necessarily performed for screening of cervical carcinoma. During the examination the doctor can detect multiple papillomas, and areas of epithelial dysplasia.
  2. Biopsy obtaining tissue material in the area of skin or mucosal changes. Cytological examination of the sample allows to identify malignant cells.
  3. Polymerase chain reaction detection of viral particles of HPV in the body. Conducting this test gives the physician the ability to determine the strain of pathogen and viral load.
  4. Digene-test – highly accurate DNA detection of oncogenic strains of human papillomavirus. The study is used as a reliable screening.
In addition to these studies, the doctor will recommend the patient be tested for other infectious diseases, including HIV and syphilis.

Medication

Developed drugs against HPV infection allow only to eliminate symptoms and to prevent malignancy tissues. The complete elimination of the virus by drug therapy impossible. Oral and topical agents are appointed in the case of high risk of carcinogenesis, immune deficiency and other adverse conditions. If the virus does not manifest itself by external changes, rather General preventive measures.

A possible destination

  1. Salicylic acid for wart removal. Not used for skin treatment of face and genitals.
  2. Creams and ointments containing immunomodulatory agent.
  3. Podofilox – ointment that has a cytostatic effect. The application of medication to the affected skin leads to the destruction of pathogenic elements.
  4. Trichloroacetic acid for chemical cautery of common and genital warts. Can cause local expression of a section.

These drugs should only be used under medical supervision. After removal of warts, an HPV infection may occur again and even spread to other areas.

Surgical treatment

surgical treatment of papilloma

The doctor can offer the patient surgical and minimally invasive methods of wart removal. Typically, these methods do not cause complications, but in the first days after the intervention can occur tissue bleeding.

Interventions:

  1. conventional surgical excision;
  2. liquid nitrogen freezing and subsequent destruction of the affected tissues;
  3. electric coagulation;
  4. removal of papillomas with a laser.;
  5. the use of radiowave of a "knife".

All procedures are performed under local anesthesia. Specialist will choose the most safe method of treatment of genital warts.

Forecast

For human papillomavirus infection depends on the immune status of the patient and the particular strain of the virus. Approximately 30% of the population there are spontaneous elimination of the pathogen by the active immune system. Symptomatic disease is often seen in pregnant women, children, the elderly and immunocompromised patients.

To HPV infection is characterized by relapsing course. Formed papillomas may gradually disappear or spread to neighboring skin areas. Oncogenic strains of the virus most often striking the mucous membrane of the cervix, and occurs epithelial dysplasia increases the effect of risk factors of malignant transformation of tissues, like Smoking and use of oral contraceptives. The tumor may develop 10-20 years after the invasion of the virus into the body.

Prevention

The most reliable method of prevention is early immunization. The vaccine Gardasil that contains viral proteins and auxiliary components, effective against HPV 6, 11, 16 and 18. If administered at an early age of first sexual contact, the risk of subsequent development of cervical cancer in women less than 1%.

Additional prevention:

  1. the use of condoms;
  2. sex only with reliable partners;
  3. careful personal hygiene;
  4. gynecological examination at least once a year.