What is human papillomavirus and how to treat it

HPV vaccine

Human papillomavirus (HPV) affects epithelial cells and has a particle diameter of 55 nm. A feature is the proliferation of skin epithelium, as well as mucous membranes. At the initial stage, the pathogen usually affects the basal cells of the epithelium, entering them through microtrauma. Localized papillomas usually occur on the skin of the neck, armpits, groin and genitals (most often), oral mucosa, and nasopharynx.

This virus can be asymptomatic for many years. To detect HPV, electron microscopy or molecular hybridization methods are used.

Types of human papillomavirus

In humans, HPV is distinguished, which affects the mucous membranes and skin. Among the large number of papillomaviruses, there are species with low and high oncogenic risk. Oncogenic properties have been shown to be associated with the ability to integrate DNA into the genome of human cells.

The virus is activated in 10 to 20% of cases. Depending on its type, it can lead to benign or malignant lesions. Some HPVs are not oncogenic. They lead to the appearance of warts and genital warts. The most common are HPV 6 and 11.

HPV oncogenes are those that have a high risk of developing cancerous lesions, especially on the cervix or anus. In the skin, HPV 16 and 18 are more common, as well as HPV 5 and 8, which can lead to skin cancer. The most well-known form of cancer induced by HPV is cervical cancer. But men can also contract the papilloma virus, which in the worst case causes penile or anal cancer.

Women are often confronted with HPV 16 - this is a form in which introsomal parasitism is observed, that is, outside the (benign) cell chromosome. HPV 18 is characterized by a high risk of developing oncology - first of all, benign tumors are formed, which after some time degenerate into cancer. The virions in this case are tiny (up to 30 nm).

Various types of HPV infections cause:

  • 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 predisposing factors: increased sexual activity, vitamin deficiency, pregnancy, hypothermia, endometriosis, smoking, alcohol abuse, etc. It should be noted that a viral infection can occur even in an organism with a good immune system.

Characteristics of infection

how you can get HPV

The human papillomavirus is very contagious. It is usually spread by direct skin-to-skin or mucous-to-mucous membrane contact with an infected person. In genital infections, this most often occurs during vaginal or oral sex. A large number of sexual partners or other STIs (sexually transmitted infections) increase the risk. Indirect transmission through contaminated objects, clothing or bedding is also possible, but rarely occurs.

In 7% of cases, mother-to-child transmission of the virus can occur during childbirth when the infection is active. Your risk increases to 40% if you are infected with HPV 16 or 18.

human papillomavirus in the body

Penetrating into the epithelium, violating the 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 quickly spreads to others. Usually warts and warts do not metastasize and often go away on their own.

Symptoms of HPV

The incubation period lasts up to 9 months (on average 3 months). HPV can be present in the body without obvious symptoms. The virus can go unnoticed for months or years. Even at this stage, it is contagious.

Skin warts usually occur in clusters and increase with scratching. The two most common forms of papilloma are either grayish, hard, raised with a broken surface (common wart) or flat and reddish (flat wart). Prickly warts are found on the soles of the feet or on the heels, grow inward and are therefore often painful.

The causative agents of genital warts occur on wet and warm parts of the body, so they are localized in the folds and on the mucous membranes. They can cause symptoms such as itching or burning. The incubation period, that is, the time between infection and the onset of symptoms, in genital warts ranges from 3 weeks to 8 months.

There are several forms of genital warts caused by different pathogens:

  • Genital warts. Pale or reddish nodules that often appear in clusters and occur on the lips, vagina, penis, urethra, anal canal, and rectum. They are very contagious.
  • Flat warts. They come in the form of flat knots and are mostly found on the female genitals. They increase the risk of developing cancer.
  • Giant warts (Buschke-Levenshtein tumors). They form huge formations, destroying surrounding tissue. In rare cases, they can degenerate and lead to squamous cell carcinoma.
pills for the treatment of HPV

An infection of the mucous membranes of the upper respiratory tract is also possible. The conjunctiva of the eyes may be affected, resulting in the growth of pink stems. 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 causes discoloration of warts) or a microscope.

In addition, the virus can also settle in cells without any changes to the tissues. Then they talk about a latent infection, that is, the presence of pathogens, but without symptoms. After infection, this phase can last from several weeks to several months.

Possible consequences

When infected, viruses enter the cells of the integumentary tissue of the skin and mucous membranes, settle in the nuclei of cellular structures and multiply there. Usually, these HPV infections go unnoticed and heal on their own without consequences, as the immune system successfully fights the pathogen.

However, some types of HPV create changes in the skin, that is, growths. Possible forms include genital warts or warts and papillomas, which can affect, for example, the face, arms or legs.

The tissue changes caused are mostly benign, but can also escalate and lead to cancer. For example, cancer can develop decades after infection with HPV. Cancer of the female external genitalia (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 also possible.

Establish the diagnosis

HPV diagnosis by a doctor

A test for HPV infection is performed in women as part of preventive visits to the gynecologist. During a pelvic 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 cellular material from a mucous swab or tissue sample is tested in a laboratory for certain viruses. However, this helps to only prove the infection of the affected area, but not to make any claims as to whether the tissue changes have occurred. So, an HPV test makes sense, especially when paired with a Pap test, and can help detect early stage cancer precursors.

If the test is positive, this is not a concern yet, as infection does not always lead to cancer. Regular examination is recommended to detect tissue changes at an early stage. Conversely, a negative test result does not allow us to state whether there has been an infection in the past that the body has successfully fought with.

For men, there is no prophylactic examination in which the test would be performed regularly. If there is a matching cancer, examining the tumor can determine whether the HPV infection is causing the cancer.

Specialized DNA techniques are also used in laboratory diagnostics, such as real-time PCR. Anogenital warts caused by HPV types 6 and 11 are easily detected on a pelvic exam.

How to cure human papillomavirus

HPV in gynecology in a woman

In most cases, the disease does not require treatment because it goes away on its own and viruses are no longer detected. However, if it doesn't, the infection can last longer and persist for months or years.

To date, there is no method of systemic impact on this virus, thanks to which it would be possible to destroy it completely. However, treating the resulting warts reduces the number of viruses, so in many cases the immune system can fight off other viruses and thereby get rid of them. In some cases, the pathogens survive and can cause symptoms over and over again.

Therapeutic tactics depend on the type of HPV and the associated picture of the disease:

  • Plantar and genital warts 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 electrocoagulation are also applicable methods.

As the frequency of relapses is quite high, it is advisable to check yourself regularly and use condoms even several months after the lesions have disappeared, so as not to infect the sexual partner.

For HPV cancers, treatment is much more difficult. In cervical cancer, it is often advisable to remove the uterus, respectively, the upper part of the vagina and the ovaries. This can be supplemented with radiation therapy to rule out the likelihood of relapse. Other cancers caused by HPV are most often treated with targeted therapy, such as radiation therapy or chemotherapy.

It should be remembered that the operation is not a cardinal solution, but only solves a cosmetic problem, because after removal, the virus may remain in the surrounding tissues, and warts may reappear.

Prevention of infections

human papillomavirus on the arm

There are two vaccinations: bivalent HPV 16 and 18 and quadrivalent HPV 6, 11, 16 and 18. Vaccination is recommended for all girls 14 years of age and over.

Vaccination does not protect against all types of HPV. Therefore, all women between the ages of 25 and 65, even if they are vaccinated, are advised to have regular smear exams.

Early detection and complete removal of genital warts reduces the risk of disease. The effectiveness of using condoms in preventing the transmission of infection can significantly reduce the risk of developing this disease. The most promising method for the prevention and treatment of the early stages of the disease caused by this infection is a specific multivalent vaccine.