The human papillomavirus treatment

HPV infection is now considered the most common sexually transmitted diseases. The term "sexually transmitted diseases" (sexually transmitted diseases – STD, sexually transmitted infections – STI, sexually transmitted infections – STIs) is a group of diseases that are either transmitted only by sexual contact (intercourse) or through other sexual practices. Belong to STIs chlamydia and mycoplasmosis infection, gonorrhea, syphilis, inguinal granuloma, infections caused by viruses (human papillomavirus, herpes simplex virus, hepatitis), infections caused by protozoa and arthropods (trichomoniasis, Gardnerella vaginalis, ftiras ) and AIDS.

Virus papillomy cheloveka lechenie


HPV is a DNA virus.

This is an ordinary virus, and before whom all are equal people, it affects both men and women. There are more than 120 genotypes of HPV, which can act on different parts of the body. About 30 types affect the genitourinary system (cervix, vagina, vulva, perineum, anus, penis) and is known as genital human papillomavirus. Orientation they are divided into neocolonies (LR – low risk) – about 12 genotypes and oncogenic types (HR – high risk) – the remaining 18 genotypes. According to who estimates, in 2001 worldwide had been infected by genital HPV, about 630 million people (9-13%).

In view of the urgency of this problem, it is advisable to obtain basic information about what is human papillomavirus what human papillomavirus treatment suggests that HPV be treated with antibiotics or not, how to treat HPV, how to treat disease, etc. the Answers to these questions and is designed to provide in this article.

Infection with low-risk types (mainly HPV 6 and 11) can lead to the formation of various epithelial lesions of the anogenital region. These lesions are referred to as genital warts (or venereal spots also). Warts was first described in the early 1st century ad by the ancient physician Celsus.

Types 16, 18, 31, 33 and 35 (high risk oncogenic types) have a direct relationship to cervical dysplasia and cervical cancer. Pathological changes in the cells lining the cervix may spontaneously disappear when the body gets rid of the virus. It is shown in the histological examination. The problem occurs when some women the infection persists. These changes in the cells of the cervix can lead, eventually, to cervical cancer (if the disease is not detected early and not carried out effective treatment of HPV).

The presence of HPV-16 was detected in 60-80% of cases of Bowen's disease involving the penis. Also discussed is the fact whether the relationship of papilloma of the person (i.e. certain types of) cancer of the penis and urethra, anus, vulva and larynx.

The division of oncogenic and not oncogenic types are not very clearly – malignant neoplasms of the genitourinary system and respiratory tract can have a certain attitude to HPV types 6 and 11.

Virus papillomy cheloveka lechenie

Transmission occurs through sexual contact (oral, vaginal, anal intercourse) or by close contact (skin-to-skin) with an infected partner. Transmission without intercourse, though possible, but is a very rare phenomenon. HPV is very contagious, so it is enough to deal with this virus only once. Most people become infected soon after becoming sexually active (18-25 years). In this age category, the prevalence of HPV infection is 14-40%. Two-thirds of people who have sexual intercourse with an infected partner, according to the who, infected for 3 months.

Fortunately, in most cases, HPV infection is asymptomatic and the body within 24 months due to their immune mechanisms (in particular, cellular immunity) gets rid of the virus. This process is called spontaneous cleansing.

Infection begins with a minor injury of the mucosa that allows virus particles to penetrate deep into the epithelium and infect the basal cells. The sexual transmission wasdescribed only in 1954.

Can get infected also the newborn when passing through the birth canal. Despite the fact that it is a rare situation, it can lead to the development of warts in the throat of the child (i.e., respiratory papillomatosis). We are talking about a life-threatening situation that requires laser removal of lesions, to prevent airway obstruction. Sometimes warts in women during pregnancy can be expanded in terms of localization, which creates obstacles in terms of urination or even a barrier to the birth, in case of lesions of the vaginal wall.

The incubation time until formation of the warts within 3 weeks to 8 months.

The course of HPV infection

First of all is the transmission of the virus on the skin or mucous membranes (most often through sexual contact). It enters the cells for minor injuries. The virus "stick" to the corresponding receptors on the cell surface, penetrate into cells through the cell membrane and are absorbed into transport vesicles. In the cells they subsequently lose their protein coat (capsid), and their DNA (genetic info) gets into the cell nucleus, where the process of reproduction of the viral genome. Viruses act like parasites, able to use a cellular biochemical mechanism for the expression of their genes to fungal genomes.

Epithelium infected with HPV virus

Restoration of squamous epithelium on the surface of the mucous membranes and skin happens all the time. This process occurs without infection. Are stimulus, especially estrogen.

Epithelium infected with HPV, reacts differently and unevenly seal or keratinization. During infection of epithelial cells is multiplied DNA of the HPV virus, and as a result comes to the appearance of copies of the virus in significant quantities.

The oncogenic potential of HPV virus

The so-called cellular immunity, which provide cells known as white blood cells. There are many types of white blood cells. Non-specific defence are neutrophils or macrophages. In most vertebrates there is the so-called second type of white blood cells, also called lymphocytes, which develop sophisticated methods to identify and destroy pathogenic organisms – they recognize antigens on the surface of cells and destroy them together with viruses HPV.

So far identified over 130 different types. The HPV viruses in accordance with the risk of causing precancerous changes in the affected tissue are divided into the following types:

  • types of HPV low risk = LOW RISK (LR) cause only minor the pre-change and the formation of genital warts (e.g., types 6 and 11),
  • types of HPV high risk = HIGH RISK (HR) lead to serious precancerous and cancerous changes in the cervix (for example, types 16 and 18).

The virus subsequently takes the control mechanisms of the cell cycle and starts her own reproduction. Infected cells become genetically unstable. In addition, disturbed the progress of the split and formed different atypical and abnormal cells. They appear in smears cancer research and biopsies.

Modes of transmission of HPV

  1. The virus is usually transmitted during sexual intercourse (vaginal, anal, and oral).
  2. Transmission without sexual activity (for example, towels or soiled Laundry) are possible, but such cases are very rare (these paths should be considered, particularly in children).
  3. During sexual stimulation and especially during intercourse (even most "soft") creates microscopic fissures on the genitals, which are the gateways for the transmission.
  4. Transmission of infection may occur in women who are not having sexual intercourse but sexually active, because the infection can be introduced, for example, contaminated fingers partner.

So…

  1. Typically, the virus enters the body during sexual intercourse (90-99%).
  2. The condom cannot 100% protect against transmission, but reduces the risk of infection (whether from male to female or Vice versa).
  3. The time between infection and the first symptoms of the infection usually ranges from several weeks to 8 months, rarely possible longer periods more.
  4. Most infected people have no symptoms of infection.

It has been proven by testing for the presence of HPV in the cervix that the immune system of most women can for 12 to 18 months to cope with the infection (the woman becomes non-contagious), so it can be assumed that the immune system of men can cope with this infection during the same time period.

Risk factor

The main factor is the contact with the HPV virus and its sequel (i.e. saving) into the tissue. In addition, there are other factors that increase the relative risk of transformation of the virus into cells:

  1. Sexual behavior and number of sexual partners in their lifetime.
  2. Ethnically, man is given a genetic predisposition.
  3. A greater number of full-term babies in young women (trauma to the cervix, immunosuppression).
  4. Other infections, sexual transmitted pathogens (some genotypes of chlamydia).
  5. Smoking cigarettes (a strong epidemiological arguments).
  6. Immune disorders (especially, human immunodeficiency virus, HIV).
  7. Initiation of sexual activity duringpuberty and physical changes.
  8. Eating disorders with low levels of tocopherol, vitamin C and antioxidants.

Light a precancerous change of squamous epithelium, which causes HPV low risk, in most cases disappear spontaneously or are characterized by long-term stagnation. Only in 10% of cases leads to deterioration down to serious precancerous and about 0.15 per cent, to cancer.

Glandular epithelial lesions are rare (relative to squamous cell 1:50), but can occur faster. The natural evolution of HPV infection is identical with the development of precancerous lesions. The most serious is HPV type 16.

Diagnosis papilloma and manifestations of the disease

Below are the General methods and description techniques that are used to diagnose both the HPV virus and its manifestations.

Exploratory tests

For men

The study is being conducted smear from the urethra or the penis of a special swab that a doctor should work together with the vial for transportation to the lab. This test can be done by a dermatologist or urologist. As a result, he will inform the person whether the virus low-risk HPV (responsible for formation of genital warts) or high risk (responsible for cervical cancer).

For women

It is recommended only for women older than 30-35 years. We are talking about tests for the presence of viral DNA types with a high degree of risk. If a woman is older than 30 years HPV-positive, it means that the virus is likely present in the body for a long time and thus have a higher risk of precancerous changes. From HPV positive women aged 30 years in 30% of cases, due to the immunity the body within a few months, you may get rid of the virus without any complications (and therefore the testing of this group is not recommended – that is, because of the high positivity).

Virus papillomy cheloveka lechenie

While this test is not part of the annual preventive examination by a gynecologist and is made only on the recommendation of a gynecologist (mostly in women with worsened oncological Cytology) or at the request of the person (for a fee). Usually, it is only a test for types of HPV with high risk.

Therapeutic method

Treatment human papilloma virus is aimed at addressing the macroscopically detectable damage. Makes no sense the treatment of papilloma by treatment of subclinical lesions of the mucous membrane or attempts to eradicate the infection of the tissues.

In several studies it was shown that warts spontaneously disappear in 20-30% of cases. However, it is impossible to predict which lesions will grow and which will disappear.

Directly, the methods to to treat HPV, can be divided into treatment, topically applied by the individual, and treatment by a physician. The disease is treated with special drugs that will recommend a doctor.

Subsequent manifestations and recurrence of HPV infection

After treatment, the patient is invited to periodic inspection every 4-6 months until he is, at least in a year to live without clinical signs of the disease. In consultation, the doctor recommends the use of a condom during sexual activity. Relapses after treatment warts are very common, usually up to 25% within 3 months after treatment. Most relapses are a reactivation of the subclinical HPV infection than reinfection from a partner.

In the course of treatment, although removed macroscopic damage, but the virus remains in the body and thus comes to frequent relapses.

HPV and pregnancy

  1. HPV infection does not affect fertility.
  2. Genital warts often grow faster during pregnancy, and can be removed by laser, cryotherapy, the use of trichloroacetic acid.
  3. We recommend removal of visible warts before birth to reduce the number the presence of the virus and thereby reduce the risk of transmission to the child during childbirth.
  4. Caesarean section is only recommended when the warts block the birth canal.
  5. The risk of transmission of HPV to the baby is very low, some newborns may develop warts in the throat, larynx, bronchi and trachea, in extremely rare cases, in the eyes or on the genitals, in the most serious cases, the child develops juvenile papillomatosis of the larynx, accompanied by hoarseness, and sometimes – suffocation (this disease is very rare).
  6. The probability of precancerous changes of the cervix in pregnant women is higher, but this condition is of less importance than in nonpregnant women, have a larger percentage of women, the condition improves after delivery.

    Virus papillomy cheloveka lechenie

  7. Treatment of dysplasia during pregnancy is not recommended even in cases of severe forms, surgery should be performed only in invasive cancer, in other cases, the operation is postponed until the expiration of the 6-week period after childbirth.
  8. In women after repeated removal of lesions on the cervix that removes much of the fabric, increases the riskpremature birth.

Principles against infection

  1. Sex only with a reliable partner.
  2. Adherence to the principles of safer sex and oral sex.
  3. The monitoring of the health status and timely treatment of any diseases.
  4. At least twice a year you should visit a gynecologist.
  5. You should not skimp on health, and think about vaccination.
  6. Observance of rules of personal hygiene.