Human papilloma virus is a type of virus that causes pathological division of skin cells and mucous membranes, which leads to the formation of various defects (genital warts, papillomas, etc.). They started talking about this group of viruses not so long ago – when it was discovered that some types of HPV are associated with an increased risk of cancer. Over the past 50 years, 150 different types have been described. So far, only 80 of them have been investigated.
What is dangerous HPV
Highly oncogenic HPV subspecies (about 30 species) is a time bomb. Once in the body, they can for a long time not cause any symptoms suppressed by the immune system. But as soon as the protection falls due to diseases or immunodeficiency, the virus begins to actively replicate (multiply inside the cells).
By infecting epithelial cells, the virus leads to their active division. Altered cells are recognized by the immune system and destroyed. However, with the prolonged presence and high activity of the virus, some cells avoid destruction, forming a focus of persistent infection. Subsequent divisions, mutations can easily occur in them, leading to the appearance of a tumor.
It is possible to determine whether a subspecies is highly oncogenic, only by analysis, which is recommended to be taken if external signs of HPV have manifested. Further treatment tactics depend on the type of virus.
Scientists have noted the most dangerous subspecies: 16, 18, 31, 33, 35, 39.45, 51, 52, 56, 59, 68. For example, viruses 16, 18, 45 and 56 are associated with a risk of dysplasia and cervical cancer. This disease is dangerous because it develops for a long time without symptoms. If a woman does not regularly visit a gynecologist, she may not realize that she is sick. Unfortunately, in our country, cervical cancer is still detected in a large percentage of cases already at the stage of metastases.
In addition to cervical cancer, the virus causes oncological diseases:
So it’s clear that a man is also at risk for oncogenicity of HPV.
Papillomavirus infection today is the most common sexually transmitted infection. Other methods of infection (contact-household, from mother to fetus) are much less common. Usually a surge of infections occurs at the beginning of an active sexual life. That is why doctors strongly recommend young girls who have not yet had sexual intercourse to be vaccinated against HPV types 16 and 18 in order to protect themselves from cervical cancer. The WHO recommendation is to be vaccinated at 9–13 years of age.
Non-oncogenic viruses with low oncogenicity are also unpleasant – they cause various defects in the skin and mucous membranes, such as vulgar warts, papillomas, and spiky corns.
It should be noted that in a sufficiently large number of cases, infection with the human papillomavirus infection does not occur at all, or the disease goes away by itself when a healthy immune system suppresses the virus. Those infections are dangerous when the virus persists for a long time in the body.
From the moment of infection, the incubation period begins. It varies from a month to several years, so most often the source of the virus remains unknown. After this period ends, the external signs of the disease appear.
Some external signs of HPV infection in women and men are the same:
- Genital warts (skin outgrowths on a thin stalk, sometimes merging together) on the genitals and around the anus, rarely in the oral cavity;
- Fibro- and keratopapillomas on the skin (armpits, under the chest, on the neck, in the groin);
- Bowenoid papulosis – dark red spots, papules and plaques on the genitals.
Separately, it is worth considering the manifestations that are worth paying attention to if external signs are clearly not visible.
Possible signs of HPV in men
Symptoms of HPV infection in men can include discomfort and burning sensation when urinating, frequent urges if condylomas have “settled” in the urethra or bladder. With ulceration of these formations, a bacterial infection joins, chronic urethritis or cystitis develops.
Pain during defecation is caused by condylomas in the rectum and around the anus. Pain may occur when walking, with prolonged sitting, blood remains on toilet paper or underwear. With the addition of a bacterial infection, paraproctitis develops – purulent inflammation of the tissues of the rectum.
Other possible symptoms:
- Burning and itching of the genitals;
- Unpleasant sensations and pain during intercourse;
- heaviness in the lower back and lower abdomen;
- Signs of general intoxication (headache, chills, weakness, fever).
Possible signs of HPV in women
Genital and flat condylomas in women can also be localized in the urethra, which leads to unpleasant sensations when trying to urinate and even delay urination.
With the location of genital warts in the anus, vagina, a sensation of a foreign object inside, pain and burning during bowel movements, sexual intercourse may occur.
A specific symptom for women with HPV infection is intraepithelial neoplasia of the cervix of varying degrees. This is a precancerous change in squamous cells of the epithelium, which, without treatment, can degenerate into cancer.
Dysplasia, like cervical cancer, does not hurt, is not visible from the outside and does not bother a woman. Therefore, you need to carefully listen to your body and be sure to regularly inspect the gynecologist.
Indirect signs of precancerous changes in the epithelium of the cervical mucosa or cancer:
- Repeated spotting between menstruation (or during menopause), from minor to profuse (in the late stages);
- Menstrual irregularities;
- Vaginal bleeding after intercourse or other mechanical intervention (douching, gynecological examination);
- Severity, discomfort in the vagina and lower abdomen;
- Serous or serous-bloody discharge from the vagina, in the late stages of cancer – with an unpleasant odor;
- Prolonged weakness and a slight increase in body temperature.
If such signs appear, it is recommended to immediately consult a doctor for examination.
Diagnosis of diseases caused by HPV
If HPV is suspected, a man needs to visit a urologist, and a woman needs gynecology. Another possible option is to come to a specialized skin and venereologic dispensary, where appropriate specialists will take it.
If condylomas are located on the external genitalia, then the doctor will see them during the examination. If there are no external signs, changes in the epithelium of the genitourinary organs can be detected during urethroscopy and rectoscopy with corresponding complaints in men.
Women undergo examination on a gynecological chair using tools (Cuzco mirror, Sims mirror). In addition to a visual assessment of the condition, during the examination, a PAP test, smear sampling for PCR can be performed.
The PAP test is a fence of a cervical smear imprint (scraping) with applying it to a glass slide and drying. The material obtained during these studies (a piece of CM mucosa) is sent for cytology (laboratory examination under a microscope to detect atypical – altered cells).
Signs of atypicality may be a change in the size, shape or color of the nucleus, changes in the cytoplasm. If such cells are detected, more detailed investigation is required. Cytology will not answer the question of whether it is dysplasia or already cancer. This requires histology.
For histological analysis, a biopsy is performed – a fence of a piece of the mucous membrane with special tools. Histology makes it possible to determine the degree of change, as well as their benignness or malignancy.
Smears for PCR analysis are taken for both men (urethra) and women (cervix). For analysis, a scraping of the mucosa is used. Even for PCR analysis can take blood and other biological
Another way to detect the virus in the blood is ELISA. An enzyme-linked immunosorbent assay reveals the number and type of antibodies to HPV in the body. This makes it possible to determine the presence of the pathogen and the strength of the immune response to it, but not a subspecies of the virus. An ELISA test is usually prescribed along with PCR.
Timely treatment of neoplasia, genital warts and other manifestations, as well as a healthy lifestyle and sexual intercourse and a constant trusted partner, will protect against cancer and other unpleasant consequences of HPV.