Types of HPV: genotyping of papillomaviruses


The human papillomavirus is on a par with the herpes virus in the number of people infected with it. According to various estimates, at least two-thirds of the world's population were attacked by HPV. Many, possessing good immunity, were able to get rid of it imperceptibly for themselves. And for others, the human papillomavirus turned into a disaster, causing cancer. Most genotypes of the virus are harmless and do not even cause external symptoms, some belong to the group of high oncogenic risk. Genotyping allows us to predict the further development of a viral infection. The doctor will be able to choose the necessary examinations for the given genotype of the virus and the appropriate treatment strategy.

What is HPV symptoms

Papillomaviruses are known for a variety of strains, of which there are more than a hundred. Well studied about seven dozen of them. The main manifestations of infection are expressed as neoplasms on the skin and mucous membranes:

  • In the form of dense growths with a keratinized surface on the hands and feet;
  • Flat warts on the face, neck;
  • Rising above the surface of the epithelium of rod-shaped neoplasms, soft to the touch, pink;
  • Genital warts in the genital area, anus, in the larynx;
  • Pathological changes in the cells of the cervical mucosa.

Skin Neoplasms

The virus easily penetrates the epithelium of the skin and mucous membranes in the genitals, oral cavity, eyes. The main transmission route is from person to person:

  • Through unprotected sex
  • Through contacts with infected skin of another person (handshake, kiss);
  • When passing through the birth canal of an infected mother to her newborn baby;
  • Less commonly, through household items used in conjunction with a human carrier of HPV.

All types of human papillomaviruses are conventionally divided into three groups according to the degree of their threat to the human body:

  • Non-oncogenic;
  • Low oncological risk;
  • High oncological risk.

Some strains of the virus pose a particular danger to women, since they increase the chances of developing an oncological disease, in particular, cervical cancer, by dozens of times. In fairness, it should be noted that medical statistics confirm the development of oncology in only 1% of women infected with the HPV strain from the high cancer risk group.

Speaking about the risk of developing oncology, first of all, referring to genital warts that occurred on the glans penis in men and on the cervix in women. Other types of genital warts do not carry a similar threat. However, the appearance of papillomas on the body causes cosmetic inconvenience and physical discomfort. Injury of growths under the breast in women, in the armpits and perineum is a common phenomenon that increases the risk of degeneration of papillomas and their further spread.

Genotyping

To accurately determine the type of virus, PCR diagnostics are used. The polymerase chain reaction method allows you to establish quantitative and qualitative characteristics of the virus.

Typing of human papillomavirus provides an opportunity to predict the course of the disease. The need for a virus genotype determination procedure is justified by the following:

  • Identification of several virus strains at once may indicate the established ability of the virus to survive in the host organism for a long time, and also gives a less favorable prognosis for recovery;
  • Different types of virus have different degrees of danger for the degeneration of neoplasms into cancerous tumors. The most oncogenic of them are 16 and 18. Medical recommendations for managing patients with confirmed infection with these HPV genotypes include immediate colposcopy. If other highly oncogenic strains are found, a cytological examination is first prescribed, and then, if necessary, colposcopy;
  • The typing procedure makes it possible when re-admitting the patient to understand whether the re-infection occurred or the infection acquired a chronic form.

Woman consults a doctor

Important!

The clinical symptoms of different HPV genotypes in males and females can vary significantly. Manifestations of the disease can be visible to everyone or invisible even to the wearer.

This table presents the classification of HPV types and their meaning:

Genotype Clinical manifestations
1, 2, 3, 4, Warts that occur on the sole, otherwise referred to as “tongues,” resemble ordinary corns. May cause severe pain when pressed and walking. If you cut off the upper stratum corneum, black dots of thrombosed capillaries become visible.
2, 7 Butcher's warts, often formed on the hands after cuts, resemble a skin horn.
26 – 29, 38, 41, 49, 57, 65, 75-77 Vulgar warts are benign growths, one of the most common types transmitted by contact-household means. At the very beginning of their growth, they look like a small – no more than 2 mm in diameter – tubercle rising above the surface of the skin. In the process of growth, the wart coarsens, becoming covered with a rough crust. Often, new growths may occur near the main wart. Removal of the maternal neoplasm contributes to the disappearance of daughter growths. Sometimes in the area of ​​the appeared wart there are pain. Localization sites – everywhere on the body, but in most cases on the hands, feet, face (in the mouth, beard, eyelids), scalp.
10, 28, 49 Flat warts often occur in childhood and adolescence, so they are also called "youthful warts." They usually focus on the face and neck, as well as on the back surfaces of the hands and feet. They are a flat neoplasm of irregular shape with a diameter of not more than 5 mm, slightly rising above the surface of the skin. Usually whole conglomerates of such growths of pink or pale brown color appear. Most often they do not cause discomfort, sometimes itching is observed. To remove flat warts, radio wave surgery and laser destruction are recommended, as methods with the least risk of scars and scars.
2, 3, 5, 8, 9, 10, 12, 14, 15, 17, 19, 20-25, 37, 47, 50, 58 Verruciform epidermodysplasia is a rare skin disease that usually occurs in childhood. It provokes the growth of many flat warts of rounded smooth shape on the skin surface. Neoplasms are densely located, have no signs of inflammation, pinkish or yellow. With prolonged exposure to sunlight, they can darken, they rarely provoke squamous cell carcinoma of the skin (when infected with genotypes 5, 8, 47).
6, 11, 42, 44, 51, 54, 55, 69 Genital warts – growths on a thin stalk or in the shape of a scallop, pink, soft to the touch. Often they are concentrated on the glans penis, on the labia, vaginal mucosa, cervix, in the region of the anus, and the oral cavity. Transmitted through unprotected sexual contact. Characterized by rapid growth and seizure of new territories. Sometimes a neoplasm occurs within a few hours. One of the outstanding representatives of the group is the giant Bushke-Levenshtein condyloma, which arises in connection with the merger of many genital warts. The lack of timely elimination of growths and therapy that strengthens the immune system can lead to the transition of the disease to a malignant form, and also contributes to a number of other complications: the appearance of cracks, infections.
6, 11, 16, 18, 30, 31, 33, 35, 39, 45, 51, 52, 56, 58, 66, 69 The precancerous condition of the anal canal is intraepithelial neoplasia. These are changes in the cells of the mucosa of the lower rectum. They are characterized by hyperkeratosis and changes in the color of the epithelium (may be white, red, brown). Pathologically altered cells can rise above the surface of the epithelium or be in the same plane with it.
6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 54.56, 66, 69, 82 Oncological diseases of the cervix, glans penis, anus, mucous membranes of the oral cavity and throat. The virus intervenes in the course of healthy cell division and weakens its defense mechanisms. As a result of chaotic division, proliferation of the epithelium occurs. The disease goes through several stages:

The appearance of dysplasia of varying severity;

Non-invasive cancer (the tumor did not grow through the membrane of the epithelial cells);

Microinvasive cancer (penetration through the membrane);

Clinical stage (spread of the tumor to the rectum, bladder).

External manifestations of cervical cancer in the initial steel are practically absent. Only an annual visit to the gynecologist with a screening can help in the early diagnosis of the disease. As it develops, the following symptoms appear:

· Staining of vaginal discharge in red and brown;

Inflammatory diseases of the genital organs – cervicitis, colpitis;

· Discharges of a purulent character with an unpleasant odor;

· Painful and prolonged menstruation;

· Painful discomfort during intercourse;

· As the disease develops, problems with urination, an increase in lymph nodes, swelling of the lower extremities join.

6, 7, 11, 32, 57, 72, 73 Blooming papillomatosis – white plaques resembling cauliflower inflorescences formed in the oral cavity. More often occur in elderly people. It can spread to the trachea, bronchi, lungs. Symptoms: hoarseness, voice loss, nasal, difficulty breathing.
13, 32 Hyuk's disease – focal epithelial hyperplasia. It manifests itself in the form of single or multiple volumetric neoplasms in the oral cavity. They are painless, pink or whitish in color, sometimes self-destruct. With prolonged preservation of growth, they are eliminated surgically.

Recommendations

To avoid adverse effects due to the development of HPV infection, all women are advised to test for human papillomavirus once every five years. If the results of the analysis and a cytological smear revealed the presence of a virus of high oncogenic risk, it is necessary to be examined annually with the obligatory observance of the recommendations of the attending gynecologist.Blood sampling for analysis

Removal of neoplasms using the methods of modern medicine is quick, often painless and effective. At the disposal of dermatologists are devices for laser coagulation, radio wave surgery, cryodestruction, electrocoagulation. During the procedure, papilloma is completely eliminated, and postoperative complications are minimized. Most often, usual hygiene procedures and protection of the skin from exposure to sunlight, chemicals and other irritating factors are required.

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