In most cases, a woman learns about infection with a papillomavirus infection when visual confirmation of this appears on the body. Genital warts on the genital mucosa or changes to the cervix that were detected at the gynecologist’s appointment, no matter what the neoplasms, they always make the patient nervous and look for a way to get rid of the annoying disease. Given that the level of HPV infection in the population of our planet is close to the 90% mark, every woman has a risk of becoming a carrier of papillomavirus. What this threatens and how to cope with the infection, we will consider in this article.
What is HPV?
Infectious disease caused by human papillomavirus (HPV) is characterized by a chronic course. Once infected, the patient becomes a carrier of viral DNA, and with a suitable set of circumstances, for example, with illness, hypothermia, stress, a relapse of the infection can occur.
Once in the human body, the virus is fixed in the deep layers of the skin, and it multiplies in its upper layers. Integrating into the cell, HPV disrupts the mechanism of its division, which causes the appearance of neoplasms.
Medical scientists have discovered more than one and a half hundred types of the HPV virus. Each of them in its own way affects the body of the wearer and can manifest itself in the form of simple warts, flat growths, genital warts, growths of an unimaginable form that occur both on the skin and on the mucous membranes. Most strains do not pose a serious threat to human health. But some of them, such as 16 and 18, can lead to cervical cancer.
All strains of the virus are divided into groups according to their degree of oncogenic risk:
- Types 6, 11, 42, 43, 44, 53, 54, 55 are considered non-carcinogenic, despite the fact that they cause genital warts;
- Types 16, 18, 31, 33, 35, 45, 56, 66 can provoke the development of precancerous conditions. Cervical cancer in most cases is caused by strains 16 and 18.
Causes of HPV in women
The usual route of transmission is in contact with the skin or mucous membranes of a person infected with the virus. If a pregnant woman has genital warts, the virus can be transmitted to her baby during childbirth. Less often, but often enough, to take into account risks of this kind, HPV is transmitted through a household route.
Most often, in the first months and even years after penetration into the body, the infection does not make itself felt, and the person does not realize that he has become a carrier of the virus. Not surprisingly, over the years, people wonder where they came from papillomas.
The risk of infection increases in people who ignore the rules of personal hygiene, the need for protection during sexual intercourse, people with weakened immune systems, leading an unhealthy lifestyle and having bad habits, such as smoking. Among the risk factors are also sexual intercourse at an early age, frequent change of sexual partners.
Symptoms of infection with the human papillomavirus directly depend on its genotype:
- Genotypes 1 – 5, 10, 28, 49 cause warts. These can be ordinary warts that appear on the fingers, tongues or plantar warts, youthful warts that occur on the face;
- Genotypes 6, 11, 13, 16, 18, 31, 35 lead to the appearance of genital warts, localized in the genital area, anus, and oral cavity. Most often, sexual contact with people infected with HPV leads to their occurrence;
- Genotypes 16, 18 cause cervical dysplasia, as well as cervical cancer. Without causing pain, these diseases occur unnoticed by women. Often a bacterial infection joins dysplasia, causing itching, burning, unusual discharge, including with an admixture of blood. Such symptoms become an occasion to visit a gynecologist, where pathological changes will be diagnosed. Identifying them in the later stages complicates the treatment. That is why timely diagnosis is important.
How to detect oncogenic HPV strains, diagnosis
Since the virus affects the skin of a person, it will not be possible to determine its presence in the body through a blood test. There are 4 methods for laboratory diagnosis of HPV. Assigning such studies, the doctor aims to confirm the presence of the virus, to determine its type and oncogenicity, as well as the degree of damage to the body.
- Cytological examination. One of the most affordable financial diagnostic method. A smear for cytology is recommended for all women every two years, starting at the age of 25 years. For examination under a microscope, a smear is taken in the laboratory containing epithelial cells from two locations: the external part of the cervix (exocervix) and the cervical canal (endocervix). The test result is usually ready after 1 – 2 weeks. The disadvantage of this method is the rather frequent false-negative results.
- Colposcopy. Indications for this study are deviations from the norm in the results of a smear for cytology. Using a special device – a colposcope equipped with an optical and lighting system – a detailed examination of the tissues is performed. This study allows the recognition of pathologically altered tissues even in the early stages of development. If necessary, during colposcopy, the doctor can take a sample of the epithelium for biopsy;
- Histology. The resulting samples of infected tissues are examined under a microscope to assess the nature of the changes. Using this method, tumor neoplasms can be distinguished from ordinary condylomas. The duration of the study is about three days;
- Polymerase Chain Reaction Method (PCR). A quick and reliable way to detect bacteria and viruses, even in cases where their number is negligible. The result is largely influenced by the professionalism of the laboratory assistant, so you should pay special attention to choosing a reliable laboratory. For the diagnosis of HPV and its typing, the material is usually scraped from the urogenital tract epithelial cells. Typically, the results of the study give out on the second or third day after taking the material.
If the result is an oncogenic genotype of the virus, Digene screening is done. Its results are evaluated as follows:
- Virus DNA within 0 – 3 Lg – weakly positive result, is not clinically significant;
- DNA in the amount of 3 – 5 Lg – indicates a small degree of cancer risk;
- An increase in the marker above 5 Lg indicates a high risk of cervical cancer. Patients with such results need to undergo colposcopy annually at their treating gynecologist.
HPV treatment in women
The main objective in the treatment of HPV is the physical elimination of neoplasms wherever they appeared, because the presence of infected epithelium becomes a threat of future re-infection.
The tasks of HPV therapy also include:
- Relapse prevention;
- Minimizing the risk of complications such as cervical cancer, dysplasia, ectopia;
- Activation of the body's immune defense.
There is a wide variety of methods for removing tumors in a medical institution. This is cryodestruction, laser excision, surgery, electrocoagulation, radio wave surgery. For exposure to the virus within the body and activation of the immune system, oral and topical drugs are used. Conservative therapy is carried out using:
- Antiviral agents;
- Solutions of alkalis, acids and salts.
To cure a patient with HPV, usually requires an integrated approach, which consists in the use of drugs of various groups. The duration of treatment depends on the severity of symptoms, the general condition of the patient’s body, and individual sensitivity to certain drugs. As a rule, therapy takes from one and a half to three weeks.
Unfortunately, specific preparations, the action of which is aimed directly at papillomavirus, do not exist yet. To cure patients with HPV use:
- External medicines;
- Tablets and dragees for oral administration;
In medical practice, the following drugs are best recommended:
- Isoprinosine (in tablet form). Assign to patients with genital warts 2 tablets 3 times a day for two to four weeks. The medicine affects the cell division of the virus, stimulates the body's own immunity;
- Groprinosin is an analogue of isoprinosine, which destroys the growth mechanism of tumors;
- Candles Panavir – use 1 candle vaginally for five days. The active substance has antiviral and immunomodulating effects. Increases the body's resistance to infections without causing addiction to the components of the drug;
- Acyclovir in the form of ointment, cream, as well as its analogues Zovirax, Acigerpin and others are used for external application to infected epithelium. A medicine in the form of an ointment gently affects the integument without causing pain;
- Epigen sex spray. The active substance stimulates the local production of its own interferons, as well as interrupts the reproduction of viral DNA in the early stages. The spray is approved for use during pregnancy and breastfeeding. The drug is sprayed onto the affected areas by pressing the valve once or twice. It is recommended to carry out processing 3 times a day.
Since a virus attack is always associated with a weakening of the body's immune defense, good therapy will always include a drug from the group of immunomodulators. Both a gynecologist and a venereologist, dermatologist or immunologist can prescribe them. The drugs in this group include:
- Lycopid (in tablet form). Its effect is similar to that of vaccination, because it causes the activation of the immune system against many pathogens of infections. At a dosage of 1 mg Likopid can be used in children aged 3 years. For the treatment of papillomavirus in women, Likopid is used in a dosage of 10 mg. The tablet is taken on an empty stomach 30 minutes before a meal 1 time per day. The course of treatment is 10 days. The drug is prohibited for use during pregnancy and breastfeeding;
- Allokin-alpha (in ampoules). The action of the drug is based on the stimulation of the body's production of its own interferon. As a result, the body itself fights the virus. For the treatment of HPV infection, six injections will be required – one every two days. Injections are made in the shoulder or thigh;
- Neovir is a powerful stimulant of immunity. Injection of the drug (1 ampoule) is carried out 1 time in two days. A course of 7 injections stimulates the formation of high titers of interferons in the body, sufficient to fight the infection caused by HPV.
A medical procedure during which a pathologically altered cervical epithelium is removed is called excision. It can be implemented in various ways, the most reliable and popular of which:
- Radio wave;
During a radio wave operation, an altered cervical epithelium is exposed to a special device emitting a radio wave beam. Under its influence, pathologically altered cells evaporate. The film formed in their place after some time disappears, demonstrating a new healthy epithelium.
Electroexcision consists in removing the infected epithelium using a loop of thin wire heated by electricity. During the operation, an insignificant proportion of healthy tissues surrounding pathologically altered ones is removed. Although the procedure is considered very effective and gentle, there is a risk of bleeding.
Prevention of HPV in women
The main way to protect yourself from the virus is to consciously choose a lifestyle:
- Since the virus, which is a danger to the female body, is transmitted mainly through sexual contact, it is necessary to use condoms and observe the rules of personal hygiene;
- With each new partner, the risk of replenishing the body's viral collection increases. Monogamous relationships give peace of mind regarding possible infection;
- Routine screening for precancerous changes in the cervix. It is recommended that perfectly healthy women aged 30 to 50 undergo examination at least once, and preferably once every several years. Diagnostic tests can be done by visiting the gynecology department or by contacting a good laboratory;
- Vaccination of girls at an early age (from 9 to 13 years) with a special vaccine that protects against HPV types 16 and 18, according to the WHO, is able to effectively resist infection.