Human papillomavirus (HPV) - a large group of viruses that cause changes in the epithelium of the epidermis or mucous membranes with a tendency to chronicity. A distinctive feature of each virus is unique DNA. In the course of medical studies each type is given a serial number.
GENERAL
Virus - infectious agent composed of a nucleic acid molecule and a protein shell. With the introduction of the virus into the host organism using a parasite protein components of a person to self-reproduction. Known for more than a hundred human papillomavirus. Does not have the ability to penetrate into the circulatory system and in the internal organs, it affects only the epidermis cells.
CAUSES
HPV is the causative agent of anthroponotic. All types are transmitted only from person to person. Among urogenital infections human papillomavirus undisputed leader on prevalence. According to WHO, the virus is a carrier of 80% of mature population, 30% of people are diagnosed the disease caused by this pathogen group. Having one type of virus does not eliminate the possibility of infection by viruses of other groups.
Allocate the following transmission path:
- Sexual contact. The bulk of the cases received HPV through sexual intercourse. risk group are individuals with multiple sexual contacts.
- Intrapartum. From mothers to the newborn.
- Contact-household path while reducing the barrier function of the skin. Violation of the integrity of the dermis in the form of micro traumas opens the "entrance gate" to the penetration of the pathogen.
Factors that trigger the development of HPV:
- Bacteria overgrowth and intestinal infections.
- Chronic diseases of internal organs.
- Hypothermia.
- Chronic psycho-emotional strain.
- Malnutrition.
CLASSIFICATION
In patients suffering from various types of skin lesions and mucous membranes, the most formidable change in the epithelial characteristics is the possibility of cancer tumors.
According to the degree of tumorigenicity of HPV are:
- Not tumorigenic. Simple viruses that do not cause cancer.
- Viruses with reduced oncogenes.
- medium-risk types.
- High probability of carcinogenicity.
According to the severity of the infection process are distinguished:
- I stage - latent. The absence of alterations in the tissues and symptoms, the virus DNA is determined only in laboratory studies.
- Stage II - subclinical. Initial clinical manifestations, single alteration.
- Stage III - Clinical shape. Comprehensive picture of papillomas, warts, dysplasia and other forms.
SYMPTOMS
Clinic for diseases of various subtypes of HPV in both men and women can differ dramatically. The symptomatology may be both pronounced and imperceptible to the patient. The incubation period varies from a few days to several years.
Clinical forms of the type of virus diseases:
- Warts (vulgaris, plantar, flat). HPV 1, 2, 3, 5 types. Convex or round defects of the skin of various localization.
- Condyloma acuminate, type 6, 11 (flat, conical, papular). Growths on the genitals of different colors and shapes. There are whitish, pink, red or hyperpigmented. In the initial stage when unit condylomata patient had no complaints. When multiple expansions of patients notice itching, burning or pain.
- HPV disease infants. When the transmission of the virus from mother to child during childbirth develop:
- antogenitalnye babies warts, 6 and 11 of the type of virus; defeat the genitals and the anus;
- laryngeal (juvenile) papillomatosis. The vast majority of sick children from birth to five years. Multiple papillomas are localized on the cords, trachea, or larynx sky. The clinical picture occurs with HPV lesions: hoarseness, shortness of breath, cough. Available lesion malignancy.
- Bowen's disease. The virus affects men. Characterized by the formation of red velvety plaques in the penis.
- Warty epidermodysplasia. It called two HPV types: low onkorisk - 14, 20, 21, 25, high onkorisk - 5, 8, 47. Polymorphic flat pink papules with a warty surface.
DIAGNOSTICS
HPV diagnostics holds a gynecologist or dermatologist, depending on the nature of the injury and the form of the disease.
Basic Diagnostic Methods:
- A careful history of life and disease.
- Initial inspection of the lesion. The women - gynecological examination using a colposcope.
- Laboratory study scrapings, cytology.
- DNA hybridization.
- Histological analysis of the material obtained at biopsy.
- Electron microscopic technique.
TREATMENT
Categorically unacceptable self. In the case of injury to the build-up should be urgently contact the hospital to the profile expert.
Specific treatment for the virus does not exist. In modern medicine, there are no clear rules for the management of patients with HPV. There is a possibility of abortive course, when symptoms disappear by itself. In uncomplicated cases, which do not cause the patient discomfort, you can choose the tactics of observation.
Treatment is aimed at removing papillomatoznyh defects, immunity correction and prevention of onkopererozhdeniya.
Therapeutic measures include:
- Immunological therapy. Appointment of interferons, interferon inducers.
- Vitaminoterapiyu bracing means and improving metabolic processes in the tissues.
- Correction of psycho-emotional state. The defective appearance of the genital organs in some cases have a negative impact on self-esteem sick. In this case, it is advisable to decide on the appointment of sedatives or antidepressants.
- Medicinal substances which promote degradation foci. The drugs of choice are cytostatic and chemical groups.
- Excision of tumors: surgery, cryotherapy, electrocautery, laser therapy, diathermy, electro.
- Symptomatic treatment of cervical pathologies, dysplasia. It recommended partial destruction to prevent the degeneration of Cancer and healing substances.
- Non-specific antiviral drugs.
COMPLICATIONS
The most serious complication of HPV in patients of both sexes - malegnizatsiya defect: the development of cervical cancer, or vagina in women, penis or anus - in men.
Also various embodiments degeneration benign to malignant, warts possible injury to form bleeding ulcers and suppuration.
When respiratory papillomatosis in children, in some cases develops stenosis of the larynx. It is an acute condition, suggesting the urgent medical aid to endolaryngeal removing papillomas.
PREVENTION
The preventive measures to combat HPV, has a value overall health and immunity.
Basic preventative infection control practices:
- Protected sexual intercourse. The use of barrier contraceptives during sex reduces the risk of infection.
- Explanatory work among young people about contraception and Limitation of random, unprotected sex.
- Compliance with the rules of personal hygiene.
- Regular specialized preventive examination, specimen collection with a gynecologist for women.
- Cesarean section. With a history of a pregnant woman's HPV expedient delivery is a surgical procedure to avoid contamination baby.
- Vaccination. Recommended for early adolescence, pre-derived evidence of the absence of a child's data on HPV at the time of vaccination. Upon detection of any virus subgroup in the body to do the vaccination does not make sense. The action of the vaccine is designed to prevent infection particularly dangerous group of viruses.
Forecast
Early reference to the profile expert gives a good outlook, in many cases, however, the relapse rate is high enough. Statistics provides data on return of symptoms in 25% of cases. Healing from one HPV type does not provide a strong immunity against the virus to other groups. Possible re-infection of other subgroups. The most probable adverse outcome when malignancy defective changes.
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