Human Papillomavirus

General Illness Information

Medical Term: Human Papillomavirus (HPV)

Common Name: Papillomas

Description: Human papillomavirus is a family of viruses that cause warts, papillomas, dysplasia or cervical and genital cancer.

In adults, certain types of virus cause development of anogenital warts, or genital warts.

The virus penetrates the skin or mucosa and is met by various cells of human immune system. In most cases, immune cells destroy the virus. But if immune system is weakened, the virus succeeds in penetrating cells of basal layer of the skin or mucosal epithelium, is embedded in chromosomes of cells and changes functioning of these cells. Cells begin to excessively multiply and expand in a limited area, turning into warts and papillomas.

Manifestations and signs of papillomavirus infection depend on the type of virus and on what disease it caused. There are several groups of diseases most often caused by HPV:

  • Warts – rounded, convex, dense, absolutely painless formations that do not differ in color from surrounding skin. They appear on skin of palms, on soles, rarely on other parts of the body. Warts do not cause patients anxiety, except for aesthetic.
  • Genital warts – peculiar warts that appear, as a rule, on mucous membranes and skin of genital organs: glans penis and foreskin in men, skin of labia in women. Genital warts can also appear in bladder, urethra, on cervix, in vagina, on skin around anus, in oral cavity. Outwardly, these genital warts are similar to small convex formations, their edges are uneven (looking like cauliflower). Genital warts are widespread and extremely infectious.
  • Bovenoid papulosis – a disease characterized by appearance of rashes on skin of genitals. The most frequent localization of rashes – skin of large labia in women, glans penis in men. Rashes are flattened plaques that rise above surface of skin, yellowish, pink or white. This disease can sometimes transfer into skin cancer.
  • Bowen’s disease – a disease that develops in men. On skin of penis an elevated moist velvety plaque of red color appears, its edges are distinct. Plaque can exist for a very long time, its peripheral growth and malignancy is possible.
  • In women, HPV can cause cervical intraepithelial neoplasia, which is a precancerous condition of cervix. There are 3 stages of this process, the latter being the initial stage of cervical cancer.

Most HPV infections do not lead to appearance of symptoms or illness and disappear by themselves (about 90% – within 2 years). However, persistent infection with certain types of HPV can lead to development of precancerous pathological conditions. Without treatment, these conditions can develop into cervical cancer.

Papillomavirus infection is also involved in 20 – 90% of cases of squamous cell carcinoma of anus, oropharynx, vulva, vagina and penis.

HPV types that do not cause cancer can cause respiratory papillomatosis – a disease in which tumors grow in airways leading from nose and mouth to lungs). And although this condition very rarely leads to death, it can often lead to a disease.

Causes

  • Infection usually occurs in childhood. Through microdamaging of baby’s skin (scratches, abrasions), papillomavirus penetrates the skin and causes appearance of warts.
  • Most often this virus is transmitted during sexual intercourse, so HPV is referred to sexually transmitted diseases. Through microtraumas of sexual organs the virus is transmitted from one sexual partner to another.
  • It is also possible to get infected by contacting damaged mucous membranes or skin with discharge of a sick person (for example, through a towel). It is theoretically possible to have a contact-household way of transmission – through hygienic supplies, rim of the toilet, bathing, visiting sauna, pool, etc.
  • There were reported cases when the virus was transmitted to child from a sick mother in the process of giving birth.

Diagnosis

Diagnosis consists of several stages and, as usual, begins with clarification of patient complaints and general examination. Doctor examines skin and mucous membranes in places where warts and genital warts most often appear.

For women, examination of vagina and cervix is necessary with the help of mirrors, colposcopy, cytological examination (analysis of material of scraping taken from mucous membranes of cervix and cervical canal). In addition, doctor can take a small piece of cervical tissue for biopsy, with which you can establish initial stages of cancer.

Polymerase chain reaction is one of the most reliable methods of research, allowing to accurately determine DNA of virus in any material for analysis. This method has a disadvantage – false positive results are possible.

The most accurate diagnostic method to date is Digene-test, which detects virus, determines its type by DNA and degree of malignancy (ability of the virus to cause cancer).

Treatment

Treatment of papillomas is complex, includes:

  • antiviral therapy – to reduce activity of virus and its elimination (elimination from the body);
  • immunomodulating therapy – to improve immunity and resistance of the body to infection;
  • topical treatment (removal) of papillomas – to prevent injury of papillomas, which can cause secondary bacterial infection, as well as to eliminate cosmetic defects.

Currently, there is no antiviral drug that would cause disappearance of human papillomavirus from the body. Various interferons and interferonogens can reduce already existing condylomas, but do not reduce incidence of new ones. Therefore, the main way to treat manifestations of papillomovirus infection remains removal of condylomas by chemical or surgical methods.

Even if warts do not cause trouble to patient, it is recommended that they be treated. The main methods of treatment are cryotherapy and electrocoagulation. Genital warts are also subject to removal by cryodestruction, radio wave and electrocoagulation, as well as laser. It should be noted that removal of warts and genital warts does not cure papillomavirus infection, and their relapse is possible.

Surgical methods for treatment of diseases caused by papillomavirus infection are used mainly to remove malignant neoplasms.

To reduce the risk of possible relapse of the disease, along with mechanical methods, additional methods of treatment are applied. There are no pecific drugs against human papilloma, therefore, antiviral drugs and drugs that stimulate body’s immune system are recommended.

Also You can remove papilloma at home with various chemicals. There are many such preparations for removing warts. They are all aimed at destroying tissue of neoplasm, but differ in modes of action.

Usually, drugs for removing papillomas are released in the form of ointment, cream or solution. They are applied to required area with supplied applicator, or ordinary wooden stick. This is a necessary security measure, since most of these substances have strong burnout property. And although the procedure for removing papillomas with their help is somewhat painful, it allows to quickly get rid of them. Unfortunately, with not careful use of these means, small chemical burns of healthy skin are possible.

Before applying these means to papilloma, skin around it is coated with a cream. The drugs are applied depending on size of papilloma 1 – 3 times. Such treatment lasts until its complete disappearance.

Vaccination

Currently, not only treatment, but also prevention of infection is possible. To prevent infection, you can get vaccinated.

Vaccination provides women previously not infected with serious protection against certain types of high-risk papillomavirus. These viruses, as a rule, are always found in the body of patients with cervical cancer and genital warts. Therefore, vaccination against papillomavirus is often called “vaccination against cervical cancer”.

The vaccine is injected into the shoulder three times within six months. It is most appropriate to vaccinate girls and young women under 26 years of age. Vaccination is done either before the first intimate contact, or at the very beginning of sexual life.

There are no special restrictions for this vaccination. It is necessary to observe only general rules that are taken into account at any vaccination. Immediately before vaccination, doctor performs examination. Patient should not have serious chronic diseases and intolerance to components of vaccine. Experience shows that vaccine against papillomavirus is usually well tolerated and rarely causes side effects.

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