Update: October 2018 Human papillomavirus infection is what
is now at the hearing of the whole world. It turned out that the virus
which causes the appearance of warts on the skin and smaller formations
(papilloma) can cause genital cancer in
women and men, as well as carcinomas of the rectum and throat.
Developed vaccinations designed to protect people from the most
dangerous strains of the virus themselves can cause severe reactions.
Types of human papillomavirus infection
Warts and cervical cancer are caused by two different types.
one virus (they are called strains). The definition of only
the fact that a papillomavirus infection has occurred does not mean
that a person will develop human papillomavirus cancer: it is possible if
The strain from the group of oncogenic has entered the body. Wherein,
infection with any of the strains increases the risk of penetration
organism and another type of virus.
There are about 600 strains of papillomatosis virus,
differing in the set and sequence of proteins,
located on their shell. Scientists divide them into 27 species and 5
Depending on their ability to cause cancer, they release these types
- Having a low oncogenic risk (their ingestion is unlikely
will cause cancer). These are viruses with numbers 3, 11, 32, 34, 40-44, 6, 51,
61, 13.72 and 73.
- Having an average oncogenic risk. These are strains 35, 53, 30, 52, 45,
56, 58. They cause the appearance on the skin and mucous membranes
formations, the probability of malignancy which is higher,
than in the first case.
- High carcinogenic strains. This is primarily a virus
papillomas type 16, which causes cervical cancer in every second
women (41-54%), as well as a type 18 virus that provokes this
each tenth of its carriers has a disease. TO
high oncogenic also include strains with numbers 31, 33, 39, 50,
59, 64, 68, 70, 82.
Danger of human papillomavirus infection
WITHвойства вируса папилломатоза таковы, что обосновывается он или
in the skin, or in the mucous membrane of various organs: reproductive
(both male and female), esophagus, bronchi, oral cavity, straight
guts. It can be localized in the conjunctiva of the eye.
TOаждый штамм вируса имеет свою «излюбленную» локализацию. So,
the most dangerous types 16 and 18 are immediately “sent” when hit
genitals, and low-oncogenic viruses 6 and 11 infect
the area of the vulva and perineum, causing the development of peaked there
condyloma These same strains can cause papillomatosis in the respiratory
the child’s ways if born naturally from the mother
with genital warts.
After infection, the disease does not always develop with pronounced
symptoms. On the contrary, the disease most often goes unnoticed and
does not lead to serious consequences.
WITHамые опасные осложнения папилломавирусной инфекции – это:
- рак шейки матки. It occurs in women in
the result of infection with human papillomavirus 16 or 18
types. It is proved that the disease in the absence of
papillomavirus does not occur. And if you previously talked about the development
cervical carcinoma from erosion or ectropion, now it is
revised and denied;
- карцинома прямой кишки. He, unlike, from
the first disease may have other causes;
- рак горла. It is also caused by virus 16
- рак легких, который может возникать при
infection with 16, 18, 11, 2, 6, 30 types of virus;
- дыхательная недостаточность, которая
develops with the growth of malignant papillomas in the airways
- контактное кровотечение из кондилом. If they
are on the vulva, perineum, or
vagina, then they are provoked by sex. With other localization (in the nose,
mouth) can cause bleeding by mechanically traumatizing
their other items.
TOаждый год, по свидетельству официальных источников, в мире
slightly less than half a million (470,000) new cases are recorded
cervical cancer caused by this virus. 233 thousand women
annually die from this disease. This puts this
cancer on the 2nd place in frequency among all
cancer pathologies in gynecology (the first place is for breast cancer
glands) and to 5th place – among all causes of death in women.
Most often, women under 40 die of carcinoma of the cervix.
Ways of transmission
Papillomavirus is extremely common. According to modern
data, it can be found in 90% of the world’s population.
TOак передается вирус папилломы человека:
- sexually (with any kind of sex). Condoms reduce
the possibility of its penetration into the body (infection with
condom use was 37.8, and without it – 89.3%), but not
prevent infection completely: pore diameter in latex
It is designed to prevent sperm, while the size
the virus is too small;
- household way, when the virus penetrates damaged skin.
It occurs in the pool, bath, when using common
towels, manicure tools, dishes;
- from mother to child during childbirth: more often with independent
during cesarean section, the probability of the virus entering the
the larynx shell also exists;
- with saliva – with kisses;
- contact – when rubbing or cutting papilloma, warts or
condylomas of the skin or mucous membrane, where integrity is compromised.
This is how self-infection usually happens.
If a person’s immunity at the time of entry of the virus is strong, then
the likelihood that a disease will develop is small: most likely
the microbe will remain inactive. The risk increases
development of the disease, if there is:
- early (up to 16 years) the onset of sexual activity, or at least
- frequent (often one in 3 years) change of sexual partners;
- genital infections, such as recurrent thrush, chlamydia,
- had abortions;
- cervical diseases: erosion, ectropion;
- constant stress;
- bad habits: smoking, alcoholism;
- long-term use of birth control pills in
- metabolic disorders;
The presence of genital warts in a pregnant woman is an indication
for cesarean section – to avoid infection
respiratory tract of the child. Thus, from the mother the child is unlikely
�”Get” the microbe. Domestic oncogenic types of the virus are not
transmitted because the virus-bearing formations are not located on
skin. Therefore, the first “acquaintance” with these microbes occurs
usually during sexual intercourse, and it usually happens in
adolescence. This justifies the need for action
(in particular, vaccination) just before the first sexual experience.
TOак проявляется папилломавирусная инфекция
WITHимптомы вируса папилломы человека зависят от того, какой штамм
ingested, and what clinical form it caused. So, это
- Папиллома – единичная или множественная. it
mushroom outgrowths on the pedicles of skin color or having yellowish,
brownish or blackish tint. They show up on the skin under
mammary glands, on the neck, in the armpits, on the face, and
also on the mucous membranes of the mouth, nose or genitals. More often
papillomas occur in women. Usually they are only
may cause discomfort or
soreness Very rarely papillomas become malignant.
- Бородавки, в том числе подошвенные. it
brownish fungoid formations. In the palm and soles area
they occur in places of greatest friction and cause soreness
when pressed. Plantar warts may have a stem,
going inside healthy tissue. They can become inflamed and
- Остроконечные кондиломы. it сосочковидные
outgrowths that, when merged together, resemble cauliflower.
TOондиломы образуются на слизистых оболочках: на половых органах, в
crotch area. If they возникли в результате анального
sex, they occupy the localization around the anus.
TOондиломы могут также располагаться на слизистых оболочках
internal organs: bladder, intestines. it вызывает такие
symptoms like painful urination or bowel movements, impaired
- Cervical Cancer –
дисплазия, вызванная папилломавирусом человека –
not clinically manifested. it заболевание может быть заподозрено
during colposcopy; detected by cytology
smear from the cervical canal.
- Рак шейки матки проявляется не сразу. On
The early stages have no symptoms. A woman must
alert an itchy genital area, changing the nature of discharge
from the genital tract (they may become more abundant, they may appear
blood streaks may have an unpleasant smell)
menstrual cycle, the appearance of bleeding after sex
or in the middle of the cycle. On поздних стадиях для этой болезни характерно
leg swelling (usually on one side), pain in the spine or
- Бовеноидный папулез. So called
precancerous condition that often develops in men. For him
characteristic appearance on the skin of a different number of spots and plaques
pink or yellowish to red-brown or violet.
The surface of such plaques may be smooth or warty; they
painful on touch.
- Болезнь Боуэна – это рак кожи и слизистых,
developing from the cells of the surface layer. Looks like
bright red skin defect, having uneven contours, covered
scales and warty growths.
In men, human papillomavirus causes a particular disease –
squamous cell carcinoma of the penis. Its cause is a type 16 virus.
The latter changes the male genital tract cells under the influence of
cigarette smoke, the malignant character is acquired under
влиянием вируса простого герпеса 2 типа, если ДНTO мужчины содержит
Ras gene, if PUVA therapy, chemotherapy, or man has been performed
is sick with HIV. Squamous cell carcinoma looks different. it может быть
occurrence of a warty stain rising above the skin
overgrowths from above, it can look like an ulcer that destroys
penis. Localized tumor on the head or extreme
Cancer of the rectum caused by human papillomavirus also
more characteristic of men. Occurs mainly in individuals
Gay. Characterized by soreness
дефекации, выделениями крови или сукровицы из прямой guts.
Any form of human papillomavirus infection does not develop immediately.
after infection: it should take from 14 days to several years
(depends on immunity and supportive factors) before
the first symptoms will appear.
In order to make a diagnosis in the presence of external papillomas
or condyloma, testing for papillomavirus is not necessary. With
the presence of other clinical forms of infection are needed:
- Осмотр врача: для женщин – гинеколога, для
- TOольпоскопия (для женщин) – осмотр шейки матки
under the microscope. During the study, tests are carried out with a solution
Lugol, Pap test (smears from the cervical canal and cervix
uterus), cervical biopsy, smear sampling for examination
PCR method and Digene-test.
- Уретроскопия и ректоскопия (для мужчин). In
the time of inspection of the urethra or rectum is also
A biopsy of suspicious pre-cancer or cancer changes is performed,
also taken smears on the study by PCR method and
Thus, it is possible to pass virus tests only in the office.
gynecologist (women) or urologist (men). it ПЦР-исследование
swab from the cervical canal or urethra, or Digene-test, which
performed with material taken during biopsy or scraping
TOак лечить вирус папилломы человека, зависит от формы инфекции.
So, если речь идет о бородавках, папилломах или кондиломах,
treatment is carried out in 2 stages:
- The formation is being removed by various
методами. it может быть хирургическое иссечение
скальпелем, выжигание лазером или электрическим током, что more
эффективно в случае папиллом и condyloma For the treatment of warts with
success applies the method of cryodestruction – necrosis
pathological tissue using liquid nitrogen having a very low
- Onзначение иммуномодуляторов, задача которых –
activate your own immunity, which should no longer
give the virus a “head up” (drugs that would destroy
the virus is completely, not yet invented).
TOроме этого, важно обеспечить предупреждение повторного
infection: stop having sex with an infected person
partner (optimally – to undergo treatment with him), exclude
frequent change of sexual partners, avoid visiting saunas,
Treatment вызванной вирусом папилломы человека злокачественной
The tumor depends on the stage at which the tumor is detected. Usually it
consists of three components: surgical removal
neoplasms, chemotherapy and radiation therapy. TOогда применять
the last 2 types of treatment – only after surgery, instead of surgery
or before and after it – the oncologist decides after the examination.
A vaccine that could cure papillomavirus infection
is under development.
Given the danger of human papillomavirus infection and its significant
prevalence, against human papillomavirus was
several vaccines were synthesized:
- �”Gardasil”: directed against 16, 18 (cause cancer not only
cervix, but also the vulva, and vagina, and penis, and anus),
as well as 6 and 11 (provoke the development of genital warts) types
- �”Gardasil 9″: against 6, 16, 11, 18, 31, 33, 45, 52 and 58 strains
- «Церварикс»: направлена против 16 и 18 типов virus.
All of these vaccines are certified and passed the appropriate
checks. They do not contain the viruses themselves, but individual proteins,
contained on the capsule of these virus strains, therefore, cause
disease can not. They are recommended to perform even before the period
puberty – in 9-14 years, that is, until such time as
the child is presumably not familiar with the virus. Clear yet
recommendations only concern girls because cervical cancer
It occurs only as a result of infection with this virus, and it is distinguished
extremely high mortality. Boys also vaccinated in the same
age, but if girls can use all types of vaccines,
boys – only “Gardasil”.
For complete immunization, a triple dose of any of
vaccines. They are not interchangeable, so if started
vaccination “Gardasil”, then you need to continue re-introduction
it is this vaccine. The manufacturers of each vaccine state that
a month after the first dose,
100% protection against the viruses that are included.
But in order to form a stable immunity, you still need
triple administration of these drugs. Vaccinate
advisable to 25 years.
Both Gardasil and Cervarix differ in very high cost.
So, одна доза первого препарата стоит около 6,5 тысяч рублей, а
second – about 5.5-6 thousand rubles.
TOазалось бы, каких только денег не найдешь, чтобы уберечь
child from such a serious cancer. Тем more,
что в некоторых странах мира, а также в 18 штатах WITHША введение
одной из вакцин введено в Onциональные календари прививок. But there is
- according to research, vaccines reduce, but do not prevent
completely risk of developing cervical cancer;
- according to official data, 8% of all adverse events (or 0.003%
from all vaccinated), observed during vaccination, accounted for severe
side effects: death, disability, diseases that threaten
life and health. Also reported the death of 56 vaccinated
adult women, but no association with the vaccines themselves was found;
- In response to the vaccine, some adolescents responded
the rise in temperature to high numbers, which provoked them
convulsions, some – breathing problems, which is fatal
dangerous. It is felt that such a reaction could be observed
in carriers of a particular gene. In this case, before vaccination study
the human genome is not carried out, so find out if the child is
carrier of this gene is impossible;
- after vaccination was registered Guillain-Barre syndrome –
paralysis disease (often reversible)
legs and arms, muscle weakness and their complete “disconnection” can affect
all muscles, including respiratory;
- cases of increased risk of thromboembolism. This is a complication.
noted in 56 people, of whom 19 people had thromboembolism
pulmonary artery, because of which 4 people died;
- It is not known how vaccination affects fertility and gestation.
pregnancy: too little time has passed since vaccination
first groups of girls.
On the one hand, while there is evidence that
vaccinated women for at least 5 years
normal (according to Pap test) state of the cells of the cervix. WITH
On the other hand, on the long-term results of vaccination
early. In any case, if “from the earliest nails” to teach a girl that
preventive examinations, including at the gynecologist – this is her
benefit, you can expect that any disease can be detected
at an early stage.
So whether to vaccinate your own child or not,
Автор: TOривега Мария WITHалаватовна врач-реаниматолог