HPV infection is a contagious disease, the causative agents of which affect the skin and mucous membranes of the urogenital tract.
Virus infection routes
The most common type of virus transmission is direct contact with the skin or mucous membranes of a sick person or carrier, provided the recipient has minor injuries or abrasions on the skin. Consequently, the main routes of infection are through sexual and domestic (through dishes, pools, public transport, etc.).
Through the damaged skin and mucous membranes, the virus is invaded with further damage to rapidly dividing cells. Microorganisms have two main effects on the human integument:
- Transforming. It is based on a change in the structure of epithelial cells, which, over time, can result in cancer.
- Productive. It consists in the development of neoplasms of a benign nature (flat warts, papillomas and genital warts).
It should be borne in mind that a particular type of virus has its own specific picture of the disease.
With damage to the skin by human papilloma viruses, one of the following diseases can develop: plantar, ordinary or flat warts, papillomas. Neoplasms have a different shape (round, convex, scalloped) and color (from pale pink to dark brown), the diameter usually does not exceed 1 cm, and multiple growths can be found on the surface.
In the case of infection of the skin and mucous membranes of the organs of the reproductive system, there are:
- genital warts – growths on the mucosa of a triangular shape, prone to grouping and having a pale pink color;
- carcinoma – a malignant tumor from the mucous glands;
- papillary condylomas – are localized on the skin of the external genitalia and have the appearance of a smooth rounded shape of the element with or without pigmentation;
- papule-shaped condylomas – are most often located on the skin of the scrotum, foreskin and coronary sulcus, and not rarely – around the anus. They are characterized by the presence of pigmentation and the absence of protrusions on the surface;
- keratotic warts – found in dry skin and have a thickened tire that rises above the level of the skin;
- non-condylomatous lesions.
Cases of lesions of the mucous membrane of the tongue, oropharynx, esophagus, bronchial tree, rectum and conjunctiva are recorded. Most often, the infection occurs in a latent or subclinical form, manifest is much less common and directly correlates with the state of human immunity.
There are several approaches for the treatment of established HPV infection, which are often used comprehensively:
- The use of cytostatic drugs, chemicals in order to destroy neoplasms.
- Local and systemic immunomodulators that stimulate the human immune function.
- Physical methods for removing warts and other papillomatous growths (laser destruction, cryodestruction, electrocoagulation, radiosurgical destruction).
- Operative excision.
Cytostatic drugs in this case are used only locally, that is, on the neoplasm itself. This can be a cream or solution that must be applied to the area with rashes twice a day. The treatment is usually course: the medicine is used for three days, after which a break is made for 4 days; such courses may be 4-5. However, not all cytostatics can be applied to the perianal region, the mucous membrane of the rectum and urethra.
The destruction of pathological cells is also possible using a combination of chemicals (lactic, oxalic, acetic and nitric acid, with the addition of copper nitrate). The mixture is applied exclusively to the affected area with a glass capillary or spatula, only once. This method is suitable for foci not larger than 5 cm 2 . If necessary, re-application – the procedure can be repeated no earlier than 1-4 weeks.
Stimulation of immunity
Recombinant interferons have been clinically proven in the treatment of HPV infection. After the introduction of such drugs in the patient’s blood, the concentration of antibodies aimed at the destruction of viruses increases. They are administered rectally, subcutaneously, intramuscularly or intravenously. The effect should be expected only after prolonged systematic treatment. A number of authors indicate a regression of rashes due to local use of interferons, although in practice the percentage of such patients is quite low.
Systemic immunotropic drugs activate the synthesis of their own beta and alpha interferons, mobilize macrophages, inhibit the multiplication of viruses in the macroorganism and the production of inflammatory mediators (cytokines, in particular). Their effects also include increasing the body’s resistance to the effects of bacteria and viruses, as well as stimulating the biosynthesis of its own antibodies against pathogens. Therefore, these drugs at a high level help to cope with the disease.
- Laser removal involves the use of a carbon dioxide or erbium laser, each of which is highly accurate. Destruction of neoplasms occurs under the influence of laser pulses, the depth of which is adjusted by the doctor. “Evaporation” of pathological sites occurs. As a rule, 1-2 procedures are enough (10-30 minutes each). The method is great for removing warts on delicate and sensitive skin (scrotum, penis, eyelids).
- Cryodestruction is based on the removal of growths with liquid nitrogen. This is a kind of freezing of pathological tissues. Exposure to low temperatures (from -180 ℃ to -196 ℃) leads to necrosis of the neoplasm, followed by its rejection. After measuring the diameter of the formation, the doctor applies a cotton swab (impregnated with nitrogen), the size of which is larger by about 1 mm, an average of 180 seconds. It is possible to use an apparatus – a cryodestructor, which is also pressed against a wart or condyloma for no more than 2 minutes.
- Electrocoagulation The technique is based on the use of high-frequency current discharges emitted by a special apparatus. As a result, a high temperature is created in the tumor cells, which contributes to the destruction of proteins. A dead wart is covered with a dense crust, under which normal epithelial tissue grows, displacing the neoplasm. The epithelialization process usually takes 10-14 days.
Surgical excision is performed only by a surgeon after preliminary processing of the skin with rashes. After surgery, a sterile dressing is applied to the wound, requiring regular change.
In most cases, physical or surgical removal of growths alone is not enough, because the virus remains in the blood. This leads to the fact that therapy should be combined. That is, along with cryo- or laser destruction, systemic immunotropic drugs are prescribed that translate the virus into an inactive state.
Despite the abundance of ways to get rid of papillomatous neoplasms, none of them guarantees a 100% cure. It is proved that the effectiveness of therapy, first of all, depends on the state of the T-cell component of the patient’s immunity, and only then on the treatment regimen.