Human papillomavirus: Diagnosis and Treatment

Human papillomavirus (HPV) is a DNA virus, which promotes active cell division of organism. This leads to appearance of genital warts, warts and papillomas on the skin. Experts have identified more than 100 types of HPV, each of which has a different degree of carcinogenicity. HPV has chronic form with constant relapses. The carrier of papillomavirus is every sixth human.

Content:

1. HPV diagnosis.
2. Treatment of the disease.
1. Papilloma removal.
2. Medicament therapy.
3. Prevention of HPV.
4. References.

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The greatest danger of infection is the possibility causing development of a malignant tumor. Therefore, timely diagnosis and treatment of human papillomavirus infection minimizes the risk of cancer.
Given the danger of this infection, consider the modern methods of diagnosis, treatment and prevention of the disease.

HPV diagnosis.

In recent years, specialists note significant progress in diagnosis and treatment HPV infection. HPV diagnosis consists of several stages:

• Examination by a gynecologist / urologist or a dermatologist. The doctor conducts a standard examination of the patient.

• Cytological examination. Gynecologist takes a smear during the examination of woman. This method of research is called “cytology” or “liquid cytology”. The specialist identifies the presence or absence altered cells. Normally, they should be absent. Cell mutations appear only with the development of the disease.

The HPV test isn’t recommended as routine screening for women under the age of 30. This is because, by age 30, many women will have some strain of HPV. Most of these will clear spontaneously without intervention. However, if their Pap test showed abnormal cells, the HPV test would be done to assess their risk of more serious conditions, including cervical cancer.[1]

• Histological examination. The specialist examines a piece of tissue taken during the study. Another name of the survey is “biopsy.” A doctor examines under the microscope the degree of tissue change.

• Digene-test. A new study, which gaining popularity in medicine. Experts use the test to determine the presence significant concentrations of the virus. Due to this, doctor can identify the degree of oncogenicity viruses in the patient's body. Experts, as rules, use the Digene-test together with cytology.

• PCR analysis - the main method for the HPV diagnosis. Specialists take material for analysis from the cervix and vaginal mucosa of women, in men - from the mucous membrane of the penis. In rare cases, PCR may not give an accurate result, both false-negative and false-positive.

The HPV complex survey should include mandatory testing for the diagnosis of syphilis, HIV and hepatitis.

Treatment of the disease.

Is't possible to cure HPV? Currently there is no medications, which can kill the HPV virus. Therefore, doctors spend complex treatment. HPV can affect various parts of the epidermis, so it should be treated only on individual basis. It's also worth noting, that a person who is sick or has an HPV virus should be regularly examined by a doctor.
Treatment of HPV infection can be divided into few stages:

• removal of warts or condylomas;

• drug therapy;

Such a treatment program is applicable only if there is no risk of formation a malignant tumor or sexually transmitted infections. In this case, the treatment program includes drugs to eliminate the underlying disease.

Papilloma removal.

Modern medicine uses different methods for quickly eliminate warts and papillomas. The main disadvantage of surgical removal is the high probability of recurrence, which is 45-55%. This is due to fact, that papilloma virus is often reactivated.
Modern methods of removing papillomas:

• Laser therapy. This method is one of the most effective and safe. The specialist removes papilloma under local anesthesia for 1 procedure without bleeding. This method can be used to treat pregnant women.

• Surgical intervention. Method is considered the most affordable, but it's possible the formation of scars. The surgeon removes papillomas with the help of scalpel after prior anesthesia.

• Electrocoagulation. The method involves the removal of tumors with the help of thermal effects of electric current under local anesthesia. After the procedure, an insignificant scar remains at the site of papilloma.

• Radio wave therapy. The method is considered the safest. Experts use a special radio wave knife, which cut papillomas. After surgery, there are no scars.

• Cryotherapy. The essence of the method consists in destruction of papilomas by liquid nitrogen. The procedure is painless. However, for remove some warts may require more than 1 procedure.
• Removal by chemical means. This method is one of the oldest. It's based on the destruction of neoplasm tissues by aggressive compounds. Specialists use podophyllin, 5-fluorouracil, podophyllotoxin, Solcoderm.

Experts encourage begin the course of immunostimulation before the removal procedure.

Medicament therapy.

The main method of dealing with the virus is drug therapy. It’s carried out to prevent new papilomas. Doctors prescribe drugs that destroy the virus cells and strengthen the immune system. Following medications demonstrate the most efficiency:

• Groprinosin or analogues. Antiviral immunostimulant in the form of tablets. Drug widely used all over the world to combat papilloma virus. The drug effectively fights with virus inside the body and quickly eliminates the external symptoms.

• Allokin-alfa. Antiviral immunomodulator. Specialists prescribe medication to patients with high oncogenic risk. The doctors introduce drug intravenously.

• Genferon. A powerful antiviral drug based on interferon, taurine and benzocaine, which helps to quickly recover from HPV and increase immunity.

• Viferon (ointment, spray). The drug is effective as a local immunomodulatory preparat. Viferon is used as part of a comprehensive course of treatment. The drug helps stop development of virus and get rid of external skin manifestations.

• Isoprinosine. Another representative of immunomodulators group. These pills strengthen immune system and enhance the effect of Allokin-alpha injections.

• Salicylic acid. Over-the-counter treatments that contain salicylic acid work by removing layers of a wart a little at a time. For use on common warts, salicylic acid can cause skin irritation and isn't for use on your face.

• Imiquimod (Aldara, Zyclara). This prescription cream might enhance your immune system's ability to fight HPV. Common side effects include redness and swelling at the application site.

• Podofilox (Condylox). Another topical prescription, podofilox works by destroying genital wart tissue. Podofilox may cause pain and itching where it's applied.

• Trichloroacetic acid. This chemical treatment burns off warts on the palms, soles and genitals. It might cause local irritation. [2]

Prevention of HPV.

The papillomavirus is transmitted in three ways: sexual contact, touch and during the birth of the child. Virus, once getting into the body, can be a long time in a latent state. Activation occurs only after reducing the ability of immunity to resist the pathogen. Most often, a person doesn't know about his illness, until it obvious external signs appear. Treatment for HPV in men and women takes a lot of time and effort. Doctors carry out various painful procedures for the removal of neoplasms. In addition, they prescribe the using variety drugs to combat the virus and restore immune protection. Experts stress that preventing HPV is much easier than treatment. There are several preventive methods to protect from HPV.

• normalize rest and sleep;

• consume enough fruits and vegetables;

• adhere to hygiene rules;

• engage physical training;

• lead active and healthy lifestyle;

• have only one verified sexual partner;

• maintain immunity in the cold season, taking vitamins and immunomodulatory agents. Excellent  immunity is one of the most effective methods of preventing various viral pathologies, including HPV;

In addition, experts recommend a special vaccination. It will help vaccinate a patient from the most common types of the pathogen — the 6th, 11th, 16th, and 18th. Grafting significantly reduces the risk of laryngeal papillomatosis, genital warts, cancer and erosion of the cervix in women.
HPV is widespread among humans. However, with early diagnosis and right treatment, this virus doesn't pose a threat to human life.
Today there are two vaccines of this type. The composition of these solutions includes not only microparticles of the virus, but its DNA. The infection can't spread and cause harm to a person. Nevertheless, these particles are enough for organism to develop immunity to them.

References.

The author used various information resources for writing the article. The most actual of them presented below:

1. Family doctor
2. Mayoclinic

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• 02.02.2019.The author has updated HPV prevention information by adding new material.