Human Papilloma virus HPV

Papillary wart virus HPV

Recent developments in its causes, diagnosis, treatment and prevention

Human wart virus (HPV) is one of the viruses that belong to the group (PAPOVA), and this virus, which contains (DNA), spreads by skin-to-skin contact, especially during foreplay or sexual intercourse of any kind, as this is transmitted sexually. Global statistics Thirty million people are infected annually all over the world with this virus in the sexual region alone, and six million new infections with this virus occur annually in the United States of America and eight hundred thousand infections in Europe, and the annual prevalence of infection with this virus among women of all ages (% 26.8), while the annual prevalence of infection among women between the ages of twenty and twenty-four increases to (44.8%).

There are a hundred types of this virus, and the infection of the two types (11, 6) is the most prevalent and is not a component of tumors and is considered one of the human papillary viruses of low risk. The infection of this human papillary wart occurs in the sexual area as well as in the respiratory system as well. High-risk human papillomatosis is due to both types (16, 18) In addition to the types (31,33,35,39,45,51,52,56,58,66,68,69,73,82), and that their presence was diagnosed in cells of malignant tumors in women in the cervix, vagina or vulva, and this The latter includes (labia, labia major and small, pubic duct, clitoris, perineum, and vestibule of the vagina), knowing that the incidence of these two types (16, 18) may lead to the formation of cervical cancer by 70%, and that twelve thousand new cases of this cancer as a result of infection of these two types Of the virus diagnosed annually in the United States of America, and unfortunately, four thousand infected women die annually as a result of this, knowing that the incidence of penile cancer in men, and the incidence of exit cancer in men and women may be caused by infection with these two types of virus (16, 18) as well. It may also be caused by other types of high risk mentioned earlier.

Risk factors:

There are reasons that lead as risk factors to infection with this virus if the sexual partner is infected with it, and they are:

Having sex without a condom.
Women taking contraceptives.
Smoking: Recently, research and clinical studies indicated that one of these factors leading to infection with this virus is smoking, because it leads to a rise in the rate of tissue imbalances in the sexual area and then to the infection of malignant tumors in the genitals of both men and women.
Immunosuppression
Having a sexually transmitted disease (STD).
Multiple sexual partners.

Symptoms:

Most of these injuries may be asymptomatic, but this wart may cause pain, burning, itching, or local bleeding in the area of ​​the wart itself.

There are symptoms that women infected with this virus may complain about, especially vaginal itching or painful secretions, but in general the symptoms in patients with warts of this virus are the appearance of papillomas in the genital or sexual area, and initially it is a small warty tumor that spreads in men in The scrotum, the perineum, the body of the penis, or the external opening of the urethra, and it spreads in women to the vulva (labia major or small), vagina or cervix.

As for the latent period of infection with this virus (which is the time period from the first day of infection to the appearance of pathological symptoms, including the wart in the genital or sexual area, and it may extend from three weeks to eight months

Diagnosis:

Clinical examination of this viral disease usually begins with an examination of the sexual and genital area and the search for papillary-looking papillary tumors by a magnifying glass (x5). To diagnose the type of wart and its degree of severity in the laboratory, it is done recently by using a swab taken from the surface of the wart to diagnose the type and degree of severity of the DNA sequence of the type of human papillomavirus. This is done by the polymerase chain reaction method. (PCR)

treatment

Research and clinical results of global epidemiological diseases have shown and proven that there is a common factor between infection with this type of virus (16,18) and infection of the sexual partner (wife) with cervical cancer; Since this virus (HPV) is one of the most prevalent sexual diseases in men and women, and at the same time, its high rate of presence in the case of infection within the mosaic epithelial cells in the sexual area, it is also possible that a man infected with this virus will be exposed to penile cancer or cancer. urethra، In addition to cervical cancer, the affected woman is exposed to vaginal or vulvar cancer. As for the exposure to cancer of the outlet, it is due to not undergoing early treatment to remove the wart and to undergo protection from this virus by vaccination against this infection or its recurrence.

As for the modern and effective treatment at the present time, it is laser wart removal under local anesthesia

A few years ago, we were able, globally and locally – praise be to God – to eradicate this wart and the resulting tumors by vaporizing them with a laser beam, with a success rate of 72%, and the rate of its growth and recurrence is 28%, and there are recent clinical studies that indicate the success of topical treatment in the case of The recurrence of the wart despite its laser removal, especially in women. The most widely used one at present is Imiquimod ointment.

Where this drug leads to cellular adaptation within the human papilloma virus, leading to the secretion of a mobile substance (cytokine) inside the cell, thus reducing the multiplication of the virus inside it, where it is eliminated after that, and the cure rate for women is 77% and for men 40%, as for the other ointment The so-called sinecatechins, it is a compound consisting of an antioxidant and an antiviral, the use of which leads to the activation of cellular autoimmunity and then the elimination of the virus, and the cure rate is 52%.

As for the two new vaccines, they have a quadruple efficiency of vaccination against these viruses, as these contain the protein (L1), which is the largest capsid protein of this virus. To be of quadruple vaccinating efficiency against the virus, and the first vaccine is commercially called Gardasil,This vaccination protects research and clinically from infection with the papilloma virus type (6,11,16,18), and also protects by 40% of infection with the types (31,33,35,39,45,51,56,58,59) and that The preventive efficacy of this vaccine against the recurrence of infection with these types of human papillary viruses may last up to six years, and the second and new vaccine is called commercially (Cervarix) has proven to be protective against the papilloma virus that causes cervical cancer of types (16,18,31,45). The vaccination of these two types of vaccine is done by injecting them into the thigh muscle or the shoulder, and this vaccination is done at separate intervals from each other and during three periods where the Gardasil vaccination begins immediately after treatment and after two and six months,As for the Cervarix vaccine, vaccination also begins immediately after treatment, one month later, and three months later. It is currently recommended that women between the ages of 65-21 undergo a Pap smear (PAPSMEAR) every three years to detect cervical cancer.

Prof. Dr. Samir Al-Samarrai

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