Is HPV type 16 treated in women? PCR test for HPV - what is it and how to take it? In this case, a contraindication for analysis is

HPV types 16 and 18 in women are an infection of papilloma (Human Papillomavirus), which can cause pelvic cancer. Representatives of the fair sex may not be aware of their pathological condition.

Often it is discovered only during a medical examination. The earlier the pathogen is identified, the greater the chance of a favorable outcome.

What are HPV types 16 and 18

Papillomavirus 16 and 18 increases the risk of malignant tumors in women. Such as dysplasia, cancer of the genital organs, vagina and cervix. Pathology is detected during gynecological screening.

Papillomavirus types 16 and 18 do not yet indicate a cancerous tumor, but increase the risk of its occurrence. The infectious process affects the mucous membranes and deep layers of the epithelium of the genital organs and the cervical canal. As a rule, the pathogen begins to develop in the body of women of reproductive age.

It is quite difficult to say how HPV 16 and 18 differ from other types in women. Externally, they are very similar to other papillomas. The difference exists in the genetic information of the DNA of HPV types 16 and 18.

There are 2 possible outcomes of the disease. Representatives of the fair sex either recover or die. It all depends on the body’s defenses, the stage of the disease at which effective therapy was started. Thus, if we talk about what HPV (papilloma) types 16 and 18 are, it is a pathogen that increases the risk of developing malignant tumors, usually leading to death.

Probability of infection

According to statistics, papillomavirus 16 causes cancer more often than type 18. The risk of developing cervical cancer when infected with the first type is 50%, with the second - 10%.

Moreover, in men, infection rarely provokes cancer. 90-95% of them are only carriers of pathogenic DNA HPV 16 and 18.

HPV types 16 and 18 may have the following routes of infection in women:

• sexually;
• vertical route of infection (in pregnant women, from mother to child during childbirth);
• through household items (especially personal hygiene products).

Reasons that can cause infection:

• frequent change of sexual partner;
• intimate intimacy without protection;
• from 5 or more sexual partners;
• entering into intimate relationships at an early age (before 16 years).

Factors that increase the risk of infection:

• abortion;
• inflammation in the vagina and uterus;
• STI;
• vaginal dysbiosis;
• gynecological pathologies of a chronic nature.

Experts have noticed that usually females with this pathology have concomitant diseases. Such as chlamydia, ureaplasmosis and others.

Stages of the disease

Papillomavirus in women 16 and 18 has four stages of development:

• Initial (incubation). It is asymptomatic. The exact duration of this stage cannot be determined. It all depends on the type of infection, the individual characteristics of the patient’s body, and the nature of the pathology. The pathogenic microorganism is latent, since it does not change the structure of cells, but is already amenable to diagnostic examinations.
• Second phase. Characteristic formations appear on the skin. During this period, the active development of pathogenic microorganisms occurs.
• Dysplasia. There is a combination of microorganisms that cause pathology and the DNA of human cells. This is a precancerous condition.
• Fourth stage (malignant). This is the final stage of development. During this period, cancerous tumors are already diagnosed.

The earlier the disease is detected, the easier it will be to cure it. Therefore, it is recommended to periodically get tested for the presence of pathogen varieties. Especially those who are predisposed to it.

Symptoms

Manifestations of a pathological condition in a person can be different. It all depends on the strain. As a rule, in humans, when the papilloma virus begins to develop in the body, warts appear in the external and internal genital organs. During intimacy, bleeding is observed. All this is accompanied by the following symptoms:

• burning and itching in intimate places;
• disruption of urine output;
• pain during intimacy.

However, these symptoms may indicate the presence of many diseases (cystitis, urethritis, etc.). Without special tests, the disease cannot be distinguished from other pathologies of the genitourinary system. T Only after a complete diagnosis can a doctor make an accurate diagnosis and prescribe the necessary treatment.

Diagnostics

If you suspect papillomavirus types 16 and 18, you should consult a gynecologist for diagnostic tests. First of all, the doctor collects an anamnesis of the disease (how long ago the symptoms appeared, what pathologies close relatives suffer from, etc.). After this, an examination is carried out on a gynecological chair (external manifestations are examined). Using special mirrors, the cervix and vagina are examined. In addition, biomaterial is collected for analysis.

Screening is performed to detect infected cells. This analysis of HPV 16 and 18 allows you to detect pathological changes even without external signs. After this, PCR is prescribed - this is an analysis to detect the DNA of an oncological virus. The purpose of the polymerase chain reaction is not only to identify the pathogen, but also to typify the infection. It is important to know how the analysis is taken. It is collected using a smear from the cervix. 2 hours after the last trip to the toilet. A negative indicator means that no pathogenic microorganisms were detected. Positive that you may be infected.

Quantitative reference values ​​may be shown erroneously. Additionally, the following diagnostic examinations may be prescribed:

• colposcopy (examination of the cervix);
• special tests with ethanoic acid, Lugol's solution;
• digene test (test rate is below 100 thousand pathogen copies/1 ml of material).

If the presence of a pathogen is detected, the woman is prescribed an additional examination to identify concomitant diseases that are sexually transmitted.

Treatment

Treatment of papilloma viruses (HPV types 16 and 18) must be carried out. Even if there are no clear symptoms of the pathological condition. If you do not start the necessary therapy, the risk of cancer increases significantly. Therapeutic measures are aimed not only at eliminating external signs, but also at suppressing the activity of the pathogen.

Complex therapy is used to treat human papillomavirus. If a pathogen is detected, the following techniques are used:

• Medication. Local and general medications are prescribed. The specialist determines what to treat based on the degree, progression of development and individual characteristics of the woman. The list of drugs for HPV is extensive.
• Invasive. The method is based on surgical removal of growths.
• Folk. These methods can be used only after the recommendation of a doctor. He will tell you what you can do and what not, based on your individual characteristics.

Patients often worry whether human papillomavirus types 18 and 16 can be cured. It is impossible to completely get rid of the disease. But if therapy is started on time and the treatment regimen is correctly selected by a specialist, then the pathology will not provoke the development of oncology.

Consequences of deletion

Surgery is usually prescribed for grade 2 and 3 dysplasia. At stage 1, conservative methods are used. In women with stage 2 HPV, treatment is also carried out with medications. If therapy does not bring any results, surgery is prescribed. The following methods of mechanical removal of growths can be performed:

• cryodestruction;
• radio wave therapy;
• diathermocoagulation.

Patients are very worried and ask the doctor what danger lies behind surgery. At stage 2 of dysplasia development, 2/3 of the epithelium is affected. The operation will not cause loss of reproductive function. At stage 3 of pathology development, most of the cells are affected. In this case, the reproductive organ may be completely removed. As a result, the woman will not be able to get pregnant.

How to live with this virus

Many patients who have been diagnosed with a pathogenic microorganism do not know how to live with it further, because it is not completely curable. Don't despair and give up. Despite the fact that papilloma 16 and 18 is a terrible disease that can lead to dire consequences, it is still possible to avoid cancer with adequate treatment.

After treatment has been carried out and pathogenic microorganisms have been suppressed, the following recommendations must be followed to prevent the risk of relapse:

• Eat rationally. Consume foods that contain beneficial elements. To strengthen the immune system, take vitamin complexes.
• To increase the protective functions of the body, do morning exercises and hardening procedures.
• Treat all diseases in a timely manner. Do not let them become chronic.
• Regularly attend antenatal clinics.
• Lead a measured intimate life. Select sexual partners carefully. Use contraception.

Although there is no way to cure the pathology completely, malignant neoplasms form only under certain circumstances. If you follow all the recommendations listed above, you will be able to reduce the risk of cancer to a minimum.

If you have not been infected but are concerned that you will, you are advised to routinely get vaccinated against the pathogen. Follow all the recommendations described earlier. All diseases in the human body develop due to weakened defenses of the body. Strengthen your immune system, watch your lifestyle, and then you won’t be afraid of any infection.

Video

HPV 16 in a woman - how to live after infection.

Human papillomavirus type 16/18, HPV 16/18- qualitative detection of human papillomavirus of high oncogenic risk in scrapings of the urogenital tract, using the polymerase chain reaction method with real-time detection.

The PCR method with real-time detection of results allows you to determine the amount of DNA of clinically significant HPV types in a sample.

Human papillomavirus (HPV)- a widespread infectious disease of the genitourinary organs, which can cause cervical cancer in women and squamous cell carcinoma in men.

Different types of HPV cause the development of:

• cervical, vulval, vaginal dysplasia of the cervix;
• pre-invasive and invasive cancer of the cervix, cancer of the vagina and perianal area;
• genital warts, urinary tract;
• genital warts.

According to some researchers, the frequency of infection with the virus is directly proportional to the number of sexual partners: with one partner, HPV is detected in 17–20% of women, with 5 or more partners - in 70–80%.

Incubation period
The incubation period can last from 2 months to 2–10 years. HPV is characterized by a latent course of the disease, in which there are no clinical manifestations and no changes are detected during colposcopic, cytological and histological examination. In 30% of cases, the virus can be cleared within 6–12 months. Diagnosis of latent HPV infection is carried out only by PCR.

Clinical manifestations
HPV can affect the epithelium in different ways: contribute to the emergence of benign formations (papillomas, condylomas) or the combination of papillomavirus DNA with the cell gene, which leads to dysplasia and neoplasia, and subsequently to cancer. The most common area of ​​cancer localization is the transition zone of the cervix to the cervical canal.

Clinical forms of human papillomavirus infection are found in 40–60% of men who are sexual partners of infected women. Their lesions are caused by the same types of HPV as women. In 2/3 of cases, characteristic rashes appear on the skin and mucous membranes of the genital organs.

Indications for the study:

• persons being tested for other STIs;
• women with a burdened obstetric and gynecological history - manifestations of transforming dysplasia to varying degrees;
• men according to clinical indications;
• weakened immunity;
• preventive screening studies.

Women
Submitting scrapings is not allowed on menstrual days. Avoid taking antibiotics two weeks, and three days before taking - vaginal suppositories, tampons, spermicides. One day before the test, you should not have sexual intercourse. You should not douche on the eve of the examination. After an ultrasound using a transvaginal sensor, at least 48 hours must pass.

Interpretation of results
The format for issuing the result of HPV type 16/18 is detected/not detected.

Reasons for the positive result:

• the presence of HPV genotypes 16 and 18 in the studied material, which is associated with a high risk of developing cervical cancer and other neoplasms of the anogenital area.

• the absence of HPV genotypes 16 and 18 in the studied material, which does not exclude the possibility of infection with HPV of other genotypes.

• A false negative result is possible if the material is collected and stored incorrectly, as well as if the virus content in the material is below a detectable level.
• A false positive result may be due to contamination of the material.

• HPV infection does not always lead to cervical cancer.
• Simultaneous infection with several HPV genotypes is possible.
• The result of the analysis must be interpreted taking into account the conclusions of cytological and histological studies.

Papillomavirus type 16 is one of the most dangerous microorganisms that affects a person’s weak immune system, regardless of age or gender. The danger of the disease lies in the fact that symptoms of the pathology appear only several months or years after infection. People who pay little attention to their health are at high risk for developing HPV infection.

It is important to note that papillomavirus has been known for a long time. To date, experts have identified approximately 600 strains of HPV (HPV). In medicine, type 16 papillomavirus is recognized as the most dangerous. It can cause the development of malignant tumors of the cervix in women. In addition, the above type of virus is capable of infecting the mucous membranes and skin of the male genitalia, thereby provoking the occurrence of malignant tumors of the penis. In men, HPV type 16 can be detected at any age, starting from puberty. Often, infection occurs in early childhood, when the virus penetrates through damaged areas of the skin.

Mechanisms of development of HPV infection

During infection, HPV is able to invade a defenseless body and spread to the outer layers of the skin and mucous membranes. Subsequently, the virus remains in the cells, which, under certain conditions, contributes to the formation of carcinoma.

In the body, human papillomavirus type 16 spreads throughout the circulatory system and contributes to disruption of the function of cellular structures. Next, the process of growth and very rapid division of infected cells begins, which leads to the penetration of the virus into the skin and mucous membranes.

The most common manifestations of HPV infection are neoplasms such as condylomas and warts vulgaris. A viral infection can also cause the formation of warts, both benign and malignant.

Quite often, after infection, the human body may not show obvious signs of HPV genotype 16. In such circumstances, only examination can identify the disease. The basis of diagnosis is the detection of DNA of HPV 16, 18 and other types using PCR.

Routes of infection

Methods of transmission of infection:

• contact-household route (the virus penetrates through microtraumas on the skin),
• sexual intercourse (you can become infected during sex - viruses that provoke the development of papillomas on the genitals can be transmitted to one of the partners),
• self-infection (HPV spreads to healthy areas of the skin during hair removal),
• from mother to fetus (in children, growths are observed on the genitals, at the anus, in the mouth and larynx).

In women, the disease can manifest itself in the form of various condylomas on the cervix. Infection occurs through direct contact with the skin or mucous membranes of a virus carrier. A gynecologist can identify the disease during an examination.

Symptoms

HPV 16 may not appear for a long time. Over time, new growths begin to appear on the surface of the body in the form of warts and other growths. At the initial stages, benign round-shaped elements with a diameter of approximately 10 mm appear. The shade of the growths can be either light or almost dark. Favorite localizations are knees, fingers, elbows.

The most common sign of the disease is small flat warts. They can occur on the skin, on the surface of the mucous membranes or genitals of the patient.

HPV 16 can lead to the development of a dangerous disease called bowenoid papulosis. This pathology can cause irreversible changes in the patient's body. The disease manifests itself in the form of erythematous spots, papules or plaques on the genitals, perineum, perianal area and thighs.

Papillomavirus genotype 16 appears more often in women. The disease can be detected when a flesh-colored rash appears on the genitals, and later on the thighs. The volume of rashes and the speed of development of clinical manifestations are determined by the state of immunity.

Diseases caused by HPV type 16

The above ailment is expressed in the form:

• flat warts,
• bowenoid papulosis,
• vulgar growths,
• epidermodysplasia verruciformis,
• plantar growths,
• laryngeal papillomatosis,
• genital warts.

Common warts are contracted through household means. Vulgar growths are more common in adolescents and are localized on the hands. Self-healing is possible when immunity is normalized. Many children may not even be aware of the presence of papillomavirus and live with it all their lives.

A distinctive feature of flat warts is that they are almost invisible on the skin and are small in size (up to four millimeters).

Plantar growths lead to thickening of the skin and have unclear boundaries. When these warts grow deeply, they can cause pain while walking.

Epidermodysplasia verruciformis can be characterized by the presence of abundant, flat, pink rashes. Most often, this pathology occurs in adolescents who are genetically predisposed to it.

Anogenital warts develop in men on the head of the penis, partially affecting the foreskin. In women - in the vestibule of the vagina, on the labia, at the anus.

Laryngeal papillomatosis occurs in children under five years of age who are infected with HPV infection during childbirth. The main symptom is hoarseness and difficulty swallowing (dysphagia). If there are a large number of tumors, shortness of breath and other breathing problems may occur.

Specifics of the course of HPV infection

HPV 16 in men usually leads to the formation of growths in the anus and penis. This type of tumor often degenerates into cancer. In men, the development of recurrent respiratory papillomatosis is also noted. With this pathology, benign elements are located on the vocal cords, larynx and trachea.

In women, as a rule, there is an asymptomatic course of the disease. In most cases, anogenital warts occur in females who have an active sexual life, in the age group from 17 to 36 years. From the age of 27, it is recommended to regularly undergo tests (cytological examination) for papillomavirus, especially for types 16, 18 and 52. This will allow the disease to be detected at an early, completely curable stage.

It is important to note that women can be carriers of the virus for many years. And only after menopause the infection can manifest itself in the form of malignant tumors of the genitals. For women, HPV 16 may pose an increased threat, since it is this type of virus that leads to the formation of cervical tumors.

Therapy methods

Many people are interested in the answer to the question: if HPV is detected, what to do and how to treat it correctly? If HPV type 16 is detected in women, treatment should be comprehensive. Local treatment consists of removing anogenital warts using one of the methods popular in dermatology. So, you can get rid of growths using the following methods:

• cryodestruction,
• surgical intervention,
• laser therapy,
• radio wave method.

Systemic therapy is based on the use of antiviral and immunostimulating drugs. They are taken in the early stages of the disease with weakened immunity, based on the results of the immunogram. By prescribing one such medication (for example, Isoprinosine or Groprinosin), the doctor can solve two problems at once - suppress the activity of the virus and significantly strengthen the body’s protective functions.

To strengthen the immune system, the following also play an important role:

• hardening procedures,
• fighting bad habits,
• availability of adequate and constant nutrition,
• performing therapeutic exercises.

The treatment regimen also includes external antiviral agents. These are primarily ointments based on the substance acyclovir - the medications Zovirax, Acigerpin and others. These products have a delicate effect on the skin, which prevents burns.

How to treat when HPV leads to cancer? In such circumstances, it is recommended to go through:

• Operation.
• Radiation therapy.
• Chemotherapy.

Medical experts are not ready to confirm the existence of drugs that can permanently cure a person from HPV. At the same time, complex therapy with immunomodulators and antiviral drugs, as well as removal of growths in various ways, has positive results confirmed in practice in the form of persistent remission of the disease.

The icosahedral nucleocapsid of the papilloma virus contains fragments of double-stranded DNA, for the replication of which it requires foreign proteins. HPV gains access to them by invading human cells by endocytosis of the cell receptor, and forms its shell from cell membrane proteins. At the same time, type 16 virus is characterized by integration into the genome of a cell, and penetration into its nucleus is a necessary condition for replication. But if a person’s immunity is strong enough, the virus remains in the cell in the so-called episomal form.

Replication of HPV 16 occurs in the epidermis, more precisely, in the basal cells of the stratified squamous epithelium of the stratum corneum of the skin and the cells of the squamous non-keratinizing epithelium of the mucous membranes, in which the process of cell mitosis and migration constantly occurs. Obviously, a favorable factor for this virus is the looser intercellular matrix of the epithelium of the genitals, perineum and perianal area, as well as local high humidity.

In addition, the cells of the surface epithelium of these areas are quite often subject to microtrauma (abrasions), and many experts are confident that damage to HPV 16 with its activation occurs only when the epithelial barrier is broken. Moreover, being an opportunistic infection, HPV takes advantage of the fact that cellular immunity can be significantly weakened by bacteria often present in the anogenital area, in particular when chlamydia or ureaplasma and HPV 16 are combined, as well as other viral infections, for example, herpeviruses.

The pathogenesis of malignancy induced by HPV consists of the interaction of the primary viral oncoproteins E6 and E7 with the nuclei of anti-oncogene cells (tumor suppressor proteins p53 and pRb), due to which these cells degrade and cease to perform their protective function. And then the neoplastic process begins: the cell cycle changes, control of cell growth is lost, the rate of their proliferation increases, and mutations occur in cell structures. Ultimately, this leads to the development of dysplasia or a tumor.

Pathogenesis

HPV is an epitheliotropic DNA virus of direct action, that is, when it penetrates an epithelial or mucosal cell, the virion integrates into the genome of a human cell and combines with it, forming a special latent form. In this form, it can remain in cells for a very long time without causing any symptoms (for more details, see below in the Pathogenesis section).

HPV infection is very common, but in 80-90% of people, the immune system is able to cope with it on its own, and the person may not even realize that he has been infected with this virus.

But sometimes the virus openly reveals its presence. More than 30 strains affect the mucous membranes of the genitourinary tract and the epidermis of the anogenital area. Thus, low-risk serotypes (HPV 6, 11, 42, 43 and 44) ​​can cause genital warts with frequent involvement of the perianal zone; they can also provoke the development of respiratory papillomatosis. And the highest risk serotypes – HPV 16, 18, 31, 45 – are associated with cervical lesions with a high probability of developing into cervical cancer.

Therefore, how HPV 16 is transmitted is clear: it is sexually transmissible, that is, sexually (including all types of sexual contact). Moreover, hidden HPV, even without external signs, is also transmitted to a sexual partner. And unprotected sex increases the likelihood of infection by 75%. As a rule, in two thirds of people who have sexual contact with a partner infected with papillomavirus, genital papillomas may appear within two to three months.

How is HPV 16 transmitted?

Although the sexual tract is not the only way HPV spreads: all its serotypes are extremely contagious and can be transmitted through contact with infected mucous membranes or dermis. Presumably, the infection can spread from one part of the body to another: gynecologists believe that the virus can first infect the cervix and then spread to the vagina and vulva.

A natural question arises: is HPV 16 transmitted through saliva? Viruses associated with benign and malignant lesions of the skin and mucous membranes cause oral papillomas, and in at least 90% of cases, HPV type 16 is involved in the development of oropharyngeal cancer - squamous cell carcinoma of the throat. So virologists believe that saliva may play a role in transmission. Although experts from the American Cancer Society claim that this virus does not spread through any biological fluids.

The main risk factors for HPV 16 infection include weakened immunity, early onset of sexual activity, multiple sexual partners, decreased pH (acidification) of the body, and the presence of inflammatory diseases of the genital area. Smoking and long-term use of oral contraceptives also reduce resistance to papillomaviruses.

Incubation period

The incubation period after infection with dermatotropic HPV serotypes - with manifestation in the form of papilloma or genital condyloma - varies from several weeks to a year. However, most warts appear within two to three months.

With oncogenic papilloma viruses, everything is much more complicated. The incubation period for HPV 16—for signs of malignant transformation of cervical cells to begin to appear—is quite long. Studies have shown that the average incubation period from initially diagnosed HPV 16 to diagnosed low-grade dysplasia (intraepithelial neoplasia) of the cervix is ​​5 years, and to cervical carcinoma in situ - 12-15 years.

It is believed that this virus may remain latent or persistent for even longer, which increases the likelihood of infecting sexual partners throughout their lives. And how long people live with HPV 16 depends on whether it manifested itself, causing the development of cancer, or not. But the very presence of this virus - with asymptomatic or subclinical existence in the body - does not affect life expectancy in any way.

One should keep in mind the widespread latent carriage of HPV 16, which can only be detected by partial genotyping using polymerase chain reaction - when the patient is tested for STDs. In such cases, according to several foreign studies, the positive result of the asymptomatic presence of the virus can be 27-44%.

Epidemiology

According to some estimates, from 50 to 80% of men and women of sexually active age will eventually become infected with HPV...

According to the latest WHO data, two-thirds of all cases of precancerous conditions and cervical cancer are caused by types HPV 16 and HPV 18. And experts from the American Cancer Society say that this type of virus is detected in 90% of patients with this diagnosis.

CDC statistics provide the following official figures: in the United States, 6.2 million new people are infected with all types of HPV every year; Currently, 79 million Americans are infected with papillomavirus, of which 20 million are infected with the HPV 16 virus, and these are people of reproductive age. Up to 20% of patients with genital papillomas and condylomas have other sexually transmitted diseases.

The prevalence of HPV 16 in women (about 18%) is twice as high as in men (8%).

According to the Journal of Virology, every day about 12 thousand Americans aged 15 to 24 years old become infected with HPV. Of these, approximately 0.1% are HPV type 16.

Also, this virus (in combination with HPV 31) in 23-25% of cases is a trigger for a subset of squamous cell carcinomas of the mouth and pharynx.

Symptoms

If the papillomavirus does not manifest itself in most people, then there are no symptoms of HPV 16. When a persistent infection becomes active, its first signs most often take the form of benign epithelial neoplasia – papillomas and condylomas. Various sizes and shapes genital warts in women can occur on the external genitalia, in the vagina, on the cervix, in the perineum, outside and inside the anus.

Diseases caused by HPV 16

Gynecologists draw the attention of their patients to the fact that any discharge due to HPV 16 in women appears only in cases of its activation and development of diseases (see below), and the nature of the discharge depends on many additional factors. And a latent infection never leads to the appearance of pathological vaginal discharge.

HPV 16 and pregnancy

HPV infection does not reduce fertility and does not directly affect the possibility of conception, and to the question - is it possible to get pregnant with HPV 16 - gynecologists give an affirmative answer.

True, when a viral infection leads to changes in the cervix, they should be treated. This applies to both planned conventional conception and IVF with HPV type 16. Doctors recommend postponing pregnancy until treatment is completed.

You also need to take into account the fact that - against the background of physiologically determined immunosuppression and an increase in blood flow and the number of vessels in the genital area - genital warts during pregnancy (especially between 12 and 14 weeks) can grow faster and cause irritation or other symptoms (swelling, soreness , burning, bleeding, problems with urination).

The risk of transmitting HPV to the baby is extremely low, and a caesarean section is not recommended simply because the pregnant woman has the virus. Therefore, the answer to the question – is it possible to give birth with HPV 16 – is also affirmative.

Diagnostics

Detection of papillomavirus in the body, that is, diagnosis of HPV 16, is only possible using microbiological molecular methods.

HPV tests include a qualitative test performed by examining a vaginal or cervical smear (taken by a gynecologist) using HPV polymerase chain reaction (PCR); At the same time, a quantitative analysis for HPV 16 is done - PCR/HPV HCR.

The norms of HPV type 16 are relative, since the numerical expression is the number of living virions (more precisely, copies of HPV DNA or markers of their genomes - Lg) per 10 5 (100 thousand). cells of biological material, the viral load of HPV 16 is determined. The greater their number, the higher the activity of infection and the higher the viral load:

• viral concentration (that is, the likelihood of oncology with the development of the diagnosed pathology) is very high - 5 Lg and above;
• the number of viruses is of clinical significance (when diagnosing an etiologically related disease) - range from 3 to 5 Lg;
• insignificant viral concentration – below 3 Lg;

And using PCR genotyping, the specific type of papillomavirus is determined, that is, its DNA is determined in comparison with reference (standard) samples. The test may be designated HPV 16 PCR/HPV 16 DNA. The biological material for this analysis is a scraping from the mucous membrane of the cervix or its canal. Its significance is that the oncogenic virus can be identified before the PAP test (Papanicolaou smear) can detect any abnormal cervical cells.

Treatment

The first and main question is whether HPV type 16 can be treated? The second and also important question is what to do with HPV 16?

There is no radical therapy for papillomavirus, since there is nothing yet to free the body from its presence, and only diseases in which this type of HPV is involved can be treated.

In 2012, European guidelines for the treatment of anogenital warts (condylomata acuminata) were published, and it was emphasized that only surgical treatment (removal of papillomas and condylomas by surgery) gives a positive result in almost all patients.

And cauterization of erosion with HPV 16 is carried out in the same way as in the absence of this infection, see - Cauterization of cervical erosion

Algorithms and existing treatment regimens for HPV 16 also include drug therapy. And below we will name the main medications that are most often used in clinical practice today.

To reduce the oncogenic load and activate cellular immunity (T-lymphocytes, macrophages, dendritic cells, etc.), immunomodulators for HPV 16 are prescribed - drugs containing interferon or its analogues.

The drug Alloferon or Allokin alpha stimulates the synthesis of endogenous leukocyte α-, β and γ-interferons. It is administered subcutaneously - 1 mg every two days. In total, such injections for HPV 16 are given no more than nine times (most often limited to six injections), but if necessary, after a short break, the course of treatment can be repeated. This product is not for use in children, pregnant or lactating women, or in the presence of autoimmune diseases.

The immunomodulatory drug Isoprinosine (other trade names are Pranobex, Groprinosine, Inosine, Novirin) is prescribed two tablets (0.5 g each) three times a day for two to four weeks. The drug may cause side effects such as decreased appetite, headache and joint pain, nausea, abdominal pain, and intestinal disorders. Its contraindications include chronic renal failure, the presence of bladder stones, pregnancy and breastfeeding.

Cycloferon (Neovir) induces the production of interferons due to the action of acridoneacetic acid. Available in the form of tablets, injection solution and liniment. Tablets are used one or two per day (before meals) for three weeks. A course of injections (IV or IM) is prescribed for severe lesions, usually one injection per day. The drug is not used for liver cirrhosis and pregnancy. Liniment is used topically: by instillation into the urethra or vagina.

Medicines that enhance immunity include Polyoxidonium (Azoximer bromide) - lyophilisate for preparing a solution (for IM and IV administration), vaginal suppositories -

For adults (except pregnant women), injections for HPV 16 are given twice a week or every other day (one injection in a single dose of 6 mg). For children, the dose of Polyoxidonium is determined at the rate of 0.1 mg per kilogram of weight; administered once during the day, the course of treatment is 7-10 injections. Vaginal suppositories are used in the evening (before bedtime - one suppository per day for a decade).

But the drug Amiksin is used to prevent influenza and reduce the manifestations of ARVI, but is not prescribed for DNA viruses.

Suppositories, gel and injection solution Panavir contain potato sprout extract: the product is declared as antiviral and at the same time immunomodulatory (not registered in International Pharmacopoeia).

The dietary supplement Promisan with green tea extract, which, according to the description, is recommended for the prevention of cancer, as well as Indol (Indole-3-carbinol), containing indole derivatives obtained from broccoli, are not medicinal.

Externally - for superficially located anogenital condylomas of small size - use Podophyllotoxin solution (Podofilox, Condilin), as well as Keravort cream (Imiquimod) - once a day, every other day (at night), for a month; If repeated courses of treatment are necessary, a break should be taken. Both drugs are contraindicated in children and pregnant women.

A very common remedy for topical use is vaginal and rectal suppositories for HPV 16:

Genferon (with α2-interferon) – one suppository invaginally (for men – rectally);

Viferon (with interferon, vitamins C and E);

Vitaferon (with interferon and vitamin C), etc. More information in the article - Suppositories for HPV

But vaginal capsules (not suppositories) Polygynax are intended for the treatment of candidiasis and bacterial infections of the vagina; they are useless for viruses.

Traditional treatment for HPV 16

What does traditional treatment for HPV 16 recommend? Garlic and iodine cauterization of condylomas; lubricating them with propolis tincture with the addition of fresh onion juice; applications with a concentrated solution of baking soda or tincture of green walnut peels on kerosene.

They claim that externally applied hydrogen peroxide against HPV 16 or a 10% aqueous solution of ammonia (ammonia) can help.

Papillomaviruses are a large group of DNA-containing viruses that infect the surface cells of the epithelium of organs and tissues. Most often, the skin comes under their attack, but sometimes the mucous membranes as well.

HPV type 16 in women can provoke the formation of a variety of tumors. And not only benign, but also cancerous.

The forms of damage can be very different. There are options that do not give any symptoms at all, for example, keratoses or dysplasia. There are options with pronounced manifestations - warts, papillomas, condylomas. Many of them are harmless and may disappear on their own.

And only in rare cases do benign formations degenerate and become carcinomas. This is a malignant tumor, also called epithelial cancer. Develops from altered epithelium of various organs.

Today there is reliable evidence that the human papillomavirus is the main cause of cervical cancer in women.

Moreover, not all human papillomaviruses are oncogenic. Of the 100 known variants, only 17 are considered dangerous. The rest do not pose any threat to life and health.

The highest risk group includes HPV types: 16, 18, 31, 33, 35, 39, 45, 46, 51, 52, 56, 58, 59 and 68.

Low-risk viruses remain HPV types: 6, 11, 42, 43, 44.

Types 16 and 18 are especially dangerous for women. They are the ones that most often cause cervical cancer. These two viruses account for 70% of all diagnosed cervical cancers. Moreover, squamous cell carcinoma is HPV type 16. and glandular cancer – type 18.

How does infection occur?

The prevalence of human papillomavirus infection today is very high. The DNA of one or another HPV type virus, and sometimes several at once, is found in 80% of all inhabitants of the planet.

Moreover, the most dangerous HPV types 16 and 18 are sexually transmitted infections. It is practically impossible to become infected with them through blood, through household contact or by airborne droplets.

In total, there are three ways of infection with HPV type 16.

1. Sexual route – oral, traditional or non-traditional sex with an already infected partner.
2. Intrauterine route - infection of the fetus from an infected mother through the placenta and amniotic fluid.
3. During childbirth - infection of the newborn when passing through the birth canal with condylomas present.

Household or airborne transmission is very rare. However, HPV type 16 in women can also be detected through prolonged family contact with an infected person.

Many people ask this question: where could HPV 16 appear in a woman? Most likely, the most common reason is to blame here - sexual intercourse without protection from infection.

What happens next

HPV type 16 DNA in women, after entering the body, does not give any symptoms at all. In this case, the person does not even suspect that he is infected. There will be no runny nose, headache, sneezing or rashes.

Moreover, it has been proven that 75% of all women who lead an active sexual life become infected several times over the course of their lives. However, in most of them, the virus is eliminated from the blood on its own due to the active functioning of the immune system.

For the rest, the virus freezes for many years, that is, it goes into a latent state, but does not leave the cells. Such a hidden infection is a ticking time bomb. And in the case when there are disturbances and malfunctions in the functioning of the immune system, the virus wakes up and begins to behave very actively. Which is expressed in the appearance of the first symptoms and complaints on the part of the woman.

The main reasons for decreased immunity for activation of HPV type 16

1. Pregnancy.
2. the onset of old age and old age.
3. Exacerbation of chronic gynecological, somatic, inflammatory or infectious diseases.
4. Infection with chlamydia, genital herpes, trichomoniasis, cytomegalovirus, syphilis, HIV or AIDS infection.
5. Problems with hormones.
6. Obesity.
7. Metabolic and neuroendocrine diseases.
8. Abortions, surgeries, difficult births, injuries.
9. Chronic stress, physical exhaustion.
10. Treatment with cytotoxic, immunosuppressive drugs.
11. Ionizing radiation, prolonged frequent exposure to the sun, radiation therapy.
12. Smoking.
13. Alcoholism.

All this forces the virus, which was previously just dormant, to wake up and begin to act.

Symptoms of HPV type 16 in women

Above we looked at how HPV type 16 is transmitted in women. Now it's time to learn about the symptoms of this insidious and unpleasant disease.

Latent stage

At this stage there are no symptoms of the disease. The presence of the virus can only be detected in one way - a blood test. but even an asymptomatic course at this stage can already cause the development of cervical cancer.

Subclinical stage

HPV infection at this stage either worsens or subsides again, which is expressed in the occasional appearance of vulvovaginitis, endocervicitis, and cervical pseudo-erosions. Sometimes you may experience burning, itching, and in the rarest cases – abnormal discharge in a minimal amount from the vagina.

In this case, cervical smears reveal:

1. Koilocytes.
2. Leukocytes.
3. Atypical cells.
4. Pathogenic flora (not always).

Histological examination of cervical mucus reveals pathological changes in the structure of the cervical epithelium.

Clinical stage

At this stage, HPV infection in women is already papillomatosis or condylomatosis of the vulva, vagina, cervix, and genital area. All the symptoms appear clearly and the diagnosis is not at all difficult to make.

HPV type 16 and cervical cancer. How are they related?

Each papillomavirus, which belongs to the high-risk group, includes specific structural proteins - oncoproteins E 6 and E 9. They are able to completely disable immunity inside the cell. And there are especially many such proteins in HPV type 16.

By integrating into the DNA of a healthy cell, they cause genetic instability - they provoke cell mutation and cause cervical cancer.

Initially, this condition will have a different name - cervical dysplasia or cervical intraepithelial neoplasia (CIN). This pathological process is caused by an abnormally large proliferation of atypical cells that have changed under the influence of HPV.

Therefore, cervical dysplasia is an early manifestation of human papillomavirus infection, which is caused by HPV types 16 or 18.

In this case, moderate or severe degree is a precancerous condition. And at the age of 40–49 years, it can degenerate into clinically pronounced cancer. But such a rebirth will last for many years in a row.

If this condition is noticed promptly and the patient receives proper and complete treatment, it will help completely prevent the development of cervical cancer in the future.

It is for this reason that every woman who is sexually active must undergo a smear for oncocytology, called a Pap test, once a year.

DNA diagnostics

In order to find out if you are infected with HPV type 16, you need to do a fairly simple test, the material for which is a vaginal smear or cervical scraping. There are two diagnostic methods: PCR and Digene-Test. Let's look at both in more detail.

PCR - polymerase chain reaction method

This is a popular and reliable way to determine the presence of CD in a person’s DEC. it is highly sensitive and helps detect even minimal amounts of virus.

But it has one negative side - with its help it is impossible to say at what stage the disease is - whether the body is undergoing an active infection process or is in a dormant state.

Type 16 congenital malformation in women - interpretation of PCR analysis

Hybrid capture method or HPV Digene-Test (HC2)

The second name for this test is the double gene trap system. The main advantage of this method over PCR is the ability to determine at what stage the process of infection of epithelial cells by the virus is.

AmpliSens HPV 16/18-FL HPV screening tests are sometimes used to detect the concentration of single HPV 16/18 serotypes.

Clinically significant (reference) viral load level

Interpretation of the obtained result Digene-Test (HC2)

PAP test or smear for cervical cytology

This is one of the most popular and reliable tests. A study of stained smears - impressions of scraping the surface of the cervix - is carried out under a microscope.

By the number of changed cells, by their structure, deformation, the degree of damage can be determined:

1. CIN 1 – mild.
2. CIN 2 – average.
3. CIN 3 – severe.
4. CIS – carcinoma.

All these studies can be completed at the antenatal clinic at your place of residence.

Endoscopic diagnostics

Extended colposcopy is an examination of the membranes of the vagina and cervix using a colposcope.

If there are altered areas of the epithelium, the woman must be sent for a biopsy. And only after receiving the results of this study, an accurate diagnosis is made and the issue of treatment is decided.

If a woman is diagnosed with HPV type 16 - what to do?

It is known for sure that the presence of a large amount of HPV DNA in women is always accompanied by dysplasia of the cervical epithelium. The degree of severity may vary.

In this case, the procedure for an HPV test “+” (positive) can be seen in the figure presented.

Treatment

To date, not a single drug has been created that would help destroy or remove the HPV 16 virus from a woman’s body.

Therefore, the main treatment is aimed at destroying tissues in the body that have undergone significant changes, as well as improving and strengthening general or local immunity.

In other words, a woman’s type 16 HPV virus is not treated, but only its clinical manifestations are treated, that is, symptoms and consequences - condylomas, cervical canal dysplasia, cervical cancer. It is also necessary to identify and eliminate the causes of decreased immunity.

Local treatment

Is HPV type 16 curable in women? No, this condition cannot be cured. But if necessary, you can completely get rid of already affected and changed tissues. The following methods are used for this:

1. Cryodestruction.
2. Laser treatment.
3. Diathermocoagulation.
4. Electrosurgical excision.
5. The use of chemicals - solcoderm, trichloroacetic acid, podophyllotoxin.

Therapy is carried out on an outpatient basis within the walls of the antenatal clinic.

Immunological treatments

How else can you treat HPV type 16 in women? Nonspecific antiviral therapy may be required, which includes the use of:

1. Preparations of interferons a-, β-, γ-.
2. Endogenous interferon inducers.

Only the doctor decides which medicine is suitable in a particular case. Some drugs can cause serious side effects.

Treatment of cervical dysplasia (CIN)

How is HPV type 16 treated in women with cervical dysplasia? It all depends on the severity of the disease.

CIN 1 – mild degree

Dynamic observation with re-examination every 6 months. Mandatory identification of concomitant sexually transmitted diseases. In the absence of regression of dysplasia - local treatment: cryodestruction, laser therapy, surgical excision of pathological tissue of the cervix.

CIN 2 – average degree

Laser treatment, surgical excision of pathological tissue of the cervix.

CIN 3 – severe course

Amputation of the cervix. If any variant of CIN is combined with fibroids or endometriosis, the uterus must be removed.

Is it possible to self-heal from symptoms?

HPV type 16 in women, according to reviews on forums, can go away on its own. This happens in 50% of all cases. This is possible under the following conditions:

1. Low viral load.
2. Single condylomas.
3. A small number of atypical cells.
4. Mild dysplasia (CIN 1).

In this case, complete regression of the manifestations of the disease and cure are possible.

Prevention

Unfortunately, even a condom is not able to protect a woman from infection. Therefore, the only way to avoid the disease is to choose a sexual partner wisely.

Great hopes are placed on vaccination against human papillomavirus type 16, but it is carried out only for a fee and only at a certain age.

And in order to catch the disease in the early stages of development, it is recommended to be examined by a gynecologist once a year.

Probability of getting cervical cancer with a “+” test for HPV type 16

Not all women who test positive for HPV type 16 develop cervical cancer. Therefore, human papillomavirus infection is a mandatory, but far from the only condition for the development of the disease.

In other words, all women with cervical cancer were infected with HPV type 16. And only very few infected people were diagnosed with cervical cancer.

The main provoking factors for the development of cancer when infected with HPV type 16 include:

1. Genetic predisposition.
2. Secondary immunodeficiency.
3. Diseases of the uterus - polyps, endometrial hyperplasia, fibroids, endometriosis.
4. Injuries to the cervix during childbirth or abortion, which significantly disrupts the blood circulation process.
5. Smoking.
6. Long-term use of hormonal contraception (COC) without a doctor's prescription.

We must remember that HPV infection significantly increases the risk of developing cancer. But it does not develop in all cases, and with adequate and timely treatment, the virus can be transferred from an active state to a dormant state for a long time.