SYMPTOMS

HOW TO KNOW IF YOU HAVE

PAPILLOMAVIRUS INFECTION?

The first thing is to go to the gynecologist for the annual review 
and to perform a cytology. If the cytology has a suspected virus result, even if there are no symptoms of the disease, it is necessary to continue with medical follow-up and the tests that the physician deems appropriate.

The infection of the human papillomavirus is very varied because the clinical manifestations of the infection can have a broad spectrum of presentation and be:

  • Clinical lesions (visible).

  • Subclinical (not visible but diag- nosed by some generally cellular method ). 

  •  Latent (where the infection is present, but in the inactive state).

WHAT CAN HAPPEN IF YOU HAVE

THE HUMAN PAPILLOMAVIRUS?

Infection with the human papillomavirus follows an evolutionary course. It starts being asymptomatic, manifesting only as a finding of cytology or other diagnostic techniques.

It can be a latent infection, when diagnosed with an intentional search when performing a colposcopy or biopsy.

But when the infection is symptomatic and clinically visible, it can occur in a variety of ways.

CONDILOMAS

The most striking clinical manifestation is condyloma acuminata or warts. They are visible lesions that can occur in both the cervix and the vagina, vulva, urethra, anus, penis, perineum, larynx, skin.

They are seen as proliferative vegetative lesions in the form of irregular lumps, sometimes described as cauliflowers. They can be skin color, pink or white, single or multiple, soft, variable in size and confluent.

CONDYLOMAS IN SKIN 

Also known as verruca vulgaris. It is most often caused by HPVs 1, 2, 4 and 7. They usually appear in adolescence or childhood, obtained by person-to-person contact. Like all papilloma virus infections, it can be a latent infection and present as a wart for weeks to months after contact with the infected person. It is frequent the disappearance of the wart, although in adults it is usually more resistant and take years in which this occurs.

Warts on the skin are not considered a disease that can trigger cancer or require medical treatment.

The treatment is not necessary unless it is requested by aesthetics, or causes pain or is very large. It consists of topical drugs and rarely requires surgical treatment.

CONDILOMATOSIS VAGINAL

The lesions produced by the papilloma virus in the vagina are similar to those of the cervix, since both come from the same embryological tissues. They differ from the vulva condylomas because the vagina has a large amount of glycogen.

 

Condylomas are commonly associated with vulva and vagina, so they should be intentionally searched when diagnosed in either area. The diagnosis in the vagina is made with the visualization of the lesions and the subsequent confirmation in the microscope. However, it is usually more difficult to diagnose in the vagina, since it is an organ with abundant roughness in the reproductive stage.

Viruses mainly involved in vaginal condylomas are 16 and 18. Since high-risk viruses are closely monitored, if the infection does not resolve spontaneously, it can develop into vaginal intraepithelial neoplasia or cancer of the vagina .

CONDYLOMAS IN VULVA

The vulva is the area of ​​female external genitalia, so the visualization of condylomata is usually very accessible. If the lesions do not spontaneously remit, they can distort the anatomy of the area considerably and become painful lesions due to the location and high sensitivity of the vulva, although this depends on the number and size of the condylomata.

The viruses most frequently associated with condyloma vulva are 6, 11 and 42. Although they are low-risk viruses, there may be infections from several types of viruses. It is rare, but there is also vulvar cancer related to HPV infection. To avoid vulvar neoplasias, colposcopic diagnosis and pathological confirmation by biopsies are warranted.

CONDILOMAS IN PENE

Although condylomata are often the cause of a physician's visit, visible condylomata are not the most frequent manifestation of HPV infection, if not subclinical infections.

The viruses most frequently involved in the penile condylomas are 6 and 11.

The diagnosis of condylomas in penis is made by visualization of the warts. However, they usually coexist with subclinical infection, so it is necessary to perform a penescopy and occasionally to take cytologies and biopsies to rule out malignant processes.

The incubation period varies from 3 weeks to 8 months, so warts usually appear within 2 to 3 months after infection. The rate of spontaneous regression of infection is not known. The clinical manifestations of HPV infection in the penis are very varied. They can range from skin, mucous, giant, flat condylomas, to cancer. Generally the location of the condylomata is in areas of friction during intercourse, therefore the frenulum, foreskin and glans are the most frequently affected areas of the penis. It is believed that uncircumcised men are more prone to infection and transmission of HPV.

CONDILOMAS IN ANO

The area of ​​the anal canal, like the cervix, has a transformation zone of the epithelium, which makes it more susceptible tohuman papillomavirus infection and to the progression of virus infection, both high and low grade.

Condylomas are the most frequent clinical manifestation of infection. They can occur at any age, but it is more common in adults 20 to 25 years. Condylomas in the anus are more predisposed in women, either through anal intercourse or by auto infection of the vulva at the anus. In homosexual men there is no predisposition for age and can occur at any time during the active sex life.

CONDILOMAS IN PREGNANCY

If condylomas are diagnosed in pregnancy, the size and location of the condylomata should be considered.

It is necessary to evaluate the treatment during gestation, since the large condylomata can be related to problems during the birth by preventing the passage of the fetus through the birth canal and the possibilities of laryngeal infection of the newborn.

YOUNG LARYNGAL PAPILOMATOSIS

It is an infectious disease of the laryngeal mucosa that causes benign tumors. It usually affects children or young adults and although there is no evidence of the time of infection, it is believed to occur at the time of delivery in women with condylomatosis.

It can occur at any age and in adulthood has a greater predilection for males.

Approximately 25 HPV types have been linked to this infection. The most frequent are the viruses 6, 11, 30, 16 and 18, the latter two with a high risk of becoming malignant also in the larynx.

The incidence in the United States in children 2 to 4 years old is 4, 3 per 100,000 children. The diagnosis is made when the affected person has difficulty speaking, such as dysphonia or difficulty breathing, and the visualization of the papillomas in the larynx, although they can also be found in the air and digestive tract.

The condylomas are visualized by means of a laryngoscope with which a biopsy is taken, since the diagnosis must be confirmed with the microscope.

Condylomas are the most common clinical manifestation of papilloma virus infection and can affect any area of ​​sexual contact.

Laryngeal papillomatosis can be transmitted by contact in the birth canal, although it can appear at any age.

Condyloma in the birth canal can prevent the free passage of the fetus and prevent the birth is natural.