Antiviral therapy for human papillomavirus infection. Effective drugs for the treatment of HPV

In recent years, in Russia, as in many countries of the world, the incidence of papillomavirus infection has been increasing. The problem of its diagnosis and treatment attracts the attention of doctors of various specialties: dermatologists, gynecologists, urologists, oncologists, pathomorphologists, immunologists, virologists. This is due to the high contagiousness and tendency to increase the frequency of this disease, as well as the ability of some varieties of the human papillomavirus (HPV) to initiate malignant processes. The latter mostly concerns the genital manifestations of human papillomavirus infection.

Human papillomavirus (HPV) is epitheliotropic and is found in the skin, oral mucosa, conjunctiva, esophagus, bronchi, and rectum.

There is evidence in the literature that the introduction of HPV infection occurs at the level of immature epithelial cells of the skin and mucous membranes (basal layer). The result of this introduction is cell proliferation, but without the production of viral particles, since proliferating epithelial cells are not able to support the life cycle of viruses. Complete replication of HPV occurs only in highly specialized cells of stratified squamous epithelium: granular, spiny skin cells, superficial epithelial cells of the cervical mucosa. Currently, about 100 types of papillomaviruses have been described. It should be noted their tissue and species specificity. Different types of HPV are associated with different types of lesions. It has been established that certain types of HPV are associated with the urogenital region. There are varieties:

• low oncological risk;
• average oncological risk;
• high cancer risk.

Structure of the viral genome

Papillomaviruses belong to the papovavirus family ( Papovaviridae), affecting cattle, birds, as well as humans and capable of infecting the basal cells of the skin and squamous epithelium. Papillomaviruses are one of the most heterogeneous groups of viruses, the differentiation criterion of which is the degree of genetic relatedness of viruses according to molecular hybridization data: it ranges from 10 to 85%. The diameter of viral particles is 55 nm. The virus has no outer shell. The capsid of the virus consists of 72 capsomeres. A detailed analysis of the HPV DNA molecule became possible after the development of a DNA cleavage technique using endonucleases and analysis of these fragments using gel electrophoresis.

Papanicolaou-stained preparations revealed a specific set of features characterizing the nucleus and cytoplasm of epithelial cells (koilocytic atypia of cells) caused by the cytopathic action of papillomaviruses.

A specific cell for this infection is a koilocyte, which is an oxyphilic-stained epithelial cell with clear boundaries and a clearly defined perinuclear zone of enlightenment and numerous vacuoles in the cytoplasm.

The term "koilocytic dysplasia" was introduced by H. S. Stegner in 1981. It is assumed that these changes are the result of the reproduction of a virus that causes a violation of cell metabolism, leading to their partial necrosis with the formation of balloon-like cells.

A cytological examination of the foci caused by HPV infection showed that the cellular material contains mostly non-nuclear, or orthokeratotic, cells. About 20% of the scales contain nuclei - the so-called. parakeratotic cells.

It should be remembered that morphology alone is not enough to detect HPV. In this regard, it is advisable to use the polymerase chain reaction (PCR) method, hybridization in situ. Increasingly, there are reports in the literature of detection of HPV infection in urine by PCR as an alternative method for testing specimens from the cervix. Along with this, one-tube nested PCR and type-specific nucleotide hybridization are used.

The PCR method is used for asymptomatic or asymptomatic forms of the disease caused by HPV infection.

Immunochemical methods can detect HPV antigens in the tissues of genital warts in 71.4% of cases, by hybridization in 96.5% and by PCR in 10% of cases.

The efficiency of DNA hybridization does not exceed the efficiency of histological examination, but it allows to identify patients with a high degree of this infection.

Clinic for HPV infection

Clinical manifestations of HPV infection of the genitals are very variable. Currently, they are divided into genital warts, papillary varieties of warts (with pronounced exophytic growth), as well as flat and inverted (intraepithelial) with endophytic growth. The latter variant, also known as "subclinical HPV infection", is the most difficult to diagnose, since there are no clear microscopic changes in the epithelium. In this case, to determine the clear boundaries of the lesion, special screening techniques are required.

A peculiar variant of genital warts is bowenoid papulosis and giant condyloma Bushke-Levenshtein. Genital warts (CC) are fibroepithelial formations on the surface of the skin and mucous membranes, with a thin stalk or wide base in the form of a single nodule or multiple epithelial outgrowths resembling cockscombs or cauliflower in appearance. Diagnosis of large warts does not cause difficulties. Genital warts are localized mainly in places of maceration: labia minora, vagina, cervix, urethral mouth, anus, skin. In men, OCs are located in the foreskin, on the glans penis, perinatal region, less often endouretally. The incubation period ranges from one to 12 months (average 3-6 months).

Studies of recent decades indicate that 85% of patients with typical vulvar and perineal OC have additional foci of HPV infection in the vagina or cervix, and almost every fourth of them have HPV-associated diseases - cervical intraepithelial neoplasia (CVN) of various severity. One of the clinical varieties of diseases caused by HPV infection are bowenoid papules associated with HP 16, sometimes pigmented on the skin and mucous membranes of both sexes, more often resembling common warts or seborrheic keratosis. In contrast to Bowen's disease, Bowenoid papules are benign and spontaneously regress, although they may occasionally become malignant. The course is asymptomatic.

Some authors refer Lewandowski-Lutz verruciform epidermodysplasia to this group of diseases. This disease is based on local and genetic disorders associated with chronic HPV infection.

J. M. Handley and W. J. Dinsmore (1994), based on literature data, as well as their own research, proposed a classification of clinical forms of HPV infection and associated diseases ().

In the vast majority of cases, manifest forms of HPV infection are combined with other sexually transmitted diseases. According to Bernard K. and Mugi K. (1996), manifest forms of HPV infection usually occur as a result of a number of factors:

• social;
• infectious, associated with associations of sexually transmitted diseases (STDs);
• associated with changes in immune status.

The most significant is the impact of HPV-associated infections of the urogenital tract: urogenital chlamydia, mycoplasmosis, cytomegalovirus and herpetic infections, dysbiotic conditions. The result of their influence on the course of HPV infection is the chronization of the process, the formation of persistent, as a rule, non-specific inflammatory changes in the urogenital area, and significant difficulties in carrying out therapeutic measures.

The significance of the presence of a concomitant infection for the treatment of condylomatosis is explained by the following circumstances.

• The presence of STDs associated with HPV infection lengthens the duration of treatment of the latter by an average of three times.
• In most cases, relapses are associated with the above reason.
• Epithelialization of cervical erosions after the destruction of warts can only be achieved if there is a preliminary scan for concomitant STDs and bacterial vaginosis.

The possibility of a relationship between cervical neoplasia and venereal disease has been discussed for many years. In the group of women suffering from invasive cervical cancer (CC), there was a higher incidence of nonspecific microflora, including trichomonas and gardnerella infections. Examples of such influence have been discussed in relation to Treponema pallidum, Neisseria gonorrhoeae, Chlamidia trachomatis, herpes simplex virus type 2, cytomegalovirus, human papillomavirus. Epidemiological studies have convincingly shown that an undeniable risk factor for the occurrence of precancerous changes and cervical cancer is genital HPV infection.

Principles of treatment for HPV infection

Given the fact that specific antiviral drugs and vaccines that act on HPV are not yet available, it is generally accepted that complete elimination of the virus from the body cannot be achieved. The goal of therapy is to eliminate clinical and subclinical forms of HPV infection.

To date, in the arsenal of practitioners there are many methods for removing anogenital warts. Their effectiveness varies from 30 to 90%, but none of the methods is a panacea, since the relapse rate is quite high with any method of treatment. Treatment should be strictly individual: it is necessary to select the most optimal solution in each case, sometimes taking into account the wishes of the patient himself. The problem of recurrence does not depend on the choice of therapy. Recurrences of anogenital warts are most often associated not with reinfection from a sexual partner, but with reactivation of the infection. There are three ways in which events unfold in the absence of treatment:

• warts may resolve on their own;
• remain unchanged;
• progress.

In this case, the possibility of persistence of the virus in the absence of any clinical manifestations should always be taken into account.

Choosing the most optimal method in each specific case, it is necessary to be guided by four main characteristics:

• effectiveness in this pathology;
• relapse rate after treatment;
• tolerability (minimum side effects);
• ease of procedures.

In addition to the removal of anogenital warts, it is necessary to solve the following important tasks:

1. Identify and treat patients with anogenital warts (and their sexual partners) for other sexually transmitted diseases (STDs).

2. Screen all women with anogenital warts for cervical intraepithelial neoplasia (CVN) using cytology and colposcopy.

3. Support further monitoring of CVN foci in the early stages for the timely detection of their progression or the development of microinvasive carcinoma.

4. Actively treat anogenital warts, early-stage neoplasia with advanced clinical presentation, late-stage neoplasia, and squamous cell carcinoma.

In fact, the treatment of anogenital HPV lesions is aimed either at the destruction of papillomatous foci by one method or another, or at the stimulation of an antiviral immune response, a combination of these approaches is possible.

Destructive Methods

Physical destructive methods

Surgical excision. Currently used infrequently, mainly used in the treatment of malignant neoplasms, when a wide excision is needed. This method may require hospitalization due to the fact that during the excision, quite severe bleeding may occur, and a long postoperative period will require special therapy.

electrosurgical methods. These include electrocoagulation, electroacoustics, fulgation, electrosurgical excision (electroexcision) using an electric knife. Not so long ago, plasma began to be used in medicine. Our scientists have developed an original plasma coagulator (plasmaskin) EKH-1, which has no foreign analogues. Temperature measurements in plasma showed that it can reach 2000-2500°C. Such high temperatures, in turn, provide the ability to work in a non-contact mode, the operation time is significantly reduced, and thereby the necrosis zone is reduced. In addition, with such exposure, in most cases, the pain threshold is not exceeded. This temperature regime provides almost complete combustion of neoplasms.

Advantages of this method:

• availability;
• cheapness;
• sufficiently high efficiency;
• the possibility of using in an outpatient setting;
• reduced risk of bleeding.

Disadvantages:

• the need for anesthesia
• when using this method, infectious HPV DNA is isolated along with the resulting smoke, so it is necessary to create adequate conditions for work - vacuum smoke extraction, use of protective masks.

Laser excision. A fairly effective and safe method is the excision of warts with a laser. In practice, neodymium and CO lasers are used. When using a CO laser, the surrounding tissues are less damaged, and a neodymium laser gives a better hemostatic effect. In addition to the fact that the laser physically removes lesions, studies have shown that laser radiation has a toxic effect on HPV. Procedures require well-trained personnel. When using lasers, anesthesia is necessary - often local or local anesthesia is sufficient, which allows procedures to be performed on an outpatient basis. Laser excision and surgical methods are approximately equally effective. Laser therapy can be successfully used to treat common, resistant to other therapy warts. It allows you to stop recurrence in about 40% of patients. Studies have shown that such an ineffective result is due to the fact that CO laser is ineffective when it comes to eliminating the genome from lesions that are resistant to treatment (according to the PCR method, molecular biological cure occurs in 26% of patients).

The use of CO laser is the method of choice in the treatment of CVI. Apply laser conization of the cervix. Relapses are observed in 2% of patients. A mild method of laser therapy is vaporization, which does not cause almost any complications. Laser vaporization has been successfully used in the treatment of low-grade CVI. Relapses are observed in 4% of patients.

Laser therapy has been successfully used to treat genital warts in pregnant women. There are reports of the treatment of pregnant women at the 28-35th week of pregnancy. Most patients recovered after the first session. There were no complications during childbirth or in newborns.

Of the side effects should be noted ulceration, bleeding, secondary infection, scarring. As with electrosurgical techniques, HPV DNA is shed in smoke, which also requires precautions.

Laser therapy is not widely used due to the high cost of equipment and the need to train experienced personnel.

Cryotherapy. A fairly effective and safe method that involves the use of liquid nitrogen, nitrogen oxide and carbon dioxide as a refrigerant. In this case, there is a rapid freezing of both intra- and extracellular fluid, leading to lysis and cell death during thawing. Cryotherapy usually does not require anesthesia, although local anesthetics can be used if necessary. Cryotherapy can be used in the treatment of not very large warts of various localization. If the warts are multiple, then the removal should be carried out in several stages. This method is characterized by the following side effects: the development of local redness, swelling, followed by the formation of blisters and their ulceration. To reduce damage to surrounding tissues, before the procedure, the surface of the warts is treated with KY-gel, which, when frozen, makes it possible to carefully lift and separate the lesion from the underlying epithelium.

The method can be used in gynecological practice.

The combined use of cryodestruction and plasma coagulation seems to us to be extremely promising, which makes it possible to avoid the disadvantages inherent in the above methods separately.

Chemical destructive methods. This group of products includes solutions of acids, alkalis, salts. Among them, ferezol, hydrogen peroxide, solutions of quinacrine and chingamin, preparations of mercury and arsenic, bismuth, preparations based on salicylic and lactic acids, acetic and nitric acids, thuja and celandine juices can be mentioned. All these drugs are readily available, but they have a low, poorly predictable efficiency, and give numerous side effects.

Isoprinosine should be used in combination with locally destructive treatments.

The effectiveness of combined treatment of PV, according to the literature, ranges from 38 to 96%.

Combined treatments. For the treatment of manifestations of HPV infection, various methods are proposed based on the use of immune preparations in combination with laser, electrosurgical and cryodestructive effects.

The combined use of the above methods can reduce the number of relapses and thereby increase the effectiveness of treatment.

Good results have been obtained using a combined method of treating warts, including the destruction of foci by cryodestruction (exposure temperature from -160 to -180°C, exposure 40-120 s, twice) in combination with immunity stimulation. To stimulate local immunity, the affected area was treated with an emulsion containing interferon (IF), and to stimulate the immune system of the whole body, the drug kemantan was administered at a dose of 0.2 g three times a day orally for 10 days.

A combination of various destructive methods is possible. If there are manifestations of HPV infection on the skin and mucous membranes, cryopreservation is preliminarily performed for 10-30 s, which makes it possible to clearly identify the boundaries of the lesion due to the characteristic papillary surface of the lesions, which turns white. The affected area is then exposed to plasma (using the Plasmaskin apparatus).

A number of researchers recognize the surgical removal of all visible lesions, followed by local administration of interferon, as the best way to treat anogenital warts. In some cases, general and local application of IF is advisable before surgical excision of extensive condylomas.

The therapeutic effect of the use of IF is absent if the disease lasts more than one year, as well as in immunodeficiency.

Currently, there are not many remedies that can be used after the use of destructive methods. In particular, the drug impran has now appeared for topical application in the area of ​​lesions after a destructive effect.

Specific antiviral therapy

Currently, there are no drugs that have a specific effect on HPV. Known drugs that suppress the replication of the herpes simplex virus (acyclovir, ganciclovir) were ineffective in the treatment of anogenital HPV infection.

Theoretically, vaccination is an ideal method for the treatment and prevention of anogenital warts.

There are reports of the effective use of IF inducers. Of interest is the topical application of a low molecular weight derivative of imiquidachinolinamine - imiquimod, which is an inducer of cytokines and, in particular, L-IF. It is used in the form of a 5% cream three times a week or daily at night until the rashes completely disappear (but not more than 4 months). Complete disappearance of warts is observed in 13-56% of cases. With daily use, local side effects more often developed: redness, swelling, erosion. The cream is especially indicated for the treatment of subclinical HPV infection. Perhaps the use of virazole.

The effect of the use of IF monotherapy is still insufficiently studied and not very high, in addition, it is necessary to take into account the high cost of such treatment. As a result, this method is not widely used in practice.

Isoprinosine. In recent years, the attention of immunologists has attracted a new immunomodulator isoprinosine, which is a complex of inosine and salts of N,N-dimethylamine-2-propanol and P-acetaminobenzoic acid. The drug can be used in the form of tablets or solution for parenteral injection. The active substance in this complex seems to be inosine, and the amino alcohol salt stimulates its penetration through the membrane of lymphocytes and other cells.

Isoprinosine has a powerful and broad immunomodulatory effect. Numerous data and extensive literature indicate that in vitro the drug significantly enhances the proliferation of T-lymphocytes induced by mitogens or specific antigens, as well as the differentiation of pre-T-lymphocytes into more mature T-lymphocytes, accompanied by the appearance on their surface of the corresponding antigens. PI also stimulates mitogen-induced B-lymphocyte proliferation. The stimulating effect of isoprinolin on the activity of natural killer cells (NK cells) in healthy people and the functional ability of cytotoxic T-lymphocytes has been proven. The drug improves the ratio of CD4+/CD8+; increases the production of IL-2 by T-lymphocytes; promotes maturation and proliferation of T-cells; activates the synthesis of IL-1 by macrophages. PI has an antiviral effect and prevents the use of ribosomal RNA for virus propagation. It should be noted that in the case of the use of isoprinolin with other immunocorrectors, it significantly enhanced the antiviral effect of the latter.

Various treatment regimens with the use of isoprinolin have been adopted, depending on the size of warts, their localization and the degree of malignancy.

Scheme 1: treatment of small, multiple genital warts with a low degree of malignancy.

The drug is taken in 2 tablets. three times a day for 14-28 days.

Scheme 2: treatment of multiple warts with separate large warts or flat warts of the cervix.

Among the chemical preparations used in our country and abroad that have a destructive effect, one can single out TCA and nitric acid, as well as a combined acid preparation - Solcoderm.

TCA and nitric acid. TCA is used in 80-90% concentration and causes the formation of local coagulative necrosis. A solution of nitric acid has a similar effect. Due to their low cost and availability, both methods are quite widespread to this day. Acids are effective for the treatment of warts of the vulva, preputial sac, coronal sulcus, glans penis, especially in cases where the use of PF and PFG is contraindicated. Cauterization is carried out once a week for 5-6 weeks. The effectiveness of the use of TCA and nitric acid is approximately 70-80%. In some cases, a local reaction may develop in the form of weeping and ulceration.

Solcoderm. Solcoderm is an aqueous solution, the active component of which is the products of the interaction of organic acids (acetic, oxalic and lactic) and metal ions with nitric acid.

Acid. The solution contains nitrites in the amount of 0.02 mg/ml.

The properties and mechanism of action of Solcoderm are listed below, which distinguish it from other drugs of this group used in destructive methods:

• when applied topically, Solcoderm causes immediate intravital fixation of the tissue on which it is applied;
• the effect of the drug is strictly limited to the place of application;
• a sign of an immediate effect is a change in the color of the treated area;
• devitalized tissue dries up and darkens (mummification effect);
• The "mummified" scab is torn off on its own;
• the healing process is short and complications (secondary infection or scarring) are rare.

General characteristics of treatment with Solcoderm:

• the drug has a precisely limited local effect on the pathologically altered tissue on which it is applied, while the surrounding tissue is not damaged;
• the method is suitable for the treatment of various skin neoplasms;
• the treatment is painless;
• rapid healing, no complications;
• treatment is carried out on an outpatient basis and does not require special equipment;
• the absence of any restrictions for the patient.

Indications for the use of Solcoderm: simple warts, plantar warts, anogenital warts (genital warts), seborrheic keratoses, actinokeratosis, basal cell epitheliomas (basaliomas).

Solcoderm is very easy to use and quite effective for the treatment of genital warts of any localization. In most cases, a single application is sufficient.

Cytotoxic drugs

Podophyllin (PF). Pofillin is a resin derived from plants. P. pelatum and P. emodi growing in North America and the Himalayas. For the treatment of warts in the anogenital area, a 10-25% solution of PF in ethanol or benzoin tincture is used. It binds to the microtubule apparatus of the cell and inhibits mitosis, and also inhibits the transport of nucleic acids, resulting in inhibition of DNA synthesis and cell division.

The use of PF is a simple, affordable, fairly safe method of treatment that can be used on an outpatient basis, as well as independently by patients. The drug is applied once or twice a week for a maximum of 5 weeks in an amount of not more than 0.5 ml per procedure. The patient needs to ensure that water does not fall on the treated area for 4-6 hours after the procedure. PF is not recommended for use in vaginal, cervical and intraepithelial warts. According to a number of authors, the recurrence rate varies from 0 to 67%.

Approximately 10-15% of patients develop local adverse reactions in the form of weeping contact dermatitis. Particularly severe complications in the form of multiple ulcerations occur with improper self-application. As a result of prolonged or improper use of PF, patients may experience various adverse reactions, such as nausea, vomiting, abdominal pain, diarrhea, symptoms of damage to the kidneys, myocardium, liver, central nervous system and bone marrow.

The use of PF is contraindicated during pregnancy, since there have been cases of teratogenic effects on the fetus and intrauterine death of the fetus.

Many researchers consider PF an insufficiently studied and crudely purified plant extract, and therefore recommend using only highly purified podophyllotoxins, and self-administration of the drug by the patients themselves is undesirable due to the above complications.

Podophyllotoxin (PFT) (condilin). PFT is the most therapeutically active PF fraction. Available in the form of solutions of 0.25, 0.3 and 0.5%, as well as in the form of a cream of 0.15, 0.3 and 0.5%.

It is usually prescribed twice a day for three days a week in a row for 4-5 weeks.

Despite the fact that PFT is better purified than PF, a high frequency of side effects has been reported with the use of PFT, especially its 0.5% solution. Most often, as a result of the use of PFT, the following side effects are observed: local inflammatory reactions (erythema, burning, soreness, itching, weeping and erosion in the area of ​​application). Although systemic side effects are not described in the literature, it is recommended to limit the use of PFT to a dose of 0.2 ml per procedure.

The disadvantages of PFT are its high cost and long duration of treatment.

5-fluorouracil (5-FU). 5-fluorouracil (5-FU) is a pyrimidine antagonist and has the ability to disrupt the synthesis of both cellular and viral DNA. For the treatment of warts of the anogenital region, it is prescribed in the form of a 5% cream. In the treatment of intravaginal warts, the drug is prescribed once at night for a week or once a week for 10 weeks. The degree of effectiveness of the drug, according to various researchers, is 85-90%. When using 5-FU, weeping erosions on the vaginal mucosa may occur, up to the development of severe weeping contact dermatitis. In the treatment of warts of the terminal part of the urethra, the cream is injected immediately after urinating at night for 3-8 days. Complete cure of intraurethral warts is observed in 90-95% of men. However, during the treatment there are many side effects: stenosis and strictures of the urethra, dysuria, ulceration. The drug is contraindicated in pregnancy.

Immunological methods

Interferon. Since the human papillomavirus persists in epithelial cells and the use of destructive methods does not guarantee against relapses, the use of IF both as monotherapy and in combination with other methods of treatment is promising in this regard.

IFs are endogenous cytokines with antiviral, antiproliferative, and immunomodulatory properties. There are three main classes of IF: leukocyte (L-IF), fibroblastic (F-IF), and T-lymphocytic (T-IF). IF can be applied topically, intrafocally and systemically (subcutaneously, intramuscularly or intravenously). It has been established that when using IF in patients, the amount of viral DNA in the lesions decreases (according to PCR), which correlates with clinical improvement or disappearance of the lesion.

There are data concerning the use of domestic IF for the treatment of genital warts - human leukocyte interferon (HLI). It was used intrafocal (under the papilloma) at a dose of 100,000-500,000 IU, for a course of 3-6 procedures, in combination with the application of an interferon ointment with an activity of 40 IU to the lesions. CLI can be administered systemically and in the treatment of widespread lesions in combination with destructive methods.

L-IF can be considered the most effective drug for various methods, schemes and doses of administration. With the systemic use of L-IF, the complete disappearance of warts was observed in 11-100% of patients. The effectiveness of F-IF was 45-82%. The effectiveness of T-IF, shown in different studies, is much lower than that of L-IF and F-IF, and varies from 7 to 57%.

It should be remembered that the unsystematic use of various methods of treatment leads to a high percentage of relapses, however, the development of certain algorithms that take into account the gender of patients, the location and number of rashes can significantly reduce the number of relapses.

Table 1. Anogenital HPV infection and HPV-associated diseases

HPV infection

Expanded clinical forms (visible to the naked eye or not visible, but determined in the presence of appropriate symptoms):

• warts (genital warts, flat warts, vulgar warts)
• symptomatic intraepithelial neoplasia in the early stages - koilocytosis, dyskeratosis in the absence of dysplasia (flat warts)

Subclinical forms (not visible to the naked eye and asymptomatic, detected only by colposcopy and / or cytological or histological examination

• asymptomatic intraepithelial neoplasia (VN) in the early stages - koilocytosis, dyskeratosis in the absence of dysplasia (flat warts)

Latent forms (lack of morphological or histological changes upon detection of HPV DNA)

Table 2. Diseases associated with HPV

Clinical and subclinical forms:

• VL in the early stages - mild dysplasia, / + -/ koilocytosis, dyskeratosis (VL stage 1)
• LN in the later stages - severe dysplasia, / + -/ koilocytosis, dyskeratosis (LN stage 2)
• Advanced LN - severe dysplasia or carcinoma in situ /+-/ koilocytosis, dyskeratosis (LN stage 3, or CIS)

Microinvasive squamous cell carcinoma:

• clinically visible or invisible, but with appropriate symptoms
• subclinical, not visible to the naked eye and asymptomatic, revealed only by cytological and histological examination
• latent - the absence of morphological and histological changes when HPV infection DNA is detected by molecular hybridization
• intraepithelial neoplasia

Table 3. Classification of treatments for anogenital warts

Destructive Methods

1. physical
   • surgical excision
   • electrosurgical methods
   • cryotherapy
   • laser therapy
2. chemical
   • Nitric acid
   • trichloroacetic acid (TCA)
   • solcoderm

Cytotoxic methods

• podophyllin (PF)
• podophyllotoxin (PFT)
• 5-fluorouracil

Immunological methods

• interferons
• isoprinosine

Combined Methods

• combined application of various methods

Human papillomavirus (or HPV) refers to a whole group of infectious agents.

• Some types of viruses cause the growth of benign neoplasms on the skin - warts and papillomas.
• More than 40 species can provoke damage to the genital organs - the appearance of genital warts on the mucous membranes.
• Some types of virus are safe, others have oncogenic properties and can provoke malignant degeneration of tissues, development of cervical cancer in women.

The main ways of transmission of the virus:

• sexual (main route of transmission genital warts);
• household - through skin damage when touched or when visiting public places (pools, saunas, beauty salons, etc.);
• from mother to newborn during passage through the birth canal.

Once in the human body, the virus can exist for a long time (up to several years) asymptomatically.

But with a decrease in immunity and the presence of other predisposing factors, the virus is activated and causes the appearance of growths.

The biggest misconception of many people suffering from papillomavirus people is that this disease is a common cosmetic defect. Experts insist that even harmless small warts carry a mortal danger.

First of all, they indicate the presence in the body of a virus similar to herpes. External manifestations of the disease are only the "tip of the iceberg" - one of the external manifestations of the infection.

It has been proven that human papillomavirus is one of the most common infectious diseases on Earth. Its carriers are 70% of the inhabitants of our planet.

Types of HPV drugs

Medicines used in the treatment of HPV are divided into the following groups:

1. Antivirals.
2. Immunostimulants.
3. Means for the destruction of neoplasms.

First you need to determine the nature of the neoplasm: it is sometimes difficult to distinguish a papilloma from a mole or condyloma. Then, using PCR analysis, establish the type of virus, since some of them contribute to the development of malignant neoplasms.

Medicines against papilloma can be used in combination or separately.

Treatment results

Liquid nitrogen, homeopathy, folk recipes - all these remedies for removing papillomas are used in accordance with certain criteria. Small benign formations may disappear after a single treatment with a special pencil.

When it comes to homeopathy and other areas of alternative medicine, the treatment will take longer.

Among the products from papillomas, garlic, vinegar, potatoes, parietal protein of a chicken egg are most often mentioned. All of these remedies are often referred to as "homemade" because most of them can be found in the kitchen.

After the use of drugs, the DNA of the virus remains in the human body. The purpose of using drugs for papillomas is to get rid of external manifestations, strengthen immunity, and achieve the transition of HPV infection to a latent form.

Only local impact is possible with single formations on the body. In other cases, its effectiveness is 25-50%.

What conditions are necessary to achieve the best result?

• full diagnostics;
• combined approach to treatment;
• selection of the optimal treatment regimen.

Therefore, the key to successful treatment of papillomavirus is timely seeking medical help. There are a lot of medicines for papilloma, and a specialist should determine which one is best for a person in each case.

There are a lot of medicines for papilloma, and a specialist should determine which one is best for a person in each case. Papillock Plus balm Papillock Plus is an effective remedy for papillomas and warts. Then I applied it with a toothpick (it is more accurate, it takes less solution than the plastic included in the kit) on the wart itself verrukacid 7 times at intervals of 4 minutes.

The entire big toe was completely covered in small warts. There were several "candidates" for destruction on the upper eyelid closer to the eyebrows.

I would like to draw your attention to the fact that I am in no way campaigning specifically for Yodantipyrin. As a rule, a single treatment is sufficient to remove small warts.

First you need to understand what it is, consult a doctor and start treatment. It is better to treat HPV comprehensively, combining drugs from both categories: this is the most reliable option.

warts on the hands with a dense keratinized surface and plantar warts, it is necessary to eliminate the stratum corneum. To get rid of growths at home, you need not only to take medication, but also to strengthen the protective function of the body.

This happens when the immune system is weakened due to various diseases, hormonal failure or prolonged stress. Pharmaceutical preparations are especially popular, which are produced in several dosage forms: injections, tablets, suppositories, ointments and gels.

Papillomavirus infection is one of the most common viral diseases of the skin and mucous membranes.

Supercleaner” for the treatment of papillomas and warts. and did not regret - from.

To do this, it is sprayed onto the problem area, as a result of which the neoplasm changes color towards light, and then disappears. Many doctors advise it to their patients with osteochondrosis.

The position of this area of ​​the skin should approach the horizontal, then even a drop of the drug that accidentally gets on healthy skin will not flow. Larger papillomas (2-3 mm in size) are lubricated with the preparation 3-4 times, taking breaks to dry the applied liquid.

Unfortunately, various formations on the skin can appear in any person. Unfortunately, the removal of papillomas does not automatically get rid of the virus itself that lives in the body.

I'll drink now to strengthen the immune system so that it doesn't get out again. Papilloma is considered a benign formation that appears suddenly and causes discomfort to a person.

The maximum that well-chosen preparations are capable of is to keep microorganisms "in a black body", to stop their reproduction. Do not know what to buy a remedy for removing papillomas in a pharmacy? Immunostimulants are forbidden to use: They are sold in a pharmacy by prescription.

Intramuscular injections of the drug are given every other day, up to 10 injections per course. Such a drug is applied to the affected areas using an applicator.

Also, you can not apply the medicine for papillomas. papillomas on the neck, face, etc.

from warts. These funds must be applied pointwise very carefully.

Olesya from Rostov-on-Don writes: “About 5 years ago I faced the problem of papillomas. "Ferezol" is a dark brown oily liquid that has a pronounced smell of phenol.

The following medicines are most often prescribed by doctors in this case: Papilloma or a wart can be located in a very uncomfortable place, for example, on the face, hands, eyelids, genitals.

Improving immunity is what the body needs during the fight against the human papillomavirus.

HPV treatment is carried out in a complex, includes:

1. external influence on neoplasm tissues;
2. suppression of virus activity by antiviral drugs;
3. correction of immunity with the help of immunomodulating agents and vitamin complexes, which can be purchased at a pharmacy.

Antivirals

Antivirals are used to suppress HPV.

But it is important to understand that the treatment of the virus suppresses its activity, but does not completely rid the person of the infection.

Commonly prescribed drugs that have shown high effectiveness in the fight against the virus are:

• Groprinosin;
• Isoprinosine;
• Cycloferon;
• Galavit.

Preparations Groprinosin, Isoprinosine, Cycloferon inhibit the infection and stimulate their own immunity, that is, they have both antiviral and immunomodulatory effects.

• Groprinosin acts more gently, therefore it is the drug of choice for the treatment of children and the elderly.
• Galavit is taken for a long time, it can also be prescribed to children.

Drugs affect not only the virus, but the entire body. Do not use them without a doctor's recommendation!

Immunomodulators

To correct one's own immunity and increase the body's defenses, the following are most often prescribed:

• Likopid - tablets, used in combination with antiviral agents;
• Viferon and Genferon are interferon preparations in the form of rectal and vaginal suppositories that act both on the virus and on the immune system, stimulating the production of their own interferon;
• Allokin-alpha is an injectable biological product that has an immunomodulatory and antiviral effect.

Photo: viferon - a means to stimulate the immune system and fight the virus

Medical treatment of warts best medicines

So far, experts have not been able to create a drug that would destroy papillomavirus in the human body. Antiviral agents are able to suppress the multiplication of a non-cellular agent, improve the functioning of the immune system.

It is necessary to take such drugs only as prescribed by a specialist who will choose a medication after appropriate tests and draw up an individual regimen for its administration.

Indications for taking funds from papillomavirus are the following situations:

1. If the PCR method confirms infection with a virus of high and potential high oncogenic risk;
2. If there are multiple papillomas on the skin and mucous membranes (that is, with very high HPV activity);
3. If the body is in a primary or secondary immunodeficiency state (immunity is not able to cope with the infection on its own).

Antiviral drugs prescribed for papillomavirus cannot be used during the period of gestation and breastfeeding, as well as in case of individual intolerance to the components that make up the product.

Here are some antiviral drugs for papillomas:

Isoprinosine

Tablets that prevent a non-cellular agent from multiplying, as well as stimulating the immune system. If a person has ordinary papillomas on the skin, then for therapy it will be enough to drink a course of medications.

When warts are noticed on the skin, the patient is also shown surgical intervention.

Isoprinosine is taken from 14 to 28 days, and the dosage of the drug is determined depending on the age of the patient.

Panavir

A drug based on natural ingredients, known as a powerful immunomodulator and virus blocker. Panavir is available in the following dosage forms: suppositories for vaginal and rectal use, spray, gel, and injection solution.

The active substance of this medication, which promotes the synthesis of interferon in the human body, was isolated from potato tops. Often, the remedy is prescribed in the form of a gel, which is required to treat the affected areas of the skin twice a day.

If papillomas have formed in the vagina or in the anus, then suppositories are used to eliminate them. Panavir helps especially well in the initial stages, when the growths are not widespread.

Cycloferon

An HPV drug that induces interferon. The drug has anti-inflammatory, immunomodulatory and antiviral effects.

Cycloferon exists in the form of tablets, as well as in the form of a special solution for injections, which are prescribed to the patient up to 10 times per course of therapy and put them every other day.

Allokin alpha

It is a lyophilisate intended for the preparation of a solution and subsequent injections. It is based on a compound found in the larvae of calliphorids (carrion flies) and isolated from them.

Thanks to this solution against HPV in humans, the synthesis of interferon is stimulated, a decrease in the activity of the virus and an antitumor effect are also noted.

The therapeutic course consists of 6 injections, which are given subcutaneously once every two days.

The cure for papillomas

Therapy for papillomavirus infection is effective when combined destructive treatment (removal of papillomas and warts) with the use of antiviral and immunomodulatory agents. They suppress the activity of the virus, reduce the risk of re-growth of neoplasms after removal.

Medicines for human papillomavirus:

Experts are increasingly speaking in favor of systemic antiviral treatment. The times when papillomas were only removed, without complex therapy, should be a thing of the past.

It is good that new, highly efficient devices appear, for example, the Surgitron for radiotherapy. The increase in the number of infected HPV, the frequency of relapses - all this is a reason to take the disease seriously, not to consider its treatment as the prerogative of cosmetic surgery.

With papillomatosis, the following over-the-counter drugs are applied locally:

Drug treatment of skin neoplasms caused by HPV is rarely complete without drugs from this group. They have a detrimental effect on the virus, prevent its reproduction, and have an immunomodulatory effect.

Pharmaceutical preparations are especially popular, which are produced in several dosage forms: injections, tablets, suppositories, ointments and gels. Usually, with single formations, local application may be sufficient.

Antiviral ointments and gels are prescribed before and after the procedure of laser therapy, electrocoagulation, and after it, they provide high efficiency of treatment and prevention of relapses.

What are the indications for the appointment of systemic drugs against the virus:

• HPV infection of high and potentially high oncological risk, confirmed by PCR;
• multiple papillomas on the body (this indicates high HPV activity);
• primary and secondary immunodeficiency states (when the body cannot cope with the viral load on its own).

Antiviral drugs (injections and tablets) are contraindicated:

• during pregnancy;
• during lactation;
• with individual intolerance.

Most medicines are available by prescription.

What antiviral drugs are considered the most effective, and are able to get rid of papillomas?

The drug is available in tablets. This is one of the most popular cures for papilloma today. The active substance is inosine (purine derivative). Has a complex effect:

• blocks the enzymes of the virus, causing its death;
• activates the production of interferon;
• activates lymphocytes;
• inhibits the formation of inflammatory mediators.

It is prescribed 2 tablets per day for 2 weeks, if necessary, it is possible to extend the course of treatment up to a month. May be used in children over 3 years of age.

While taking Isoprinosine, nausea, headaches, exacerbation of gout may occur.

The drug is available in two forms: injection and tablets. The active ingredient is meglumine acridone acetate. The mechanism of action is the induction of interferon.

• antiviral;
• immunomodulatory;
• anti-inflammatory.

Intramuscular injections of the drug are given every other day, up to 10 injections per course.

Lyophilizate for the preparation of an injection solution. The active substance is a synthetic analogue of alloferon, isolated from the larvae of carrion flies (calliphoride).

• stimulates the production of interferon in humans and the mechanisms of cellular immunity;
• acts against tumors;
• contributes to the death of the virus.

Injections are made subcutaneously every 2 days, 6 injections per course of treatment. The agent is well tolerated.

Release form: solution for intravenous injections, ointment, gel spray inlayt for the treatment of the oral cavity, gel spray intim for the treatment of papillomas on the genitals. The active substance is a glycoside isolated from nightshade stems.

"Civilized methods" in the treatment of warts combine ointments and antiviral drugs. Since all these remedies are very strong, they must be used with caution: ointments can cause burns, and tablets can cause general harm to health.

External preparations

Cryopharma and Wartner - a drug for warts for freezing neoplasms at home. The tool is used for about 10 days, this time should be enough to completely get rid of papilloma.

The preparations are somewhat painful and may leave scars. Not recommended for children and pregnant women, as well as for removing formations in open areas of the body.

Ferezol and Verrukacid - a liquid from warts in drops, kills tumor tissue. Use 1 time per week. Do not use in sensitive places: on the genitals, in the anus, between the fingers. The preparations do not leave scars on the skin.

Kondilin, Lyapis Vartek, Solcoderm are creamy preparations for removing warts that act in exactly the same way as Ferezol.

Keratolics are preparations for warts that cause active exfoliation of neoplasm tissues. During treatment with these agents, it is necessary to protect healthy skin with a regular patch.

Kolomak is a drug based on salicylic acid. Softens wart tissue. The peculiarity of the application is that only one neoplasm can be treated at a time.

Salipod is a patch, its action is similar to that of Kolomak. In order for the patch to act more effectively, the formation must first be steamed.

Any external preparation for removing warts, which is based on an antiviral effect, can be used both independently and in combination. An integrated approach is more effective. Such means are popular: oxolinic ointment, Viru-Merz, Panavir, Viferon.

Oral antiviral drugs for warts should be prescribed by your doctor.

Apples for warts. memo

Iodine is not ignored, it is applied 2 times a day directly to the tubercle. Since the drug can cause a burn, healthy tissue must be protected with a cream.

Castor oil must be rubbed into the problem area. The method is rather inconvenient, since the rubbing time is 10-15 minutes. The procedure is repeated every day for a month.

People willingly believe in miracles. Some methods are outright nonsense - ironic gentlemen think so. But as soon as the skin bulges, they look into their grandmother's notebook to fish out a nice and safe recipe for warts.

For this method, you will need a round vegetable or fruit: a potato, beetroot, apple, onion, or something else. Cut it in half, rub the papilloma with one half.

Connect the halves and tie them with a thread so that they do not fall apart. Bury in the ground.

Choose a place with high humidity. You need to wait until the "treasure" rots, then the warts will disappear without a trace.

A simple and amazing cure for papillomas and warts from matches. Break off the heads of matches, set fire to them on a dry saucer. Cool and grind the coals. Drop a couple of drops of water (to make a thick gruel), lubricate the papilloma. Repeat 2-3 times a day until the complete disappearance of formations.

Celandine juice - fresh or prepared for the winter (how to prepare juice, you can read on our website) - apply to the wart several times a day. Try not to get on healthy skin. This tool is recognized as one of the most effective.

Tea tree oil is the least dangerous and most gentle remedy. Apply to the formation pointwise 2-3 times a day.

Prepare this ointment: mix castor oil and soda to make a thick slurry. Apply to the formation, fix with a plaster. Change the bandage 2 times a day.

Chop the peel of two lemons and fill it with table vinegar 9% (100 g). Let it brew for a week. Lubricate the problem area 2 times a day. Lotion should not be applied to healthy tissues.

Cut out pieces of onion that are convenient for applying to a sore spot, soak them in 9% vinegar. Attach to the wart, fix, leave overnight. Repeat the procedure every day.

Home remedies and pharmaceutical preparations for warts or papillomas can get rid of formations. This may take 2-3 weeks or even a month or two. You can use the services of cosmetologists, or you can remove the neoplasm on your own.

P.S. Surely you have an interesting and unusual recipe for treating warts? Share with us in the comments!

And the old 2 in the photo has become larger, more voluminous, with a pronounced relief. Ferezol is a reliable remedy for removing papillomas and warts. In a pharmacy, you can often see a cosmetic liquid intended for the treatment of human papillomavirus infection - Super Cleaner. The drug is treated from 5 to 30 days with repeated lubrication of growths per day. - For external use, the medicine is used twice a day, strictly according to the instructions. It is also necessary to conduct a course of therapy aimed at increasing immunity and normalizing the functioning of the nervous system. Before starting treatment for papillomas, you should consult a doctor and monitor the skin's reaction to drug treatment and how the papillomavirus behaves.

Folk remedies for papilloma. Traditional medicine has existed throughout the life of people.

After a couple of days, the formation will begin to decrease, and after five or six days it will disappear completely. The best healers are garlic and vinegar ointment, as well as an ointment made on the basis of celandine.

The most famous remedy of this type is the Salipod patch, which is glued to the wart. However, this medication also has a drawback - it cannot be used to eliminate formations on the face, in the groin, chest and underarms.

The Papillux preparation pleasantly surprises with its composition - it consists of 50 natural plant components (extracts).

What medicines for papillomavirus infection are common today, the main drugs for papillomas and warts, and which ones. Therefore, the choice of a medicine for warts and papillomas in a pharmacy is of no small importance.

Local (external) preparations are applied to the tissues of the growths: the altered cells die and fall off. We will be glad to help you, because the best doctors in Russia cooperate with us.

For any disease, many people do not know which remedy to choose from the many offered. They effectively get rid of warts, but often leave incurable scars after use.

For viruses that cause genital warts, sexual transmission has been proven. Pencil for removing warts and papillomas is easy to use, acts quickly.

It has an antiseptic and keratolytic effect. Its main active substances are salicylic acid and sulfur.

Cryo does not help (my opinion is a scam for a lot of money). You cauterize 5 mm, and the blister with lymph inside grows by 2 or 3 cm.

For this, probably, a lapis pencil or a laser, or a super celandine in a pharmacy, is better. After removing the wart, you need to drink isoprinosine 2 tablets three times a day.

To kill the papilloma virus in the body and prevent recurrence. If it is not possible to buy it yourself, you can ask your friends, for sure, someone will help in acquiring.

I spent 1400 rubles (200 rubles apiece) and killed a lot of time (the doctor took a big delay from the time of the appointment). And then you see that it grows into the skin very deeply.

They cannot be used to remove warts on the face. In the pharmacy you can buy such a tool as Mountain celandine.

The papillomavirus, once in the body, can settle in it for a long time. Preparations for the elimination of papillomas and warts have a number of differences.

It enters the human body from dogs, from fish and freshwater reservoirs, pork meat, even through the skin when walking barefoot. It can be seen that it has weakened in me - papillomas have appeared on my neck.

In these cases, I have never met a simpler remedy than verrukacid. But how to remove the cause - does anyone have experience in using an antiviral in such cases.

Apparently, I need to go to the surgeon ... Aldara helps very well, however, the price of the cream is very high. It is an effective domestic drug designed to remove a number of benign formations on the skin (warts, papillomas, genital warts, dry calluses, keratomas).

Many years later, the body failed again, reappeared on the foot. Thus, removing such formations from the surface of the skin cannot guarantee that they will not appear somewhere else on the body.

Systemic drugs (tablets, capsules) inhibit papillomaviruses from the inside. In the same way, I removed a huge wart from the finger of my grandson -5 years old.

Cut off a piece of onion and glue it to the wart with a plaster at night. Pharmaceutical celandine is too strong, ferezol seems to have ceased to be sold at all.

there were many other options, but in the end I took verrukacid. Medicines against papilloma can be used in combination or separately.

In the first days of therapy, there may be a short-term increase in body temperature to subfebrile values. The remedy for papillomas should be prescribed by the attending physician.

The cost of one package of medicine is on average. Oxolinic ointment for warts and papillomas Immunomodulators are also many preparations that contain natural ingredients.

More than 100 types of human papillomavirus (HPV) are known, each of which causes neoplasms of a certain type and localization: papillomas on the body, mucous membranes, convex and flat warts on the arms and legs, genital warts and other growths.

Choosing an effective cure for papillomas is not an easy task, so it is better to entrust it to a dermatovenereologist. Two groups of drugs are in demand, fundamentally different in their action.

Here's why: What medicine for papillomas and warts will produce the best effect? ​​Papillomavirus can spoil not only the appearance.

Home remedies for papillomas

In addition to external effects on papilloma tissues, various home remedies need to strengthen the immune system, cleanse the body of toxins and toxins, and support liver function.

To strengthen immunity

An effective immune system strengthening herbal collection includes in equal proportions:

• Castor oil;
• Garlic ointment;
• Lapis pencil;
• Celandine (super celandine);
• Potato juice.

Castor oil is rubbed into the formation in a circular motion for 10 minutes. The procedure should be repeated no more than 2 times a week.

Age spots on the skin can be made less noticeable if they are treated 2 times a day (in the evening and in the morning) with castor oil.

You can not injure papillomas, warts and condylomas. More effective treatment is carried out if the drug is applied after rejection of part of the formation tissues.

Only a month after the use of castor oil, the first signs of epithelium rejection are observed.

Local protection is important in papillomavirus infection. Despite active treatment, the virus remains in the body forever.

The immune system destroys the active pathogen by producing antibodies to its antigens. With immunodeficiency, the mechanism is disrupted, so HPV gets opportunities for intracellular reproduction.

Prevention of papillomas

Drug treatment of papillomas may not be necessary if care is taken in advance not to become infected with HPV. Preventive measures are aimed primarily at maintaining the body's defenses.

In order not to have to use drugs for papillomas, you need to provide a high-quality and balanced diet that will ensure that the body receives the necessary amount of vitamins and minerals.

Papillomavirus infection is by far the most common pathology. The pathogen affects the integumentary epithelium and mucous membranes of the urogenital tract, oral cavity, throat, tongue, nose. Medications are selected taking into account the type of virus, which is determined in the process of diagnostic measures. Modern methods of treating HPV in women with effective drugs can eliminate the external manifestations of the infection, curbing its spread, and strengthen the immune system.

HPV is a highly specific human infection that can affect the cells of the integumentary and mucosal epithelium. A high concentration is found in the seminal fluid, urethra, Bartholin glands, located on the eve of the vagina. Infection occurs through sexual or contact-household contact, and the presence of microtrauma increases the risk of infection. To date, more than 100 types of papillomavirus have been identified, 35 of them have a pathological effect on the urogenital tract.

The degeneration of normal cells into cancer cells is preceded by tissue dysplasia, which can be treated in the early stages. The appearance of genital warts and warts rarely leads to such severe complications, most often they cause cosmetic discomfort. But localized on the body in places of greatest injury (genitals, anus, inner thighs), they increase the risk of developing a precancerous condition. To avoid sad consequences, it is necessary to regularly undergo an examination and remove growths.

Attention! It has been proven that HPV is the only group of viruses that causes the formation of malignant processes. The most formidable of them are cervical cancer in women and penis cancer in men.

Treatment of HPV in women is a complex process. Its effectiveness and feasibility to this day remain topical topics for discussion in the existing probability of complete elimination of the virus. Until now, specific drug treatment has not been developed, so attempts to achieve the complete destruction of the pathogen remain inconclusive. The fight against HPV is mainly aimed at suppressing its activity, removing existing pathological neoplasia, and immunocorrection.

The Importance of Diagnosis

Genital warts and other growths on the skin are easy to diagnose, since their presence is determined by visual inspection. It is much more difficult to identify the pathology at an early stage, because the disease is characterized by a long latent period, during which the virus is dormant and does not attempt to reproduce. And here modern diagnostics comes to the rescue.

The use of laboratory methods is aimed at studying the biopsy at the cellular level, detecting HPV DNA, E7 oncoprotein, and determining antibodies to the virus. An integrated approach involves the following procedures:

• clinical examination of the external genital organs in order to identify growths;
• colposcopy to determine the presence of intraepithelial neoplasia;
• Papanicolaou testing (PAP test);
• immunological methods - PIF, ELISA, RSK;
• PCR - polymerase chain reaction;
• DNA probe;
• cytological examination;
• histology and biopsy of a tissue sample.

It is important to know! Important in the process of research is the typing of HPV, the determination of its group affiliation, taking into account oncogenic risk. This is achieved using the Digene test.

Goals of medical treatment

Despite the rapid development of medicine, the creation of advanced diagnostic methods and highly effective medicines, a specific cure for papillomavirus has not yet been invented to completely destroy it. Therapy is aimed primarily at eliminating the external manifestations of HPV, as well as for the treatment of a number of other problems:

• prevention of reactivation of the virus;
• reducing the risk of complications, including the prevention of cervical cancer;
• stimulating the immune system, strengthening the defense mechanism.

What methods the doctor will operate on and how he will treat HPV in women, what drugs he will choose, depends on many factors: history, somatic status, size of neoplasms, their number and localization. The woman's tolerance to prescribed medications is also taken into account.

Commonly used medicines for women

Local treatment of HPV in women is aimed at removing growths (warts, warts) and atypically altered epithelium using cytostatics, chemical coagulants, and destructive methods. After that, in order to prevent relapse, therapy with antiviral drugs, nonspecific immunomodulators, and interferon inducers is indicated. Since the virus is transmitted sexually, both partners must be treated at the same time.

Immune Boosting Drugs

A fairly common range of antiviral drugs for human papillomavirus, which increase the body's defenses, is prescribed after determining the woman's immune status. They allow you to achieve stable remission, and in some cases reduce the size of papillomas. The following dosage forms are considered affordable and convenient to use:

• dragees, lozenges, papillomavirus tablets;
• rectal and vaginal suppositories;
• suspensions;
• solutions for injections;
• ointments, gels, creams for external use.

Among the medicines, the drug "Indinol" and vitamin complexes are popular.

With the human papillomavirus, the following list of drugs is also used for treatment.

"Likopid". HPV sublingual tablets for women. They have a pronounced effect, strengthens the immune system, allowing the body to fight the virus on its own. The action of the drug is equivalent to a vaccine.

"Viferon". One of the most effective means in the treatment of HPV infection in women. A pronounced stimulating effect is achieved due to the recombinant human interferon Alpha 2, which is part of it. It prevents infection with strains of high oncogenic risk. It is prescribed in the form of suppositories or ointments.

"Altevir". Effective immunostimulator. It contains human alpha 2 interferon. The combined agent has antiviral and immunomodulatory effects. Used in the treatment and prevention of cancerous tumors. Stimulates the synthesis of cytokines and enzymes. It is given as an injection.

Antiviral medicines

To date, there are no drugs with a specific action aimed at destroying the DNA of the papillomavirus. Antiviral drugs for HPV suppress the replication of the causative RNA. The list of the most popular includes the tools described below.

Groprinosin. Highly effective cure for HPV. The action is aimed at stimulating immunoglobulin, the production of Alpha and Gamma interferon. As a result, the manifestations of the virus are significantly suppressed, and the risk of re-formation of neoplasia is reduced. If necessary, the drug can be replaced by an effective, but cheaper analogue of Isoprinosine.

"Allokin-alpha". The drug is effective against HPV of high carcinogenic risk and is often used in the treatment of cervical dysplasia. It is also actively used in the treatment of recurrent papillomatosis. It is not recommended to prescribe the drug during pregnancy, lactation and autoimmune diseases.

Panavir. An inexpensive combined antiviral drug has a good antiviral, immunostimulating effect. It is prescribed for the formation of genital warts in the urogenital tract. A feature of the drug is the absence of an addictive effect.

With no less success in the treatment of HPV, such medicines as Acyclovir, Galavit, Proteflazid (for the treatment of the papillomavirus and herpes of the child) are used.

Means for the destruction of growths

It is possible to fight cosmetic defects on the skin that are caused by the activity of a viral infection with the help of cytostatics and chemical coagulants. The following drugs are widely used.

"Podofilin". The tool is made from resins of plant origin. It is produced in the form of a solution that is used externally on warts or papillomas. The exception is genital warts, which form on the mucous membranes of the internal genital organs. The tool is recommended to be used according to the scheme: apply to the pathologically altered area directly under the root and wash off after 4-6 hours. It is used once every 3-6 days, a course of 4-5 weeks.

Ferezol. Cytotoxic drug in the form of a solution with the property of mummification. Contains phenol and tricreazole. Processing with the composition is carried out once every 10 days. Used until clinical effect is obtained. Compared to other drugs, it has a low price.

"5-fluoroacyl". The most popular cytostatic comes in the form of a cream. It is applied externally to treat pathological growths once every ten days, preferably at bedtime.

Solcoderm. Consists of a mixture of acids of organic and inorganic origin. It is applied with an applicator to an area up to 4-5 cm. Each session is carried out at intervals of 1-4 weeks. Can be used both externally and internally.

"Epigen Spray". It is used for irrigation of altered areas both outside and on the mucous epithelium in a course of seven days. In the latter case, a special nozzle is used. During the day it is allowed to apply up to 6 times.

Advice! Prescription cytostatics can only be recommended for external use. They can not be used in the treatment of warts localized on the mucous membranes. During therapy, side effects in the form of nausea, vomiting are possible.

Reviews of women about the best drugs

Medicine does not stand still, which allows many women not only to get rid of external growths caused by HPV, but also to get a stable remission. This is evidenced by the reviews that are found on the Internet.

Alena, 37 years old

“Several years ago I had small “pendants” - papillomas. They did not cause discomfort, but I still went to the doctor. He diagnosed me with HPV infection. I was prescribed injections of "Cycloferon", immunomodulators - "Likopid", "Lavomax". The growths were removed by the surgeon. After I completed the course of treatment, I managed to achieve a stable remission.

Lyudmila, 29 years old

“During pregnancy, still at an early stage, I noticed incomprehensible growths in the form of moles on a thin leg. Frightened, I immediately ran to the therapist. He referred me to the gynecology department. The doctor prescribed the drug "Aevit" and candles "Viferon". He also explained that this will not affect the intrauterine development and subsequent life of the fetus, but I can infect it at the time of labor. Now I am seeing him and looking forward to the birth of the baby.”

Preventive measures

Vaccination is considered an effective measure to prevent the reproduction of HPV.
A full course of three vaccinations results in the production of antibodies to 4 strains, and strengthens the defense mechanism against many other types of virus. For immunization, quadrivalent serum "Gardasil" and bivalent serum - "Cervarix" are used. The vaccine does not contain HPV DNA, so it is not dangerous and does not carry the risk of infection. The procedure is optional, recommended for adolescents aged 9-14 and women under the age of thirty.

Conclusion

HPV is considered a dangerous disease that requires highly accurate diagnosis and adequate treatment. Properly selected therapy allows you to get rid of the external manifestations of the infection in a few days, and at the next stage - to suppress the activity of the virus and strengthen the immune system. Only with this approach, the patient will be able to get more chances for a full recovery.

The papilloma virus causes an unpleasant disease, clinically manifested by growths on the skin and mucous membranes. It is necessary to treat HPV comprehensively, taking into account antiviral drugs, immunostimulants, and remove papillomas.

The human papillomavirus causes a contagious infectious disease. The causative agent is transmitted from the carrier to a healthy person in three ways - from mother to child during childbirth, by household contact, through sexual contact. The last option is the most common. Once in the human body, the pathogen is attacked by the immune system, after which it goes into a latent state.

To activate the virus, a strong immune decline must occur (hypothermia, antibiotics, stress, etc.). As soon as a favorable environment for the reproduction of an infection is established in the body, viral formations appear on the human body - warts, papillomas, condylomas. The location of the growths depends on the method of infection. For newborns who passed through the birth canal with pronounced formations, papillomatosis of the larynx is characteristic. People who become infected during sexual contact experience warts in the genital area and anus. Using other people's things leads to the appearance of warts on the hands and feet.

The virus knows how to adapt well. It is quite difficult to completely remove the pathogen from the body with the help of medicines, sometimes without surgical intervention, it is impossible.

Which doctor to contact

HPV is an infectious disease. Theoretically, an infectious disease doctor should deal with pathology. The patient should consult a general practitioner or family doctor. If papillomavirus is suspected, a referral to a specialized specialist will follow.

Condylomas in the woman's vaginal area will be examined by a gynecologist. Perhaps, in addition to the examination, a colposcopy and taking smears for further research will be required. A thorough diagnosis is necessary for formations on the cervix.

Men will go to the urologist. The penis and urethra will be examined.

Formations on the surface of the skin of the body will be examined by a dermatologist - venereologist. The doctor will identify the type of growths, conduct additional studies and prescribe the necessary treatment to eliminate papillomavirus.

To detect the type of HPV, a laboratory test is necessary. It is relevant for suspected oncogenic strains. In women, these types of HPV lead to dysplasia and cervical cancer. In men, they can cause oncology of the head of the penis. If a dangerous strain is found, observation by an oncologist may be required. If the results are negative, the patient will continue treatment in gynecology or urology.

To identify the causes of the immune decline or if formations occur frequently, even after complex treatment, an immunologist's consultation is required.

If a person cannot get an appointment with a therapist, you can contact a specialized doctor. If manifestations of papillomavirus occur, postponing a visit to the doctor is dangerous to health.

HPV Treatment Methods

Treating the human papillomavirus is difficult. To achieve the result, it is necessary to carry out a set of measures, which will include stimulation of immunity, suppression of the pathogen and excision of growths. This tactic helps to prevent the risk of relapse, which is often observed in older patients. For young people, removal is enough, the immune system is able to fight the infection on its own.

Antivirals

Antiviral drugs are necessary to suppress the infectious process. The substances that make up such drugs block the ability of the pathogen to reproduce, thereby preventing the likelihood of the appearance of new viral foci.

Viferon is the most common antiviral drug. Interferes with the synthesis of proteins by the virus, inhibiting the ability to spread. Relieves itching in the affected area. Available in the form of suppositories for rectal administration and as an ointment for external treatment. The treatment regimen is selected individually, depending on the severity of the symptoms. Analogue - Cycloferon.

Allokin Alpha is the most effective antiviral drug. Enhances the production of antibodies to the pathogen. According to statistics, 80% of patients treated with Allokin show clear improvements in a short period of time. The medicine is injected subcutaneously. The course of treatment is 6 injections.

Panavir is an antiviral agent for systemic use. It is used in the complex therapy of papillomavirus. Release form - solution for intravenous administration.

Immunostimulants

Medicines, the main focus of which is the restoration of the body's immune defenses, are important components of proper treatment. The immunostimulator helps the body recover, create the necessary barrier.

Immunomax is an immune system stimulant. The medication is used exclusively as prescribed by the doctor. It is injected into a vein or under the skin. Treatment consists of 2 stages.

Isoprinosine is an immunostimulant that helps the maturation of T lymphocytes and the active production of antibodies to the virus, restores the required level of immunoglobulins. Administered by injection. The average course of therapy is 2 - 8 weeks.

Genferon is a drug for restoring natural defenses. Available in the form of rectal and urogenital suppositories. The main component is recombined human interferon.

Hardware methods for removing papillomas

Removal of papillomas by hardware methods allows you to effectively and quickly get rid of growths on the body. The main procedures for excision are:

1. Laser burning. Produced by exposure to a laser beam that vaporizes the wart tissue. The advantages of the method are high accuracy and efficiency. The disadvantage is the inability to conduct histology to detect cervical cancer. The laser burns out the entire formation.
2. Cryodestruction or freezing with liquid nitrogen. Under the influence of low temperature nitrogen, papilloma tissues are destroyed and die. Healing time takes up to 2 weeks.
3. Radio wave excision. Removal is carried out in layers using high-frequency waves. The method is painless and bloodless. It is considered the least invasive method of treatment.
4. Diathermoelectrocoagulation. Due to the coagulative property, the risk of blood flow and the spread of infection is completely excluded.
5. Surgical removal. The procedure is performed extremely rarely due to trauma. If further histological examination is required or for special indications, this is the best option.

The patient can choose the technique of hardware treatment independently, taking into account the recommendations of the attending physician.

Other treatments

Removal of formations at home can be done with chemical pharmaceutical products. When choosing a drug, you should take into account the effect of drugs on the skin. For example, therapy of the intimate area should be carried out with special sparing means. Available in the form of ointments, drops, aerosols. Effective means from a pharmacy are:

• Ferozol;
• Dermavit;
• Supercleaner;
• Mountain celandine;
• Wartner Crio;
• Verrukacid;
• Kondilin;
• Epigen intimate;
• Vartek;
• Solcoderm;
• Kollomak.

Purchase preparations to remove growths as prescribed by the doctor. Please read the instructions carefully before use.

Non-traditional HPV suppressive treatment involves the use of medicinal plants, herbs, food and other improvised means. Celandine juice is considered an effective substance for removing warts in folk medicine. They treat damaged areas until the papillomas disappear completely. Use garlic, soda solution, citric acid, laundry soap, ammonia, iodine, kerosene.

1. Antimonium krudum - for warts on the hands and soles.
2. Causticum - with growths in the armpits, hands, face, ears, neck.
3. Argentum nitricum - removal of formations on the mucous membranes.
4. Thuja is a universal antiviral agent.

Adherents of homeopathy should consult with a specialist before purchasing medicines.

Another method of adjuvant therapy is taking vitamins. The drugs have a beneficial effect on the immune system, helping to get rid of a viral disease.

Is it possible to get rid of the papilloma virus in the body

Human papillomavirus refers to those diseases that are almost impossible to completely remove from the body. A carrier of PVI can face relapses of the disease throughout life, subject to weak immune defenses.

There is information about the self-healing of the body. This phenomenon is observed in young patients with strong immunity. HPV is exfoliated from the surface of the cervix during 3 menstrual cycles. Even without treatment in such patients, the virus clears itself 2 years after infection. This can happen if the infection manifested itself during pregnancy. In such a case, after childbirth, all clinical symptoms of the disease completely disappear.

If a person pays attention to immunity, leads a healthy lifestyle, is treated correctly and in a timely manner, the risk of reappearance of growths on the body is negligible.

Prevention of re-infection is the observance of hygiene standards, the presence of a permanent sexual partner, the timely treatment of acute diseases and vaccination.

Treatment prognosis and possible complications

Comprehensive treatment of the human papillomavirus will remove the symptoms of the disease and introduce the infection into a "sleeping state". The main task of the patient is to follow the doctor's recommendations during the rehabilitation period, to maintain the normal functioning of the immune system.

If left untreated, there is a risk of worsening the disease. Papillomas in the mouth affect the vocal cords. Growths on the body can be injured, the introduction of pathogenic infections is likely. Condylomas in the anogenital region can damage the tissues of external, internal organs. The growth of growths leads to papillomatosis. The most dangerous complication of papillomavirus is oncology.

When choosing a method of treating HPV, whether it is taking a pill or hardware treatment, a person should remember the need for diagnosis. Only a correct diagnosis can be the basis for further tactics of the doctor.

Modern antiviral drugs are available in the form of tablets for oral administration, ointments, solutions and gels for the treatment of papillomatous growths. Topical preparations are intended directly for the removal of formations and have a cauterizing or freezing effect.

Attention! The result of the desire of modern manufacturers to improve their own medicines has been the emergence of highly effective drugs containing interferon, a protein that counteracts viruses and pathogens, obtained through synthesis in the laboratory.

Such drugs exclude the recurrence of warts, which patients often face after the removal of growths.

Local treatment of papillomas and similar formations is definitely recommended to be supplemented with antiviral drugs produced in the form of tablets. These funds are designed to suppress the activity of papillomavirus from the inside. Without the use of oral antiviral drugs, the use of creams, ointments and solutions to treat growths will only be a temporary solution to the problem.

Tablets from papillomas

To date, there are many tableted antiviral drugs against HPV, which can supplement the destructive treatment of papillomas, but experts attribute the highest efficiency in this category of medicines to:

Description of ointments

Destructive treatment of papillomatous growths on human skin can be performed using a variety of drugs that differ in cost, effectiveness and side effects. If you are aimed at the rapid removal of papillomas and warts, for these purposes, experts recommend using:

Indications and side effects

The use of an antiviral drug should be approached taking into account the existing contraindications and side effects. Thus, many tablet preparations are not recommended for the treatment of children under the age of three, as well as patients diagnosed with gout, urolithiasis, heart rhythm disturbances, and hypersensitivity to the constituent components.

Attention! It is necessary to take into account the fact that not all tablets with antiviral effects are allowed to be taken by pregnant women, as well as during lactation. During the treatment period, patients may experience unpleasant side effects. We are most often talking about dizziness, arrhythmia, nausea.

Before using topical antiviral agents, it is important to exclude individual intolerance to the composition, which can cause the development of an allergic reaction, manifested by itching, rash and redness of the skin. Also, when processing growths, it is extremely important to exclude the ingress of funds into healthy areas, which is fraught with the formation of burns and wounds.

The cost of drugs for the treatment of HPV

On the shelves of modern pharmacies, you can find both expensive antiviral drugs and their cheaper counterparts, which are also quite effective. For example, the cost of Isopronisin reaches 660 rubles per package with 20 tablets, but you can use other well-known and affordable analogues, namely:

As for topical preparations, the price of the highly effective Supercleaner ranges from 15 to 110 rubles and depends on the volume and manufacturer. More expensive is the Panavir gel, which today is distinguished by its effectiveness and safety. Its cost starts from 160 rubles for a volume of 3 g.

When choosing effective antiviral drugs, preference can also be given to:

• Viferon - about 170 rubles for a volume of 12 g;
• Acyclovir - 22 rubles for a volume of 5 g;
• Verrukatsidu - 232 rubles for a volume of 2 g;
• Feresol - 366 rubles for a volume of 10 ml.

Each antiviral drug will be sufficiently effective only in the conditions of its appointment, taking into account the severity of the condition and individual characteristics. In this regard, it is recommended to trust the attending physician to determine the optimal therapy for papillomavirus.