HPV 45 type: what is it and how dangerous?

After living a large part of life, to the age of 50 people usually get a decent baggage of various diseases. Some of them are the result of irrational nutrition, wrong lifestyle, bad habits, etc., the other is formed under the influence of various viruses and infections that enter the human body and parasitize inside it. Some types of such viruses, for example HPV type 45, first described in 1987, in turn provoke the development of life-threatening health pathologies, which are called oncological. And since only the one who is warned and owns information is considered to be protected, we will try to give the reader a maximum of necessary information about such an insidious virus.

How dangerous is HPV type 45?

HPV is an abbreviation of a pathogenic factor known to us as human papillomavirus or papillomavirus. It is present in the body of a large number of people, because it is able to move quite quickly from person to person.

Papillomovirus is the cause of the appearance on the skin of tumors, which people call warts. It would seem that it is dangerous, because warts do not cause harm to health, causing only some physical and psychological discomfort. But not everything is so simple.

The fact is that the human papilloma virus has many varieties, each of which affects human health in different ways (according to various sources from 100 to 600 strains, in connection with which they had to be numbered). For this reason, different types of the virus were divided into 4 classes, indicating how dangerous this species is for humans.

The safest non-oncogenic class of HPV include types 1,2,4,5, 7, 10, 28, 41,53 and some others. It is these viruses that cause vulgar, flat and plantar warts to appear on the body, which practically do not degenerate into malignant neoplasms.

Types of HPV 3, 6, 11, 13, 32, 42, 44 and some others are considered to be representatives of a class with a low oncogenic risk. That is, the pathology associated with these viruses, detected in the early stages, does not develop into an oncological problem with timely effective treatment. Otherwise, the risk of developing cancer still remains.

HPV 30, 35, 52 and several other types is a class of average oncogenic risk. These types of virus do not always lead to cancer, but under the influence of adverse factors over time, the disease with a high probability of becoming malignant.

Viruses 16, 18, 31, 33, 39, 45, 50 and some other types are classified as factors of high oncogeneity. The presence of these viruses in the human body is very dangerous by a high degree of probability of development of oncological pathologies.

To put it bluntly, the presence of type 45 HPV in the body increases the risk of developing benign tumors into malignant tumors dozens of times, although the most oncogenic in this regard are still 16 and 18 types (HPV type 45 is found in only 5% of cases of cervical cancer) . However, this is not a reason to panic, because from the moment the virus enters the body before the beginning of the process of cell digestion, more than one year often passes. And then the degeneration of cells in this case occurs only under suitable conditions.

HPV type 45 is one of the viruses that can cause a pathological degeneration of the cells of the vaginal mucosa and cervix in women. So, it becomes one of the main reasons for the development of cervical cancer, and in particular cervical cancer. Only here it is not necessary to think, that having got in an organism, the virus at once will cause development of cancer pathology. This is a long process, going on in several stages, from the primary infection of the basal layer of the epithelium to irreversible changes in its structure, when the cells begin to divide uncontrollably, thereby increasing the number of pathogenic clones. From the moment of infection with the virus before the appearance of malignant neoplasms against the background of a decreased immunity, it can take about 10 years.

Thus, if you regularly undergo medical examinations, paying attention to the appearance of suspicious symptoms such as the appearance of warts and genital warts on the body, inflammatory processes on the internal female genitalia, etc., you can prevent the transition of the disease into a malignant form.

Getting into the human body, papilomavirus remains there for a long time. Remove it from the body is almost impossible, because the virus is implanted in the cellular structures and lives there for a long time. To prevent the development of diseases caused by HPV, it is enough to introduce the virus into an inactive state, following in the future measures to prevent its return to the active stage.

In some cases, after a time, the virus in the body was not detected even in the absence of treatment. But if he was diagnosed 3 or more times during the year for an aggravating disease, the risk of developing epithelial cancer increases more than 10-fold.

Structure of the hPV type 45

The human papilloma virus is presented in the form of spherical forms of very small size. The diameter of the HPV molecule does not exceed 55 nm. Molecules have a simple structure: a nucleus containing an annular closed DNA consisting of 2 chains, and a protein envelope (capsid).

Papillomavirus DNA contains 2 kinds of genes: early, which is denoted by the letter E, and late, designated by the letter L. E-genes are responsible for the transfer of genetic information (replication and genome) and cell modification, and L-genes (segments of genome L1 and L2) are involved in the formation of the cell membrane. Between these sites is a long-term control site (LCR), which regulates the synthesis of viral proteins.

Responsible for the appearance of malignant neoplasms are proteins E6 and E7, which are able to attach to tumor-forming genes (p53 and Rb), causing transformation of cells and their uncontrolled division. At what at highly-onocogenic viruses such joining takes place more actively.

Classification of HPV by types is based on the fact that different strains of the virus have different sequences of E6 and L1 genes, and therefore their behavior is markedly different: some do not manifest themselves throughout the life of the person, others cause the appearance of benign neoplasms, and still others like HPV type 45, provoke the transition of the latter into a malignant form, penetrating into the structure of healthy cells of the body and gradually causing them to become maglinized.

The life cycle of any virus is based on survival. And for this he needs to reproduce a set of similar molecules that have the same properties (the replication process). By itself, the virus can not live, therefore, when attached to a living organism, it begins to search for itself a host cell, forming with it one thing in common. The protein envelope of the virus is able to bind to the specific proteins of the host cell's shell, where it forms a small gap, through which it penetrates inside. It is on the basis of the material of the host cell that the virus forms its offspring.

Cell replication occurs in 2 stages: first, the chromosome set is doubled, and then the cell is directly divided into the maternal and daughter cells. When dividing a cell, the daughter molecule acquires maternal properties.

DNA cell damage can occur in both stages, and this is considered a natural accident. The program of cells is such that, for various damages, the replication process is suspended, and at that time, the p53 and Rb genes begin to correct errors. The addition of E6 and E7 virus oncoproteins violates the process, and cell division ends with malignant mutations.

In principle, until the virus finds a host cell, the proteins E6 and E7 are under the control of other proteins of the early and monitoring site. But getting into another environment, onkobelki lose control and begin to actively synthesize their own kind. In the end, this situation leads to a disruption in the functioning of the host cell.

Adhering to the host cell, the virus can exist in it in 2 forms:

• The episomal form is characterized by the fact that the virus exists outside the chromosome set of the cell, and therefore is not capable of changing its characteristics. Infectious process in this case can occur both in latent (latent) form, and with the formation of benign warts and papillomas, which is considered a kind of protective reaction of the body.
• An integrated form is the introduction of a virus into the chromosome set of the host cell, which leads to a change in its properties and confuses the immune system of a person who does not know how to treat such entities and loses control over their division. Unregulated reproduction, atypical cells cause tumor growth.

By the way, such phenomenon as neoplasia or dysplasia of tissues can be observed in both forms of HPV existence, while a benign process under the influence of certain factors can at any moment change its character to a malignant one.

Ways of penetrating HPV into the human body

The human papilloma virus, regardless of its type or strain, can live and multiply, only parasitizing on the living body. He has several opportunities to get inside the body.

HPV type 45, as one of the varieties of papillomavirus can enter the body in several ways:

• during sexual intercourse (the virus is transmitted from an infected person sexually with no means of protection in any type of sexual intercourse), the probability of infection is more than 50%,
• contact path (touching the genitals and secretions of the virus carrier, wearing his clothes, shaking hands),
• household way: by means of infected tools (in a manicure and dental salon, in a hospital with insufficient processing of equipment, using cosmetology tools and hygiene items of a person with papillomavirus, etc.), through air and water in public places (swimming pools, saunas, GYM's),
• when passing through the birth canal (a child can get infected from the mother if this virus was present in the body at the time of delivery). Later, the mother can transfer the baby HPV by contact, often touching the naked body and genitals of the child,
• there is also the possibility of self-infection by transferring the cells of the virus to other parts of the body (usually during epilation or shaving, scratching on the skin), medical workers may be infected by the virus due to medical manipulation.

Yet the most common cause of infection with papillomavirus is unprotected sex with people who are carriers of the virus (sometimes even without knowing it). At the same time, getting a virus into the body does not mean that it will necessarily cause the development of a pathology or malignant process.

So that HPV type 45 leads to the development of oncology, one or more risk factors are necessary:

• weakened immunity (in turn, the decrease in the immune response of the body and the resistance of the infection, including viral, contribute to multiple diseases of internal organs and immune pathologies, a lack of vitamins in the body, bad habits, cytostatic therapy in the past)
• presence in the body of an infectious factor (bacteria, fungus, viruses) that causes inflammatory processes in it, special attention should be paid to sexual infections and gynecological pathologies (chlamydia, gonorrhea, bacterial vaginosis, etc.)
• early onset of sexual activity, a large number of sexual partners, among whom may be viral carriers, patients with cervical cancer, etc.,
• disorders of the hormonal background (during pregnancy and menopause, during and before the menstruation, with diabetes, as well as taking steroid drugs and hormonal therapy) and metabolic processes in the body,
• weakening of the nervous regulation of the processes occurring in the body, under the influence of frequent stress and nervous overstrain,
• medical procedures on the genitals,
• hereditary predisposition to cancer diseases (the risk of oncology is always higher in those people who already had cases of cancer of different etiologies in the genus).

[1], [2], [3], [4], [5], [6], [7], [8],

Symptoms

Human papillomavirus is a rather insidious form of a living organism that does not imagine life outside the donor. But, even hitting the human body, a viral infection can behave differently depending on its condition.

Any type of HPV causes the appearance of various tumors (outgrowths) on the skin and mucous membranes: warts, pointed and flat condylomas, papillomas, but not all types of the virus are capable of provoking progressive tissue neoplasia (cancer). HPV type 45 refers to a variety of the virus with oncogenic properties.

Nevertheless, this type of human papillomavirus does not always lead to the development of cancer. It is worth saying that in most cases, papillomavirus infection occurs in a latent form, i.e. There are no symptoms of pathology. To detect a mutation of cells under the influence of the virus is possible only with the help of laboratory research of tissues.

Different types of the virus cause the appearance of external symptoms in different parts of the body. With type 45 HPV, neoplasms can be found on the skin and mucous in the area of the anus and genitals, as well as on the covers of internal genital organs in women. With the latent form of the virus pathology of type 45, the presence of the virus can be found in the cervical and vaginal membranes, although no external changes are noted.

Under the influence of provoking factors, the disease can go into a subclinical form, when only certain undefined symptoms of the pathology appear. Patients can complain of unpleasant sensations and itching in the genital area, experience discomfort during sex and urination, and find incomprehensible growths in the genital area and anus. Later similar neoplasms in the form of pointed or flat (especially dangerous) warts on the inner surface of the vagina, cervix, large intestine can be found. Histological and cytological studies show the presence of hyperkeratosis (tissue densification), in some cases even virus DNA is detected.

All this time the virus is in human cells, not interacting with their DNA, but only causing increased proliferation of limited areas. But if the immune system fails, the parasite molecules build their DNA into the chromosomal set of the carrier cell. There comes the third stage of the development of pathology - the clinical (integrated form of the existence of the virus).

At this stage, it is possible to observe a change in the structure of cells - koylocytosis, which is a sign that dysplasia of the vaginal or cervical tissues is caused by the human papillomavirus. So far, histological examinations and colposcopy have not shown the presence of mag- nylated cells, but there is a noticeable proliferation of tissues on the genitals.

In 4 stages of pathology, special laboratory studies and colposcopy will show the presence of mutated structures, and directly of cancer cells, which, when detached from the locus, can spread with the lymph flow throughout the body (invasive cancer).

Now other symptoms are added to the already existing symptoms, indicating severe pathological processes in the body: weakness, dizziness, deterioration of the skin, spotting from the genital organs, soreness in the lower abdomen in women. Similar symptoms can be observed at the 3 stages of the development of a viral infection, and it is possible to determine dysplasia or cancer only by histological studies, colposcopy and biopsy (the latter is considered the most reliable method of diagnosing cancer).

HPV type 45 in women

Because HPV infection of type 45 occurs both sexually and by contact, "catch" it can and women, and men, and even children. If you believe different sources, the incidence of human papillomavirus virus is from 60 to 90% of the population, and here sex plays a decisive role.

Nevertheless, we have already mentioned that certain conditions are necessary for the transition of virus carrying into cancer: reduced immunity, susceptibility to stress, the presence of inflammatory pathologies (most often gynecological and venereal), hormonal failures. Having studied the list of disease-provoking factors, it is easy to understand that women are more susceptible not so much to HPV infection (here partners are on equal terms) as to its transition to an integrated form with development of malignant processes, in particular cervical cancer and mucous vaginas.

In most cases, the viral infection lingers for a long time in the body affected by gynecological pathologies of an inflammatory nature (vulvovaginitis, cervicitis, atypical type of cervical erosion, or pseudo-erosion). Often the virus is adjacent to sexual infections (chlamydia, genital herpes, gonorrhea, etc.).

HPV type 45 in women can be manifested by such a symptom complex:

• sensation of itching or burning in the genital area without secretions, characteristic of candidiasis (fungal infection),
• the appearance of abundant translucent secretions without an odor, sometimes with blood veins,
• unpleasant, often painful sensations when urinating,
• discomfort and pain during intercourse,
• proliferation of internal genital tissues of inflammatory nature (condylomatosis),
•  the appearance of spiky kandil or flat painful rashes of reddish or white color on the inner and outer genitals, in the perineum, on the mucosa of the large intestine,
• bleeding when examined by a gynecologist at later stages due to a disruption in the structure of the epithelium and the rupture of sensitive tissues during mechanical exposure to them.

By the way, the condylomas themselves are not a dangerous symptom requiring urgent treatment. They bring more discomfort than harm. However, this is a signal symptom that can not be ignored in any way.

The most dangerous symptom of HPV is dysplasia of genital tissues, because it is considered a precancerous condition. The virus can wait for decades for a suitable moment to manifest its most insidious features, and neoplasia is a suitable medium for this, it is only immunity to give the slack.

HPV type 45 during pregnancy develops as well as in the usual state. That's only hormonal changes in the body during this period can be an impetus to the pathogenetic development of the human papilloma virus, which is fraught with cancer of the cervix.

The virus-carrying and its consequences do not affect the ability to have a child, either in the generic process, or in the fetal development of the fetus and its health. The thing is that the virus does not affect the reproductive function of a person and can not pass through the placental barrier, affecting the baby's tissues, even if a woman is diagnosed with dysplasia or cervical cancer.

Most often, infection with HPV type 45 virus does not lead to pregnancy disruption and various complications. As for newborns, only single cases of the birth of babies with papillomatosis of the larynx were recorded, and if the mothers diagnosed extensive papillomatous rashes on the genitals (the contact route of transmission of the infection).

Risk factors for the transition of HPV into a serious pathology are age over 35 years, the presence of sexually transmitted infections, cervical, ovarian and vaginal pathologies, immunodeficiency states.

[9], [10], [11], [12], [13],

HPV type 45 in men

Men can get infection with the HPV type 45 virus on a par with women, for example, with sexual contact. And since many representatives of the male population are polygamous and do not care much about their health, the probability of contracting the virus is even greater, as is the risk of subsequently infecting their regular sexual partner (girlfriend, bride, wife).

Men are less susceptible to stress factors, and hormonal imbalance is rarely diagnosed, so the chance of earning a serious pathology against HPV is somewhat lower in women than in women. However, even the men are not insured against the reduction of immunity against the background of various health disorders and poor heredity, and their general interest in smoking and drinking alcohol equates the chances of both sexes to a complication in the form of cancer.

HPV type 45 is especially dangerous in terms of development of oncological pathologies, and one should not think that cancer threatens only women. Men also have a certain risk of earning penile cancer with uncontrolled proliferation of tissues in some of its areas, although it is lower than in women (medium degree of oncogenicity). Fortunately, it is possible to detect pathology in men much earlier than in women whose main sexual organs are hidden deep inside.

Symptoms of developing papillomovirus infection in men can be considered:

• genital discomfort (itching, some soreness),
• the appearance of discharge from the penis, not associated with ejaculation,
• pain during sexual contact and during urination,
• condylomatous eruptions in the genital area (usually on the bridle, head or foreskin) and the perineum, as well as on the mucosa of the anus and the large intestine.

Grayish or pink growths on the penis easily injured, hurt and begin to bleed. Sometimes they merge into groups, creating additional discomfort. Against the background of reduced immunity, the epidermal tissues of the organ are growing, in which cancer cells can eventually be detected (most commonly squamous cell carcinoma is diagnosed).

Diagnostics

HPV 45 type infection is not a situation that should not be taken into account. Given the prevalence and high oncogeneity of this virus, as well as its ability to go into cancer with a decrease in protective functions of the body, it is recommended to consult the appropriate doctor (for women it is a gynecologist, for men - a urologist) for advice and treatment. Even better, if papillovirus infection is detected at an early stage during regular physical examinations, while it has not yet shown its parasitic abilities.

For the period of diagnostic measures, if suspicion of HPV is highly ionic, you need to limit all sexual contacts to avoid infection of the partner. Remember that getting a virus is much easier than getting rid of it.

All diagnostic measures taken during and after the initial examination are aimed at identifying the onco-dangerous types of the virus, because it is impossible to calculate from the outward manifestations what type of virus caused the observed epithelial changes. To do this, the virus genotype is determined, the duration of its presence in the human body and directly at the site, where changes in tissues are noted (penis in men, vagina and cervical canal in women), the prevalence of the virus (the number of cells affected by it). It is also important to determine how deeply the virus has entered the cells and whether it has caused chromosomal changes.

If a suspected oncogenic virus is suspected, a cytological and histological examination is performed (analyzes of a smear taken from the cervical canal in women or the urethra in men). If there is neoplasia of the organ tissues, colposcopy (urethroscopy) with the use of reagents to which the malignant cells are sensitive, and biopsy of the material are mandatory.

Fans of anal sex will also have to give a smear from the anus.

To establish the presence of a virus and determine its type, use the available method of poly-dimensional chain reaction (PRC analysis). The material for analysis is scraping of epithelial cells of the cervical canal or urethra (in the absence of symptoms), and in the presence of unusual discharge as a material, use them (smear).

PRC analysis allows not only to detect the presence of HPV in the body, but also to determine its type. Thus, highly ionogenic types of the virus, including HPV type 45, are easily determined in the material under study.

Alas, with the help of PRC analysis it is impossible to establish the degree of introduction of the virus into cells (viral load). With this task helps to cope with a more modern method of research "Diagen-test." It makes it possible to determine the type of virus (detect DNA of HPV 45 and other types with their characteristic features of the chromosome set), its quantitative indices and clinical burden. In addition, after a while you can find out what is the risk of degeneration of the epithelial cells into malignant cells.

It is important not only to detect the virus and identify it, but also to determine what kind of changes in epithelial cells are present in the patient, whether abnormal cells are present in the area of neoplasia or the process is benign. On this depends largely on the choice of the scheme for further treatment.

To determine the nature of the change in epithelial cells, the Pap test (or PAP test) is used to detect the presence of magenta cells in the cervical canal.

Based on the results of testing, a conclusion is made:

• there are only normal cells,
• obvious signs of the inflammatory process,
• there are single specimens of atypical cells, which requires additional examination of them for malignancy,
• there is a sufficient number of atypical cells, which gives all grounds to suspect oncology,
• Atypical cells are very numerous, which indicates the development of squamous cell carcinoma.

The sequential holding of the Daidzhen and PAP tests is considered ideal. If there is no way to pass the Dail-test, it is replaced by a PRC-analysis.

[14], [15], [16], [17]

Differential diagnosis

Differential diagnosis is carried out with pathologies such as molluscum contagiosum (smallpox virus infection), micropapillomatosis (milder vaginal eruptions compared to papillomas), pearly papules on the penis (harmless neoplasms), seborrheic keratosis (benign pathology) , intradermal nevi, cervical carcinoma (malignant pathology, not related to papillomavirus infection).

When malignant cells are detected, patients are referred for advice to an oncologist or oncogynecologist.

[18], [19], [20], [21], [22], [23]

Treatment

Papillomavirus infection, once ingested into the human body, tries to stay in it forever, and since the virus is built into the cellular structures of the body, it is not possible to remove it from there to date. The only way out is to put the virus into a sleeping state.

Suppress the activity of the virus is capable of its own cellular immunity, but the disease will still be recurrent. It is believed that the removal of genital warts can reduce the risk of degeneration of cells, and will help prevent transmission of infection to the sexual partner. Nevertheless, a certain risk remains in this case.

It is quite difficult to remove a virus from a person's blood, this is not always possible. Therefore, more effective measures are still considered to increase cellular immunity, remove neoplasms, as well as treatment of erosion and dysplasia of the cervix in women.

The removal of genital warts and warts can be done in several ways:

• Electrocoagulation or electroexcision (burning of excrescences by electric current, relapses are possible),
• laser removal (the most effective method),
• radio wave coagulation (also allows you to get rid of the growths on the genitals forever),
• exposure to local chemicals,
• surgical removal (most often practiced with large-sized condylomas, is especially effective in case of oncology lesions caused by type 45 HPV and similar forms of human papillomavirus).

Cryodestruction is used only in cases where neoplasms have small dimensions and few of them.

Procedures are performed under local anesthesia or general anesthesia.

If there are no external manifestations of the disease, treatment is not carried out at all, only the use of immunostimulants is recommended, which will help keep the virus under control.

If genital or flat cancerous growths are found on the genitals of patients, then in addition to their removal, systemic antiviral therapy and increasing immunity by appropriate means are carried out.

The goals of drug therapy are: destruction of HPV type 45 DNA and enhancement of the body's defenses to mobilize them to fight viral infection.

To combat the virus and prevent recurrences of the disease, which are possible even after removal of the warts and warts, antiviral drugs are used: Panavir, Acyclovir, Zorirax, Viferon, Groprinosin. Well, if the drugs have different forms of release, to work on the virus could be from all sides (local and systemic treatment).

As immunostimulants, you can use preparations "Immunal", "Immunomax", "Lavomax", tincture of Echinacea or Elleuterococcus, vitamin complexes.

By the way, many drugs have both antiviral and immunomodulatory effects, which makes it possible to effectively solve the problem of HPV therapy.

Quite often, a bacterial infection is added to the viral infection, which is most likely indicated by an inflammatory process in the vagina and cervical canal of the cervix. In this case, antibiotic therapy is first conducted, and then antiviral treatment is performed.

If malignant cells are found in the area of neoplasia, depending on the stage of pathology, surgical treatment (modified radical hysterectomy plus pelvic lymphadenectomy to prevent the spread of processes inside the body) will be used, chemotherapy and radiation therapy.

Treatment of external genital warts caused by the HPV type 45 virus can also be performed by alternative methods (after consulting a doctor). To remove tumors, fresh celandine juice is used (lubricate condylomas 6 to 12 times a day) or an oil based on this plant (mix equal parts of the crushed plant and vegetable oil and insist 1 month in a dark place, lubricate the growths 2-3 times a day ).

Warts and warts can also be moistened with dandelion or Kalanchoe juice.

With internal and external papilloma-like growths, you can take a decoction of herbs (melissa, horsetail, plantain, nettle plus dandelion root). Herbs are ground and mixed in equal proportions. 1 tbsp. Collection is filled with 1 glass of water, after which the composition is brought to a boil and held for 10 minutes. Withdraw from the fire, the broth is placed in a warm place for 3 hours, after which it can be taken orally one hour before meals 3 times a day. Single dose - 3 tablespoons.

Any alternative treatment is permissible only after consulting a doctor. Its use is acceptable within the framework of traditional treatment.

The control of the effectiveness of treatment is carried out once in six months-a year by the delivery of cytological and histological analyzes, as well as checking for the presence of the virus with the help of PRC and PAP tests.

Prevention of the hPV type 45

The incidence of papillomavirus infection is approximately 6-9 people out of 10 depending on the region of residence. Such a common infection makes you think about how to protect yourself from its influence.

At present, scientists have developed vaccines that prevent the development of genital cancer oncology in both women and men. Vaccines "Gardasil" and "Cervarix" activate immunity to fight with cancerous viruses, however, 45 type was not included in their list. Later "Gardasil" was improved (the modified vaccine is called "Gardasil 9"), and now it can even destroy HPV type 45.

Typically, vaccination is given to adolescents who do not yet have a sex life, which means that there is probably no HPV virus in their bodies. Most adults are already virus carriers, so vaccination is possible only with a negative result of the HPV test.

Other measures to prevent the human papillomavirus virus are the rules that prevent infection and improve the state of immunity:

• restriction of sexual contacts by one trusted partner,
• strict hygiene of hands and skin,
• reception of vitamin complexes and immunostimulating preparations (for prevention it is better to use plant tinctures),
• timely treatment of inflammatory pathologies in the body (especially the gynecological plan) and diseases that reduce immunity (ARI, acute respiratory viral infection, influenza, gastrointestinal pathology, etc.).
• rational nutrition, rich in vitamins and minerals, essential for life,
• a healthy active lifestyle,
• restriction of psychological overloads (which is not always possible) and the ability to respond correctly to stressors.

It is important to remember that without strong immunity, effective control of the virus is impossible. Therefore, immunity will have to be given special attention throughout life.

[24], [25], [26], [27], [28], [29], [30],

Forecast

As for the forecast for virus carriers, despite the high oncogeneity of HPV type 45, it is possible to fight it successfully. The development of cancer under the influence of papillomavirus is quite long (about 5-10 years), besides the symptoms of inflammation and viral infection appear much earlier, which gives good opportunities to prevent the transition of the disease into a malignant form. The main thing is not to start pathology and strictly follow the doctor's prescriptions, both in terms of diagnosis and with regard to therapy.

[31], [32], [33], [34], [35],