HPV 52 type: what is it, how to treat?

The abbreviation for HPV is currently known, probably, by everyone. It stands for human papillomavirus. Many different strains of this virus have already been found, about two hundred. HPV type 52 - one of 19 papillomaviruses recognized as oncogenic. This means that its carrier is likely to get some types of cancer, in particular, it is cancer of the cervix and rectum. In addition, in more rare cases, it can trigger the development of carcinoma of the walls of the vagina, the skin of the penis, mouth, conjunctiva and pharynx. Localizations are given in descending order of frequency of occurrence.[1], [2]

HPV type 52 belongs to the α-papillomavirus-9 species, as well as their most oncogenic representative - type 16 HPV, which is found in tumor cells more than half of patients with carcinoma of the cervix uteri and is considered the culprit of their malignant degeneration.

Structure HPV 52 type

In the resting stage, the papillomavirus cell (virion) is a microscopic sphere with a diameter of 30 nm, consisting of a DNA molecule, compactly packed with cellular proteins (histones). Virion does not even have a cell membrane. For example, the influenza virus is much more solid - four times more, it is enclosed in a membrane that forms from a similar structural component of the affected cell.

Genotype 52 of HPV is similar to the genotype of the most highly oncogenic virus 16. Previously (until 2010) they were even considered the same virus, and then “spotted” some differences and ranked them to the same species.

HPV 52 DNA is a circular double-stranded molecule packed in the nucleus of a virus cell with two types of proteins E (early or early) and L (late or late). E-proteins are responsible for the regulatory role, provide replication of the virus, and it is they who are accused of starting the process of keratinocyte malignancy, in which they settled. L-proteins are a purely structural component, the outer protein shell of the virion (capsid) is formed from them.

Life cycle HPV 52 type

Any virus is a cellular parasite. Papillomavirus parasitizes keratinocytes - cells of the upper layers of the skin and mucous membranes of living organisms. Outside these cells, the virion retains its viability for a short time, up to three hours, and then on wet towels, underwear.

HPV type 52 is transmitted mainly through genital-anal-oral contacts of any kind, penetration occurs through microdamages of the skin or mucous membranes. Domestic path is not excluded, but unlikely.

The virus infects keratinocytes near the site of implantation. It does not spread throughout the body, but self-infection is possible. This can occur during depilation or shaving if you damage the skin surface during the procedure and touch the wound with an infected surface.

The life cycle of HPV 52 corresponds to the stages of keratinocyte maturation and cytodifferentiation. Viruses, falling on the damaged epithelium, infect young, not yet differentiated cells of the basement membrane, which is located under the upper layers of more mature cells. Keratinocytes as they mature rise to the surface of the skin, viruses at this time "settle down" in the cells. E-proteins perform their functions to ensure the necessary content of HPV DNA in affected skin cells, activate the expression of viral genes, bind tumor suppressors. Immunity of an infected person also does not sleep, and in the vast majority of cases of infection (80-90%), the body destroys viruses on its own within a year. However, approximately in a fifth of the infected, the virus is inserted into the cell genome and a long chronic course of the disease begins with periodic relapses and the possible development of a neoplastic process. New viruses that are ready for infection appear at the last stage of keratinocyte differentiation and are detected depending on their localization in physiological substances: saliva, semen, vaginal secretions, and superficial layers of the skin and mucous membranes.

Symptoms

These smallest cellular parasites can in no way manifest their presence in the human body for a very long time, estimated in tens of years. Moreover, in an infected cell, the virus can be in different forms: extrachromosomal (episomal) and embedded in the DNA of the cell (intrasomal). The first option is considered more favorable.

HPV type 52 belongs to the group of viruses that prefer the skin and mucous membranes of the genital organs. The first clinical signs of its presence are genital warts (small sharp growths on the epithelium). They usually appear on the mucous membranes or skin of the genital organs, less often - in the anus, and very rarely - in the mouth. At first, these are single small formations, later, without treatment, they are merged. In appearance, these growths are similar to cauliflower florets.

HPV 52 is more commonly found in women under the age of 35 years. Moreover, in 80% of cases it is detected in the absence of any symptoms.

Condylomas, if present, are found on examination of the labia, the clitoris, the walls of the vagina and the cervix. Cervical erosion is also a reason for screening for HPV.

Sometimes condyloma visually or by touch can be found by a woman herself in accessible places when performing hygienic procedures.

The most common and dangerous consequence of infection with this type of papillomavirus is cervical cancer. [3]

HPV 52 during pregnancy has the same symptoms as non-pregnant women. Most often detected during the examination. Asymptomatic presence in the body of the virus should be observed, but not treated. In a pregnant woman, genital warts can also be found, with their small sizes they do not carry out any treatment during the period of gestation. Major condylomas in the birth canal are usually indications for delivery by caesarean section.[4]

HPV 52 in men can manifest as an increase in genital warts on the penis. The most serious consequences of parasitizing the virus are malignant neoplasms of the skin of the penis and, possibly, of the prostate gland. Infection of males occurs with the same frequency as the female. But, due to the anatomical features of the structure, the male urethra does not have an area of abnormal changes in the epithelium, so the vast majority of men do not show infection in themselves, and the virus often self-eliminates.[5]

In persons of both sexes, condylomas may be located in the anus, urethra, rectum, oral cavity. Condylomas on the mucous membrane of the urethra may manifest themselves as urinating disorders, in the rectum - by the difficulty of emptying the intestines, by the appearance of traces of blood during defecation.[6]

The presence of HPV 52 types probably increases the risk of developing colon  [7]and laryngeal cancer.[8], [9]

Diagnostics

To detect the presence of any type of human papillomavirus in the body in the absence of symptoms, an analysis of urogenital scraping (if necessary take a scraping from other places), carried out by the method of polymerase chain reaction or Digene-test (rapid high-specific screening). [10]

Qualitative analysis provides an answer on whether at least any DNA fragment of any human papillomavirus is detected in the biomaterial or not. Accordingly, the result will be positive or negative.

Analysis for HPV 52 or any other specific strain is called genotyping and is carried out with a positive result of the first stage. Often, one patient has infection with several viral genotypes.

To clarify the carcinogenic load on the body, a quantitative analysis is carried out.

Norm HPV 52 is either a negative qualitative analysis, or the level of viral invasion is lower than that determined, although some DNA fragments may have been identified.

If the result of HPV 52 is positive, then it is also ambiguous in quantitative terms:

• if the number of copies of DNA fragments does not exceed 10³ per 10⁵ keratinocytes, a low probability of developing neoplastic changes is diagnosed;
• if the number of copies of DNA fragments exceeds 10³ per 10⁵ keratinocytes, a chronic infectious process is diagnosed with a high probability of developing neoplastic changes;
• if the number of copies of DNA fragments exceeds 10⁵ by 10⁵ keratinocytes, a high carcinogenic load and an increased likelihood of cervical cancer are diagnosed.

It can be assigned to the analysis of PCR for HPV in the dynamics, usually it is done not earlier than six months. If the next time a decrease in carcinogenic load is observed, this is a favorable prognostic criterion. Growth indicates the possibility of further development of the process. Genotyping of human papillomavirus using a linear array is also used.[11]

However, the defining analysis for suspected neoplasia will be an analysis for the presence of abnormal cells. In cervical cancer, this is a smear test for oncocytology (pap test). If such cells are found, then a biopsy is done to determine the extent of the intervention. [12], [13], [14]

[15], [16]

Treatment

Conservative methods for the destruction of human papillomavirus does not exist. If the immune system does not cope with the invasion, and parasitization will lead to uncontrolled cell proliferation, modern medicine can offer only a radical relief from growths, warts, areas of modified tissue, treatment of concomitant infections and immunostimulation.

Such measures often give a temporary effect, and any change in the immune status can trigger a relapse. The indication for surgery is the result of oncocytological tests (the presence of abnormal cells), and not the fact of a positive PCR result.

What to do if HPV 52 is found? Nothing. Take this note, be observed at the gynecologist, repeat about six months later the analysis to see a quantitative indicator over time. You are a potential source of infection, you should take this into account and secure your partners as much as possible. This should be done if there are no other symptoms and no mixed infection is detected.

If found warts, warts, erosion, combined bacterial infections, sexually transmitted infections, they should be treated.

Then follow the recommendations of your gynecologist and do not neglect dispensary registration.

Prevention HPV 52 type

Monogamous relationships and, in part, barrier contraception will help prevent infection. In combination with a healthy lifestyle that provides good immunity, such measures are the best prevention of the unpleasant effects of infection with HPV of any type.

It is assumed that vaccination, carried out before the onset of sexual activity, provides protection against human papillomavirus infection. The vaccine should protect against the most carcinogenic strains 16 and 18. Given that HPV 52 belongs to the same species as HPV 16, it may help protect against it. Currently, the CDC recommends vaccinating children from 11 to 12 with two doses of HPV vaccine, rather than three, as previously, to protect against cancer caused by HPV. The second dose should be given 6-12 months after the first. WHO recommends vaccinating adolescents of any gender.[17],

In the presence of modified cells at the site of the virus or skin growths, infected people are advised to remove them and to undergo annual examinations by a gynecologist and / or a urologist in order to prevent recurrences.

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

Forecast

In almost 90% of cases, the body itself copes with the human papillomavirus. If this does not happen, then the prognosis largely depends on the age of the infected, its immune status, the type of virus. HPV 52 types are classified as carcinogenic viruses, however, in most cases other types of pathogens are found in people with malignant cell degeneration - 16 and 18.[23]

Remember that HPV infection does not mean a disease. Infection leads to the development of dysplastic processes (precancer) in 0.5% of women, and timely diagnosis, which is provided by clinical examination, allows you to take drastic measures in the initial stages of the disease and prevent its development. So a lot depends on your attitude.

[24], [25], [26],