HPV 56 type

On planet Earth there are a great many diverse forms of life. Some of these forms are so microscopic that they simply cannot be seen with the naked eye. For example, an extremely common papillomavirus, which can only be seen using a microscope with a high resolution, since the size of its virion averages only 30 nm. The papillomavirus (HPV) has more than 100 types (according to some information, about 600), and, despite its small size, is not as harmless as it may seem at first glance. Some types of virus, such as HPV type 56, can cause deadly cancer in humans. And this is an occasion to learn more about the virus in order to prevent the sad consequences in time.

HPV 56 is an oncogenic type of human papillomavirus. And although this strain, along with some others (HPV 30, 35, 45, 53, etc.), is considered to be a virus with an average oncogenic risk, you should not treat it carelessly. Indeed, the likelihood of developing cancer against the background of exposure to papillomavirus is still quite high, and the longer the virus remains in the body in an active state, the higher the risk of developing cancer.

We have answered a frequently asked question, is HPV 56 dangerous? And since the answer is positive, there is a need to consider this type of virus in more detail, to understand what it is, how it is transmitted to a person, how to diagnose its presence in the body and minimize the negative impact of the virus on human health.

[1], [2], [3]

Structure HPV 56 type

Of the presumed 600 HPV strains in nature, more than 100 can affect the human body. Not all types of virus are dangerous for humans, and many do not cause any deviations at all and do not have external manifestations. But HPV type 56 does not belong to such safe types of the virus, and although it may not manifest itself for some time, there is a risk that at some point the virus is activated and will lead to pathological changes in the structure and functioning of the body's cells.

Regardless of the type and type of virus, its virions are microparticles, the size of which can vary from 20 to 300 nm. HPV 56 type - one of the types of papillomavirus with a minimum size of virions. The diameter of a viral cell of papillomavirus is about 30-55 nm, which makes it easy to penetrate through pmikroproda in the human skin and mucous membranes. And since the mucous membrane is a more loose structure, it is more likely that infection with papillomavirus will occur when the mucous membranes come in contact, including sexual contact, which is confirmed by numerous studies. In the latter case, there is a longer and close contact, which increases the likelihood of infection.

A special feature of the papillomavirus is that its particles are not transmitted from animals to humans, i.e. The source of infection is always a person in whose body there is an active virus.

HPV virions are microparticles consisting of a core and a capsid (protein coat), but not having a membrane coat that is associated with larger viruses. To survive and multiply, such a viral cell requires a host cell, which changes its properties as a result of the active activity of the virus.

The genotype or genome of the HPV 56 type of medium oncogeneity is similar to the strains of low and high oncogenic risk and is represented by a double-stranded circular DNA molecule. In other words, papillomavirus refers to DNA-containing viruses (in total in vertebrate animals, including man, there are 11 families of such pathogens), which most often cause various human diseases. At the same time, the virion DNA is synthesized directly in the infected cell, using it as a kind of cocoon, providing protection and nourishment of the new virions formed during the synthesis. There is a process of replication or cell division, as a result of which a daughter one having one copy of the DNA molecule is synthesized on the matrix of the parent molecule.

The HPV genome consists of 3 differentiated regions that perform certain functions: the early and late regions E and L, as well as the controlling one - LCR / The latter performs many functions, including viral genome replication, DNA transcription and cell transformation under the action of the E6 oncoproteins produced in oncogenic virions and E7.

HPV type 56 is considered an oncogenic virus. This suggests that oncoproteins in such cells are produced in smaller quantities and in order for them to cause deformation of the host cells, additional conditions are required (in most cases this is a significantly reduced immunity and hereditary predisposition to cancer).

[4], [5], [6], [7], [8],

Life cycle HPV 56 type

Despite the fact that papilloma virus cells have a simple structure, it is a living microorganism, which in its development passes a certain life cycle. By itself, the virus cannot actively exist outside of a living organism, therefore, for a full-fledged existence and reproduction, it must penetrate into a living cell, in this case, the human epidermal cell.

Despite the microscopic dimensions of HPV 56 and other types, they rarely penetrate deeper, therefore cells for virions serve as surface cells of the skin and epithelium of the mucous membranes - keranocytes. The life cycle of HPV is tied to the stages of development of the main cells of the epidermis. This is a cell differentiation program of the host cell. Infection occurs when the papillomavirus virions reach the basal layer of the epidermis bordering the dermis, where young keranocytes are synthesized and actively dividing. This choice is not accidental, because it is these keranocytes that have a great potential for differentiation and acquisition of specific functions.

Oncogenic virus types are fairly integrated into the genome of the host cell, changing its properties and behavior. Such cells are prone to uncontrolled reproduction and cause dysplastic processes in the skin and mucous membranes, which with a certain probability can develop from benign to malignant. At the same time, the virus cells do not start replicating (dividing) immediately after penetration into the epidermis. They support the genotype by simple formation of a small number of copies of chromosomal DNA segments with an appropriate set of genes (amplification). This is the so-called incubation period of the virus, which can last from 2 weeks to several years.

In the process of maturation and differentiation, more mature keranocytes are forced into the spinous (subbasal) layer and higher to the skin surface. Protein synthesis and replication of HPV virions occurs when infected keranocytes are located in the subbasal layer. Using the nutrients and proteins of the host cell, virions are able to multiply. As a result, we observe unplanned division of the host cell, and an increase in the number of such divisions as the virus multiplies gives rise to and development of tumor processes that the weakened immune system cannot cope with.

Malignization (malignancy of cells) under the influence of HPV type 56 usually occurs if the body cannot cope with the virus for 6-12 months and this leads to chronic virus-carrying, which significantly weakens the human immune system. A weak immunity is one of the main conditions for the activation of the virus and the development of malignant diseases.

On the other hand, strong immunity will contribute to the elimination (removal) of viral particles from the body even before they can integrate into the genome of human cells.

To understand how HPV 56 is transmitted from person to person, you need to know that the small size of the papillomavirus virions allows them to penetrate into any microdamages on the skin. And even if there is no visible damage on the skin, it does not mean that there are none at all and the way for the virus is closed. Examination of the skin and mucous membranes under a microscope shows that a person receives a lot of microdamages (micro-tears, scratches, punctures) that they are not even aware of, and therefore contact with an infected person is potentially dangerous.

Any damage to the integrity of human skin is a direct way into the body for the papillomavirus of any kind of carcinogenicity. Usually we are talking about several types of HPV, which simultaneously or separately penetrated into the human body.

For HPV type 56, the sexual route of infection is most characteristic, i.e. Virions are transmitted during sexual contact through minor lesions on the delicate mucous membrane of the external or internal genital organs that occur during sexual intercourse. But this does not mean at all that other possible ways of infection should be discarded, for example, transmission of the virus from the mother to the fetus during the passage of the latter by the birth canal or contact route of infection if there was a violation of skin integrity at the site of contact.

And yet, the likelihood of being infected with a virus during sexual contact is much higher, and this must be kept in mind, especially when it comes to a virus that can cause cancer. It is important to understand that the penetration of the virus into the body does not mean illness, because in a large number of cases the human body is able to cope with the virus itself, not allowing it to be active and multiply.

There are certain factors that increase the risk of getting cancer with HPV 56 or another oncogenic strain. These factors include:

• weak immunity or weakened for one reason or another (immunosuppression),
• immunodeficiency states, for example, immunosuppression in HIV-infected patients,
• the presence of sexually transmitted infections that inhibit local immunity,
• lack of vitamins and trace elements in the body, which increases the permeability of the skin and reduces its resistance to infections,
• genetic or genetic predisposition, when there were already cases of development of oncology in the family,
• pregnancy (due to the restructuring of the woman’s body, it becomes more sensitive to the effects of negative factors),

In addition, there are factors that can weaken the protective functions of the body at the level of the central nervous system. This is overwork, constant stress, bad habits (smoking, drug and alcohol use), psychoactive medication.

With regard to the likelihood of infection with HPV, it is higher in those people whose lifestyle can be called questionable. Indiscriminate sex with different sexual partners, inattention to one’s health and lack of general and intimate hygiene skills contribute not only to HPV infection, but also to the spread of the virus between people.

[9],

Symptoms

It is difficult to say when HPV declares itself after it penetrates the human body. Much depends on the state of immunity. Therefore, the incubation period of the virus is so ambiguous, and the symptoms of the disease are observed only in 10 people out of 100. At the same time, the influence of the above risk factors is great. The body of the remaining 90% copes with the virus itself for a couple of years.

Oncogenic HPV types, among which HPV 56, affect predominantly the human reproductive system. In this case, both women and men can become infected with the virus equally, if there were microdamages on the skin or mucous membrane. Especially large is the number of people infected with the virus during sexual intercourse.

[10]

HPV 56 type in men

But the effect of the papillomavirus on the male and female reproductive spheres is ambiguous. HPV 56 does not cause cancer in the male, but it, although infrequently, can cause conditions dangerous to health or life. Such a specific symptom as genital warts (condyloma), characteristic of HPV, is extremely rare in the male sex.

Even more rarely, HPV type 56 is detected in men with bovenoid papulosis, which is characterized by the appearance of erythematous spots, papules and plaques affecting the skin of the genitalia. However, doctors believe that the disease, which is a precancerous condition, is provoked by the papillomavirus, namely its oncogenic strains.

In isolated cases, in the face of HPV 56 infection, Bowen's disease may develop, i.e. Intraepidermal cancer with characteristic bright red tumors with uneven edges, including on the skin of the penis. Usually, bovenoid papullosis and Bowen's disease are associated with highly oncogenic type viruses, and in particular HPV 16 or 18 types, but if there are risk factors, active reproduction of HPV can also lead to such consequences 56. Whether this theory is tested by experience, everyone decides for himself.

With a significantly weakened immune system, we can expect the virus to go beyond the intimate zone. Soft to the touch growths in the form of bodily papillae may appear in the anus, in the armpits and around them, on the neck, chest, hands and feet. There is also a risk of the virus entering the urethra, and if specific growths are formed in it, problems with urination are possible.

The appearance of tumors on the skin is not accompanied by pain, although sometimes men may complain of itching (usually in the intimate area). Minor pain and bleeding can occur with damage to the warts, which most often happens during intercourse or hygiene procedures.

The above symptoms can be considered precancerous conditions, since any neoplasms are a consequence of the activation of the virus. And while HPV 56 of the type itself does not provoke cancer, in the presence of risk factors, benign growths can develop into malignant ones. Therefore, the relationship between HPV 56 and cancer should not be rejected, even if in practice there are very few such cases, and it is difficult to establish which of the oncogenic strains identified in the patient is responsible for the development of cancer.

[11], [12], [13]

HPV type 56 in women

With women infected with the oncogenic virus, the situation is even less attractive. The risk of the appearance of external symptoms of infection in the form of warts and warts in them is markedly higher (8 out of 10 patients). Moreover, HPV 56 in women significantly reduces the local immunity, which causes the development of bacterial, fungal and some types of viral infections, for which the conditions of the female vagina are the optimal habitat, development and reproduction.

It is not surprising that many of the symptoms of activation of human papillomavirus infection are similar to the manifestations of many diseases of the female intimate sphere:

• pain during intercourse,
• pain in the lower abdomen,
• discharge from the blood after sexual contact,
• itching in the intimate area,
• pain and burning during urination.

But the most striking symptom of papillomavirus is the appearance of specific pointed outgrowths in the anal region and on the genitals (the clitoris, small and large labia, vaginal machines, which the doctor sees during a gynecological examination on the chair). Such growths may vary in color from flesh to pink or brown. They have a soft texture and a leg that attaches to the skin, can merge into groups and grow quite quickly. In this case, growth can occur in two directions: above the skin surface and inside it, which creates problems during their removal.

All this is very unpleasant and can create certain difficulties in intimate life, but they do not pose a danger to the life of a woman. Another thing is that dysplastic processes in the epithelium with a decrease in immunity and the accumulation of damaged cells can become critical. Uterine dysplasia or its cervix is considered to be a precancerous condition and may, under certain circumstances (for example, with a genetic predisposition or prolonged course), develop into uterine cancer.

Again, the risk of such an outcome is higher when infected with HPV strains of a high oncogenic type, but also a virus of moderate oncogenicity under the circumstances can cause dysplasia, and later uterine cancer.

[14], [15], [16], [17], [18]

HPV 56 and myoma

Such common female pathologies, such as erosion and its successor, cervical dysplasia are quite often associated with human papillomavirus. Another popular disease of the female reproductive system is uterine fibroids. Therefore, many women have a fair question, but is there a relationship between the papillomavirus and the formation of a benign tumor called myoma.

It must be said that the reasons for the formation of such a tumor have not yet been fully investigated, but the relationship between tumor growth and the production of female hormones has been revealed. There is no mention of HPV in connection with myoma in the scientific literature, i.e. Papillomavirus is not considered as one of the factors provoking the appearance or growth of a tumor. In addition, fibroids are tumors in the muscle layer of the organ, while the papillomavirus parasitizes mainly in the epidermal layer.

[19]

Pregnancy with HPV type 56 in women

We have already noted that pregnancy is one of the risk factors for infection and activation of the papilloma virus in a woman’s body. Disruption of the hormonal background and a decrease in the general immunity entails an increase in the sensitivity of the organism of the future mother to various kinds of infections. Among them is such a popular papillomavirus, which can enter a woman’s body both during pregnancy and before her, having intensified against the background of weakening of the body’s defenses.

It should be understood that the presence of a virus in a woman’s body is not an obstacle to conceiving and carrying a child, but the formation of specific growths on the genitals and their growth can create problems. Condylomas can be damaged during childbirth and cause bleeding, the risk of infection of the papillomavirus of the child increases during the passage of the birth canal, there is a risk of the malignant transformation of the neoplasm.

And that is not all. Genital warts can spread to the area of the anus and urethra, which will prevent the normal administration of natural needs (urination and defecation), which in pregnant women are already impaired.

Multiple warts reduce the elasticity of the walls of a woman's internal reproductive organs, which can cause bleeding during sexual intercourse and the process of delivery. In severe cases it is even necessary to resort to caesarean section in order to avoid complications during labor.

Infection of the infant with the papillomavirus during the passage through the birth canal causes problems with respiration in the postnatal period. Papillomas are most often found in a child and grow in the oropharynx, which can make it more difficult for the baby to breathe.

[20], [21], [22], [23]

Diagnostics

Viruses are microscopic pathogens parasitizing in the cells of a living organism. But in order for cellular changes to be noticeable externally, it can take quite a long time. During a long incubation period, a person may not even be aware of infection, and even after the first symptoms appear, there may still be doubts, because some manifestations of the disease are very non-specific.

HPV type 56 is one of the oncogenic types of papillomavirus, which, although rarely, but under certain circumstances can cause the development of cancer (in most cases, the oncology of the reproductive system). But even a small risk still remains a risk that cannot be ignored. And the sooner the causative agent of a dangerous disease is identified, the more opportunities to avoid it or at least slow down the pathological process.

A characteristic symptom of the presence of virus particles of HPV in the body is the appearance of peculiar growths in the form of warts, papillomas and warts on the skin and mucous membranes. The latter are also called genital warts, the appearance of which with a high probability may indicate the introduction of a dangerous type of virus into the cells of the body.

But even a specialist will not be able to determine the type of virus by eye, so before making any conclusions about the presence or absence of cancer, you need to undergo a special examination in a medical institution or a certified laboratory.

To detect a rash on the patient's body, and without the help of a doctor, it is more difficult to notice a rash localized on the genitals and internal genital organs of women. In men, the presence of the virus is usually detected by specific lesions on the penis (genital warts, plaques, unusual bright-colored neoplasms). Usually, the men go to the doctors of the urologist, andrologist or venereologist precisely about their appearance.

But it is important not only to ascertain the presence of the virus, but also to determine its type, and for this you need to pass the analysis for HPV. In this case, the usual serological studies (blood tests for antibodies and antigens) in this case are not very effective. The material for analysis of the papilloma virus in men is usually a smear or scraping from the affected area of the penis, as well as from the anus, where modified particles can be found.

In women, a physical examination and taking material for laboratory tests (a vaginal smear for cytology or a PAP test, which is taken during an examination on a gynecological chair or a coloscopy), are performed by a gynecologist.

The analysis for HPV 56 of the type is carried out as well as tests for other types of papillomavirus. Cytological and histological studies help assess the presence and prevalence of atypical cells that, under the influence of the virus, have changed their forms and properties, as well as identify the cells that have undergone malignancy. But to determine the type of virus is possible only with the help of special studies. These are the methods: Southern blot, dot blot, reverse blot, labeled probes, non-radioactive hybrid capture (daigen test), PCR analysis.

At the same time, the most accurate result (about 95%) with the minimum number of pathologically altered cells is obtained by PCR analysis, while with a sufficient prevalence of the process, the most accessible, simple to perform and therefore the Digen-test is quite common. Both studies allow not only to identify the oncogenicity of the virus, but also to calculate the concentration of the virus in the tissues of the genital organs.

Digen-test and the method of polymerase chain reaction (PCR) are the most common methods for determining oncogenic types of papillomavirus. They are completely painless and not traumatic, do not require time-consuming preparation.

Requirements for preparation for the analysis:

• refusal to take antibiotics and antiviral drugs for 3 days before the procedure of sampling the biomaterial,
• at the same time, it is worth refusing to use such means for intimate hygiene (we are talking about contraceptive gels, ointments, etc.), but it is better to refrain from sexual intercourse,
• on the eve of the analysis, deep hygienic procedures in the intimate area are not performed in order to avoid distortion of the results.

Contraindication to the analysis of women is the period of menstruation and 2-3 days after it.

Deciphering the analysis for HPV 56 or another type of papillomavirus is the work of specialists. But each patient, having received the results of tests on the hands, has the right and wants to know at least elementary criteria for assessing the presence and concentration of the virus of the studied type in the body.

When identifying tumors in the genital area, especially in the cervix, doctors immediately prescribe a study to identify oncogenic types of the virus. In addition, for each type of virus, there is a separate reagent that allows you to identify the DNA of the virus and calculate its concentration. A positive test result indicates that a particular type of virus has been detected in the body, for example, HPV 56 type, and a negative one means that the person is not infected, which, incidentally, does not exclude the presence of other types of human papillomavirus.

A positive result of the ROC-test may have the following options:

• + - weakly positive, which indicates a small amount of the detected DNA of the virus (it is either a “fresh” infection, or the immune system restrains the spread of the virus, or we are dealing with the gradual elimination of the virus from the body with good immunity or the effectiveness of antiviral treatment)
• ++ - moderately positive with a higher concentration of viral particles, when virions have the ability to multiply against the background of weakened immunity,
• +++ is clearly positive, which indicates a high activity of the virus and a significant risk of cell malignancy.

Daigen test results can be interpreted as follows:

• Lg in the range from 1 to 3 means a low concentration of viral particles,
• Lg from 3 to 5 indicates a clinically significant concentration of the virus,
• Lg more than 6 indicates a high concentration of virions and increased their activity.

If the analysis form contains the “DNA not detected” mark, then the human papillomavirus is absent or the concentration of virions is very low for its detection by this method of research.

But having received a test result a week later, you should not make hasty conclusions. The final diagnosis can only be made by a specialist doctor. In addition, there is a certain percentage of results that are called false-positive and false-negative, which is associated with improper preparation for the analysis, inappropriate storage of the biomaterial, its contamination, incompetence of the expert who conducted the analysis, which is highly sensitive. In this case, it will be necessary to undergo a retest several months later with one or another method for diagnosing HPV.

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

Treatment

The formulation of the final diagnosis and the prescription of the corresponding treatment is fully within the competence of the specialist doctor. But getting the results of the analysis on the hands of a person tend to panic, seeing on the form incomprehensible signs, numbers, words.

Discretion usually gives way to anxiety when it comes to human health, and this is a fact of life. But the papilloma virus type 56 does not mean that the patient has cancer. There are other types of virus that are more likely to cause oncology, and even so the percentage of cases remains low.

So what to do if the tests found HPV 56 type? Do not panic, but go to the doctor and follow his instructions. You should not also consider yourself a doctor, without having the appropriate medical education, and prescribe to yourself various drugs and procedures, and even more so to experience on your body what a great-grandmother of a neighbor recommended from the first floor.

Most readers know that viruses have one unpleasant feature: it is impossible to remove them from the body or destroy them with antibiotics as bacteria. Only the body itself can cope with such insidious pathogens with the assistance of a strong immune system. For this reason, the treatment of papillomavirus will primarily consist in maintaining and enhancing the immunity that deactivates the virus, as well as eliminating the negative effects of the presence of the pathogen in the body (papillomas, condylomas, dysplasia, cancer).

Treatment of the effects of infection with HPV 56 type is usually carried out by surgery. According to the doctor’s advice and the patient’s wishes, and depending on the type and prevalence of external symptoms, various methods can be chosen: surgical removal of tumors, laser treatment, cryotherapy, chemo-destruction, radiowave, electrocoagulation. When detecting malignant cells, preference is given to surgical removal of tissues with atypical cells, followed by histological examination of biopsy material. In severe cases, resorted to the removal of the uterus to save the life of the patient.

It must be understood that the removal of neoplasms of long-term relapse alone, and even more complete cure, cannot be achieved. The fact is that it is difficult for the doctor to control the effectiveness of the procedure, without being able to determine whether all infected cells were removed during the procedure. Approximately half of the cases there is a relapse of the disease. Sometimes, in the absence of positive dynamics, one has to consistently resort to different methods of treating HPV, but ideally all of them should be combined with drug antiviral and immunostimulating therapy.

Comprehensive treatment gives the highest possible percentage of long-term relapses, when the virus in the body is present in an inactive state, does not multiply, and therefore does not pose a danger. At the same time, you will have to maintain your immunity at a height throughout life, because, having felt weakness, the virus is activated again, which will be seen externally by new lesions and dysplastic processes.

Antiviral drugs prescribed for HPV have a complex effect: they have a detrimental effect on the virus, prevent its spread and stimulate the immune system. Such drugs are available in the form of injections, tablets, ointments, suppositories, etc., which are used both locally and systemically. The most popular drugs for human papillomavirus are Izoprinozin, Cycloferon, Allokin-Alpha, Panavir and some others.

Antiviral drugs can be dispensed in pharmacies without special purpose (commercially available), and on prescription. In any case, before you buy a medicine at a pharmacy, you should consult a doctor about the recommended drugs in a particular case.

Immunostimulants in our time will not interfere with almost every one of us, and even more so those with external manifestations indicate the presence of a virus, which in turn indicates a weak immunity. It can be both herbal preparations (extract of echinacea, rhodiola rosea, eleutherococcus, ginseng, etc.) or specialized drugs (Likopid, Immunomax, Immunofan, Longidaza, etc.). But again, a doctor's consultation will not be superfluous in this case.

With regard to the removal of tumors by traditional methods and special preparations, here it is worth being very careful. First, the incorrect application of methods and means can provoke the injury of healthy tissues. Secondly, it’s impossible to get rid of the virus in such a way or not to deactivate it, because removing only the external local signs cannot destroy the virus, whose virions can remain in other tissues that are not different from healthy ones.

Only a comprehensive treatment and maintaining immunity at a height will help slow the spread of the virus and reduce the risk of cancer against HPV 56 or another oncogenic type to a minimum.

Prevention HPV 56 type

Is it possible to reduce the risk of infection by a virus for those who still do not have a dangerous and insidious "neighbor" in their bodies? This is possible if selectively related to the choice of sexual partners, ideally focusing on one healthy. If a loved one is diagnosed with a virus, then during sexual intercourse it is worth using protective equipment (condoms) and strictly observe body hygiene, especially after sexual intercourse.

The requirement of hygiene will not be superfluous for lonely people, and expectant mothers can be advised to treat the virus at the planning stage of pregnancy. If the infection occurred during pregnancy, this must be reported to your doctor. It will not save a woman from the virus, but it can save the baby growing in her womb from this fate.

Those who have found a virus in the body or have its external manifestations should take care of their loved ones. Do not hide the problem, because ignorance does not relieve from responsibility, and a loved one can get a virus without even knowing it. Again, such contraceptives, such as condoms and certified antiviral lubricants, will help to prevent this situation.

Vaccination is considered another effective method for the prevention of viral infections, although in our country the vaccine is so far only available against the highly oncogenic types of virus (type 16 and 18, which most often cause cervical cancer). But it is possible that in the future this way it will be possible to defend against HPV 56 of the type related to viruses of moderate oncogenicity.

[29], [30], [31], [32], [33]

Forecast

The papillomavirus type 56 is a medium risk cancer virus, so it causes cancer rarely and usually in the presence of predisposing factors or several types of virus at the same time, among which are highly oncogenic. The prognosis of the disease in most cases is favorable, because in almost 90% of patients the immune system deactivates the virus on its own within a year.

Among the remaining patients, the percentage of those who have developed cancer on the background of HPV is extremely low. At the same time, there are few patients with type 56 virus. But this is not a reason to treat such a dangerous disease blithely, especially since timely treatment helps to reduce the risk of cancer to almost zero.

And yet, people have long known that most diseases are easier to prevent than to cure the disease itself and its consequences. This alternative wisdom is the best approach to the problem of papillomavirus. And it has become a problem because of the high prevalence of HPV.

[34], [35], [36], [37],