Human papillomavirus type 35 in women and men

Human papillomavirus (HPV abbreviation) is most commonly heard in our body due to the formation of warts on the body. In fact, it has many varieties (currently over 600 strains are known), among which there are both harmless and cancer-causing ones. HPV 35 is a high oncogenic risk virus.[1], [2]

Structure HPV type 35

Human papillomavirus is a substance-antigen that the body perceives as foreign and begins to produce antibodies to combat it. The virus has its own DNA, small size and simple structure without an external lipid membrane.[3]

HPV is subdivided into genera, denoted by Greek letters, species (Arabic numerals and genus letters) and genotypes (Arabic numerals), of which there are more than a hundred.

Life cycle HPV type 35

HPV 35, like its other genotypes, through cracks, skin damage, mucous penetrates into the basal layer of the epidermis, gradually penetrating into the cell nucleus. The division of its DNA occurs synchronously with the division of the cell's DNA, visually manifested in the form of papillomas and condylomas.

The existence of a virus outside the chromosomes of the skin cell is considered to be a benign form, embedding it in the genome, resulting in damage to the flat and glandular epithelium, turns it into a malignant neoplasm.

There are five phases in the HPV life cycle, they include (1) infection, (2) proliferation, (3) genomic phase, (4) viral synthesis, and (5) secretion. 19 In the first stage, the basal cells are infected with HPV. [4]The second stage is the expression of early viral proteins (E1 and E2). The virus retains its genomic material with a small number of copies (10–200 copies per cell). This is followed by the proliferative phase and early E6 and E7 proteins are expressed. These proteins stimulate the development of the cell cycle. Genomic amplification occurs in the suprabasal layer, and early proteins are expressed (E1, E2, E4 and E5). Then, viral synthesis occurs and late proteins are expressed (L1 and L2). In a multilayer epithelium layer, the virus is released when the cells die, and the virus begins to infect other cells. [5]It is believed that this infectious cell cycle occurs from two to three weeks. The incubation period can vary from 1 to 20 months.[6]

How is HPV 35 transmitted?

Infection with HPV 35 occurs by contact. When exfoliating the surface layers of the epithelium of warts and other neoplasms, infectious viral particles enter the environment.

The virus can be transmitted from person to person through everyday life: through a common dish, bed, towel; by tactile contact, sexual intercourse, from mother to child during labor, with surgical instruments. 

Symptoms

Most people infected with HPV never have symptoms or health problems. Most signs of HPV infection (9 out of 10) go away on their own within two years.[7]

The most common HPV of the 35th type is manifested as warts (plantar, palmar, genital).

The most common disease caused by the human papillomavirus in women is cervical cancer, less commonly vulvar, vaginal cancer. Infection, as a rule, occurs after the onset of sexual activity (simple contact of the genital organs is enough) and under normal immunity can develop up to 20 years.

A significant prevalence of genital warts, which do not contain a danger to life, but have a negative impact on sex life. [8]

HPV 35 in men is manifested by papillary growths on the penis. Regardless of gender, the virus can affect the anus, nasopharynx and other parts of the body.[9]

Diagnostics

Laboratory diagnostics is based on molecular-genetic methods for detecting fragments of HPV genome in scrapings and other biopsies. There are special test systems for the detection of polymerase chain reaction (PCR) indicating not only the presence of the virus, but also the number of copies per 10 ⁵  cells that determine the genotype and lg or viral load.

The amount of up to 3 lg of HPV DNA is considered clinically insignificant or normal, 3-5 indicates the risk of cancer cells, more than 5 indicates a high probability.

For the diagnosis of HPV, histological and cystological methods of researching the biomaterial are also used to determine the precancerous changes in the epithelium. In many countries of the world, a screening test is also used in conjunction with cytology; it is distinguished by high diagnostic accuracy. [10], [11]

Nucleic acid hybridization assays (Southern blot, in situ hybridization and dot blot) [12], signal amplification analyzes (Digene® HPV test using Hybrid Capture® 2 (hc2) and HPV HRV Cervista® analysis are also used to determine HPV ) currently approved by the FDA) [13], nucleic acid amplification methods, quantification and determination of HPV viral load[14]

Treatment

What if HPV type 35 is detected, can it be cured? At the moment, there is not a single drug in the world that can overcome HPV, including 35. Therapies are exposed to the effects of its action.[15]

Immunomodulatory agents used to treat human papillomavirus infection (HPV) are primarily used to treat external anogenital warts caused by HPV. [16]Interferon alpha, beta and gamma can be administered topically and systemically. They stimulate the production of cytokines and demonstrate strong antiviral activity. [17]Imiquimod, which is an imidazoquinolamine derivative, is also used recently. It does not possess antiviral activity in vitro, but stimulates macrophages to secrete cytokines, such as interleukin (IL) -2 and interferon alpha and gamma. The mechanisms of its action are unknown. Imiquimod has been carefully studied and is a new drug in the treatment of HPV-35. Imiquimod is dosed in an individual dose.

Prevention HPV type 35

The only preventive method to avoid HPV infection is vaccination, which is effective against four types of virus, which the 35th virus unfortunately does not include. In our country, it is not mandatory in the list of immunizations, but those who want to protect themselves from the most dangerous serotypes can do it in private clinics.

You can get vaccinated at any age, while adolescents will need 2, and adults 3 injections.

Currently, the national NHS vaccination program uses a vaccine called Gardasil. Gardasil protects against 4 types of HPV: 6, 11, 16, and 18, which account for most (more than 70%) types of cervical cancer in the UK.[18]

American Cancer Society Guidelines for the Use of HPV Vaccine 

• Routine HPV vaccination for girls and boys should be initiated between the ages of 11-12. A series of vaccinations can be started as early as 9 years old.
• HPV vaccination is also recommended for women aged 13 to 26 years and for men aged 13 to 21 who have not started vaccination or have begun but not completed the series. Men from 22 to 26 years old can also be vaccinated. *
• HPV vaccination is also recommended at the age of 26 for men who have sex with men and for people with weakened immune systems (including people with HIV infection), if they have not previously been vaccinated.

* For people aged 22 to 26 who have not yet started a vaccination or have begun, but have not completed the series, it is important to know that vaccination at an older age is less effective in reducing the risk of developing cancer. 

Using a condom during sex also reduces the risk of infection, but does not completely eliminate it, since HPV can infect areas that are not covered by the condom. [19]

Forecast

Infection with HPV 35 will not necessarily lead to deadly diseases, but the likelihood still exists. Improve prognosis tests for HPV, given at least once in 3 years.