HPV type 58 in women, men and children

Today there are more and more problems that people turn to cosmetologists, dermatologists, but they are not able to help them. This is due to the fact that the reason is not cosmetic. It must be sought much deeper, in the features of anatomy, physiology, as well as in the composition of biological fluids. In many ways, the condition is determined by the bacterial and viral load, the state of immunity. Today, one of the common causes of skin neoplasms on the skin, mucous membranes, is  HPV type 58. The abbreviation stands for type 58 human papillomavirus. But this virus causes not only neoplasms. Let us consider in more detail its features.

The most dangerous HPV?

The reason for the higher prevalence of HPV 58 in East Asia is still not fully understood. Creating a clone of tumor cells from an HPV-infected epithelium is a multi-step process involving many factors in which host genetics is likely to be the main determinant. [1]

There are many HPV genotypes. The most dangerous of them are 16, 18, 33 type. The main danger is carcinogenicity, that is, the ability to cause the development of cancer. As for type 58, it is also dangerous, since under certain circumstances it can cause malignant transformation of cells, but it is much less common than other genotypes.

The danger lies in the fact that the mucous membranes of the genitals, the reproductive system are affected, the infection can progress rapidly, going beyond the mucous membranes. Damage to the internal organs, or the entire body — the chest, abdomen, and even the neck and face — can be observed.

The third significant risk is associated with the fact that they can cause infertility in both men and women. Often lead to gynecological and urological diseases, in women they become the reason for the inability to get pregnant, have a baby, lead to abortions, miscarriages, stillbirths, premature births. There is a risk of infection of the baby during passage through the birth canal during childbirth.

Manifest in approximately the same way. A long incubation period can be observed, therefore, they are often difficult to diagnose. From the moment of infection to the moment when the first signs of the disease appear, more than one month can pass. During this period, a number of pathological changes occur in the body, many of which are irreversible. They are also transmitted all sexually.

With the skin form, growths, papillomas on the skin can appear. They can be flat, or elevated. They differ in their ability to grow and multiply fairly quickly. They can be either single or multiple. With persistence or high levels of the virus in the blood, symptoms similar to the common cold are noted. So, a person's body temperature may rise. Often there is a runny nose, cough, tonsils, tonsils, lymph nodes become inflamed.

Structure HPV type 58

Papillomaviruses have a small double-stranded DNA genome with a length of about 8 kb. [2]To date, more than 120 types of HPV have been well described, of which about 40 types can affect the genital tract. [3]About 15 types of these genital (mucous) HPVs are classified as “high risk groups” because of their oncogenic or possible oncogenic properties, either demonstrated by in vitro biochemical studies or derived from epidemiological observations. [4]The two early proteins, E6 and E7, are the main oncoproteins encoded by high-risk HPV. [5],  [6]  E6 protein binds to the p53 tumor suppressor protein in association with the protein associated with E6 (E6-AP). Overexpression of E6 leads to degradation of p53, antiapoptosis, destabilization of chromosomes, increased integration of foreign DNA and activation of telomerase. E7 binds to retinoblastoma (Rb) protein and Rb-related pocket proteins, which leads to inactivation of Rb-related pocket proteins, activation of cyclins, inhibition of cyclin-dependent kinase inhibitors and increased integration of foreign DNA and mutagenesis.

The HPV genome is packaged in L1 major capsid late protein and L2 minor capsid protein. [7],  [8] Five L1 proteins form the pentamer, and 72 pentamers make up the capsid of the virus. In L1 and L2, proteins are self-assembled into virus-like particles (VLPs), which induce high levels of neutralizing antibodies and are high protective properties. [9],  [10] L1-VLPs are components used in the development of special prophylactic vaccines. Targeting the L1 vaccine prevents infection with only certain HPV subtypes due to the lack of cross-protective epitopes in different HPV subtypes. The HPV L2 protein also induces neutralizing antibodies, the N-terminus of the L2 protein contains cross-protective epitopes and is a target for neutralizing antibodies. Therefore, targeting L2 may be an attractive approach for a candidate vaccine.

High-risk HPV genotypes 58

HPV 58 is a virus cloned in 1990 that is phylogenetically linked to HPV 16 and is classified in the genus Alfapapillomavirus, species of the α-9 groups, consisting almost entirely of carcinogenic types, having the main type HPV 16, which also covers several other species species that are associated with HR-HPV 16, including HPV 58. [11]HPV58 represents a strong association with CIN of a different degree and was isolated from specimens of genital warts, precancerous lesions, and invasive cancer.[12]

Recently, two independent studies have come to the same conclusion and have become the basis for future research. [13],  [14] Research results composed to classify embodiments HPV 58 on four lines indicated as A (subline A1 and A2), B (subline B1 and B2), C and D (subline D1 and D2). Based on 401 isolates collected from 15 countries / cities on four continents, it was found that Line A is the most common in all regions. Line C was found to be more common in Africa than elsewhere, while line D was more common in Africa than in Asia. It should be noted that the A1 subline, representing the prototype obtained from a Japanese cancer patient, was rarely found throughout the world, with the exception of Asia. It is worth further investigating whether the higher contribution of HPV58 to invasive cancer in East Asia is due to the higher oncogenicity of subline A1. The study also identified sequence signatures representing these lines, which allows for large-scale molecular epidemiological studies on HPV58.

Life cycle HPV type 58

There are five phases in the HPV life cycle that include 

1. infection
2. proliferation
3. genomic phase 
4. viral synthesis and 
5. selection. [15]

In the first stage, infections, basal cells are infected with HPV. The second stage is maintaining the genome. At this stage, early viral proteins (E1 and E2) are expressed. The virus retains its genomic material with a small number of copies (10-200 copies per cell). The proliferative phase follows and the early proteins E6 and E7 are expressed. These proteins stimulate the development of the cell cycle and regulate regulation in the parabasal layer. Genomic amplification follows in the suprabasal layer, early proteins are expressed (E1, E2, E4 and E5). Then, viral synthesis occurs and late proteins (L1 and L2) are expressed. In the epithelial layer, these structural proteins enhance viral packaging. In the multilayer layer of the epithelium, the virus is released when dead cells die, and the virus can freely infect other cells. It is believed that this infectious cell cycle occurs over a period of two to three weeks. The incubation period can vary from 1 to 20 months. [16]

Another possibility in the HPV life cycle is latency. After the initial infection, the immune system can cause a regression of the life cycle of the virus, and the virus can remain latent in the basal epithelium.

How is HPV type 58 transmitted?

Papilloma viruses are highly contagious, they are easily transmitted from person to person. The threat of infection by them exists almost everywhere, but not every person is susceptible to them. Even if a person is a carrier of this virus, this does not mean that the disease will immediately appear. It can manifest itself many years after infection, it can manifest itself after the body has weakened, for example, after a serious illness, after operations, against a background of decreased immunity and hormonal disorders, dysbiosis. Sometimes a disease can make itself felt after antibiotic therapy, chemotherapy, during pregnancy, menopause, or in adolescence against the background of increased stress on the body and hormonal changes. Therefore, each of us must know how type 58 HPV is transmitted in order to be able to protect ourselves from infection.

The main way the virus enters the body is through the genital tract, that is, the infection gets directly during intercourse, if it is unprotected. [17], Any microtrauma and damage affecting the skin, or mucous membranes, are the gates of infection, the probability of its penetration into the body increases sharply. Even if these are completely microscopic injuries that cannot be seen with the naked eye, they are enough to ensure that the infection can freely enter the body. In the absence of sexual contact, infection can also occur (in the event that there was contact of the damaged tissue with blood, or any other infected surface). [18], [19]

Also, a blood transfusion, transplantation may be the cause. Doctors and medical staff who come in contact with infected biological material are often infected.

Also, there is a high probability of infection of the child during childbirth, when passing through the birth canal of the mother, if she is infected with a virus. And this must be taken into account if a woman is planning a child. In most cases, if a woman is diagnosed with HPV type 58, this is the basis for a cesarean section, which will prevent infection of the child.

In case of bodily contact, or contact with the things of an infected patient, the risk exists only if there is damage to the skin and mucous membranes, including microscopic sizes. This has been demonstrated in school-age children who acquire HPV from sharing school supplies. [20]

Upon penetration into the body, the virus is initially in an inactive state, and only then, after some time, does it activate (that is, initially there is an incubation period). During this period, the symptoms of the disease do not appear, but the person is already a carrier of the virus, and can infect other people at this time. The disease develops upon the onset of adverse conditions of the external and internal environment. Most often, this is a decrease in immunity and a violation of the hormonal background. Also, after taking certain medications, after serious illness, activation of the virus may occur.

Therefore, if you are a carrier of a viral infection, its activation can occur under the influence of a number of factors, including after recently transferred viral, catarrhal diseases, after exacerbation of gastritis, hepatitis, and other chronic pathologies of internal organs. Bad habits, polluted environment, concomitant sexually transmitted and other diseases, a sharp change in climatic conditions, malnutrition, lack of vitamin or minerals.

There is a genetic predisposition to lower immunity, hormonal disorders, metabolic processes. In this regard, the risk group falls first of all, young people who do not have a permanent sexual partner are not protected. People get here. Leading an immoral lifestyle with frequent changes in sexual partners, with erratic and non-traditional sexual relations, taking drugs that abuse alcohol. Smoking can also be attributed to risk factors, since it causes intoxication of the body, contributes to immunity.

Epidemiology

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. The prevalence of human papillomavirus (HPV) among adults aged 18–69 years is 7.3%; High-risk HPV - 4.0%.[21]

HPV-58, which is associated with a high risk of cervical dysplasia and cervical cancer, is rare throughout the world, usually in East Asia. [22]Overall, HPV-58 is the third most common oncogenic type in Asia, but causes only 3.3% of all cases of global cervical cancer. [23],  [24]In Korea, HPV 58 is the second most common type diagnosed in women with abnormal cytological samples (10.8% of all abnormal cytology samples).

Symptoms

The main symptom is the development of warts on the body, or papillomas, which are pointed or flat neoplasms on the external genitalia, on the skin, in the oral cavity, in the anus.

In most cases, condylomas are papillary growths that rise above the surface of the body, have a pink, and sometimes flesh color. Their composition, as a rule, includes a large number of papules. Some of them are scattered throughout the body, others are grouped into separate groups. Sometimes these groups of papules fuse together, forming a separate comb.

Papillomas are often flat tumors on the surface of the skin or mucous membranes. However, they may not always be visible on the body, but are detected when they reach quite large sizes. By shade, they also often merge with the skin, do not rise above it. In most cases, they are detected by accident, during a routine examination, or during the diagnosis of other diseases. As a rule, they do not cause significant discomfort to a person. Manifestations do not affect either the mental or physical state of the body. They do not cause pain, itch and irritation do not entail, therefore a person rarely pays attention to them, and rarely consults a doctor about this. Flat papillomas are considered safer than hanging papillomas, since they are not noticeable, they do not separate from the surface of the body, therefore, they are less likely to undergo mechanical damage and pressure.

HPV 58 in women

For women, HPV 58 is significantly more dangerous than for men. This is primarily due to the high risk of fetal infection, since the virus is almost always transmitted through the birth canal, with microdamages to the baby. With a high degree of viral load and a sharply reduced immunity, milk can become infected in the woman’s body, as a result of which the infection can be transmitted to the baby. It can also cause non-gestation, premature birth, miscarriage, and miscarriage. Often causes gynecological diseases and pathologies, leading to infertility.

Also at risk are papillomas located around the internal genital organs, on the cervix. Firstly, they can be damaged during sexual intercourse (on the labia, in the vagina). Numerous injuries entail degeneration and mutations, as a result of which neoplasms can become malignant. There is also a high risk of infection, the development of inflammatory and purulent-septic processes with further progression and development of infectious diseases of the internal organs, genitourinary tract.

With the localization of neoplasms on the cervix, they can cause the inability to conceive a child, leading to serious and incurable infertility. In 80% of cases, it is condylomas and papillomas on the cervix that cause cancer. [25] In addition, during childbirth they can be damaged, torn, become the cause of bleeding, ruptures. They can also lead to uterine bleeding, miscarriage, miscarriage and premature birth.

No less dangerous are flat condylomas located on the internal organs of a woman. During a gynecological examination, they are rather difficult to diagnose, since they are very inconspicuous, they are often small in size, flesh-colored (merge with the mucous membranes). To identify them, laboratory tests are most often used, which can accurately indicate the presence or absence of infection, as well as indicate its quantitative indicators.

Often, HPV type 58, even one that proceeds in a latent form, triggers cervical dysplasia, inflammatory and dysplastic processes in the endometrium. Often becomes the cause of the development of cercical, epithelial neoplasia, carcinoma. You also need to consider that the virus is not detected in the blood immediately, but after some time (from 1 to 6 months). During this time, signs of the disease may still not develop, however, the virus will already cause significant damage to the body. Pathologies can already develop at the cellular, tissue levels.

HPV 58 in men

Often there is an overgrowth of papillomas and genital warts and to neighboring areas, organs. They can affect the entire perineal region, inguinal region. There are even cases when warts grow upward and affect first the lower abdomen, then the abdomen, chest. With deep distribution, cases are often noted in which genital warts spread to the internal organs, damage to the urethra, digestive tract, and reproductive organs is noted. And such warts, of course, already cause both physical and psychological discomfort. With mechanical damage, irritation can occur, pain appears. Psychological discomfort is associated primarily with the appearance, lack of aesthetics and beauty. The higher the warts spread, and the more noticeable they are, the worse the psychological state of a person.

Do not think that this virus is not dangerous. The greatest danger of this virus is that it is carcinogenic, that is, it has the ability to cause malignant neoplasms. With a high content of HPV type 58 in the body in men, papillomas and condylomas can develop into a malignant neoplasm. Thus, they are considered as a precancerous condition. It must be understood that not every person who has HPV type 58 detected in the blood has cancer, since the development of cancer requires a combination of many factors, including internal, external factors, a genetic predisposition, and reduced immunity. However, in most patients suffering from various forms of cancer, a fairly high content of the papilloma virus is found in the blood.

HPV 58 in the newborn

Maternal transmission was proposed by Hayek in 1956. [26] 

Possible vertical transmission mechanisms are not entirely understood. HPV DNA was isolated from the vas deferens, seminal fluid, and sperm. [27] Prenatal transmission of HPV has also been proposed. This is confirmed by the presence of HPV foci in the infant during birth. [28] HPV was detected in amniotic fluid, which was obtained by amniocentesis before rupture of the membranes,  [29] and from amniotic fluid in a primary cesarean section in which artificial rupture of the membranes was performed immediately before delivery. [30] These examples suggest mechanisms of ascending infection, rather than transplacental infection of HPV, since HPV infection does not lead to viremia. 

Most neonatal HPV infections are vertical transmission at birth. There is also the possibility that the newborn is indirectly exposed to HPV on contaminated surfaces in the birth room. HPV DNA can also be transmitted postnatally by caregivers during bathing or swaddling. 

In very young children (less than four years old), visible manifestations of HPV infection may include condyloma acuminatum. [31] Cervical and anal infections in young children are the result of sexual abuse. Oral lesions include verrucae vulgaris, papillomas, condylomas, and focal epithelial hyperplasia. [32] However, most of these lesions (75%) are the result of HPV 6 and 11. Recurrent respiratory papillomatosis in children (JORRP) is a rare, more serious disease that can occur. [33] It is estimated that JORRP occurs in 4.3 per 100,000 newborns and is caused by HPV infection of type 6 or 11; most often it occurs in first-born, born in the vagina of children of women under the age of 20 years. [34]

A newborn has all the factors predisposing to the development of HPV 58: reduced immunity, increased reactivity and sensitization, weakening, decreased stamina and resistance of the body, violation of the biochemical cycle, normal structural and functional state of the body, as well as lack of microflora, sometimes a violation of the hormonal background. Under such conditions, papillomas, condylomas, proliferation (dysplasia) develop. This is especially dangerous for children with low body weight, premature babies, with jaundice and functional liver disorders. There is always a potential risk of the progression of these conditions and their transition to malignant tumors - sarcomas, cancers, leukemia. An infection is transmitted during childbirth from an infected mother.

Among researchers, there are indications that the development of warts, papillomas and genital warts may indicate the presence of a parasitic infection in the body, and progresses with prolonged and systematic intoxication of the body with metabolic by-products of parasites. As a rule, indicates parasitic intoxication.

Diagnostics

To diagnose HPV type 58, women need to consult a gynecologist, men - to a urologist. These doctors will conduct an examination, prescribe appropriate tests, instrumental methods. Also, if necessary, additional consultations of other specialists can be appointed. In order to detect an infection that proceeds in a latent form, it will be necessary to pass an analysis for latent infections, a number of other tests. This will require a smear of urethral discharge (gynecological discharge). The doctor takes the biological material and then sends it to the laboratory, where they conduct further research.

HPV analysis 58

In the laboratory, a double study is usually carried out from this material (HPV analysis 58): standard microbiological examination and cytological examination. The first study allows you to diagnose a bacterial infection, determine dysbiosis, the condition of the mucous membranes. Cytological examination allows you to identify altered and mutated cells, and allows you to predict the likelihood of developing cancer or diagnose it in the early stages of development.

Sometimes a material is taken directly from a condyloma or papilloma (biopsy). Such a need arises when a malignant neoplasm is suspected. A biopsy sample (a piece of tissue) is transferred to the laboratory for further histological examination. The nature of tissue growth determines its affiliation with malignant or benign neoplasms.

The use of the Pap test for screening for cervical cancer in recent years has significantly reduced the incidence of cervical cancer and related mortality. [35]However, the Pap smear has a low sensitivity (<70%) for the detection of high degree squamous intraepithelial lesions (HSIL), which causes a number of problems associated with the need for additional methods to improve detection. [36]Therefore, it is recommended that human papilloma virus (HPV) DNA testing be performed in conjunction with the Pap test to improve the detection of precancerous lesions of the cervix. [37]

Monolayer cytological methods. Recently, new methods for collecting and processing samples for Pap smears have been developed to help reduce false negative results. In these methods, the sample is collected in a preservation solution, and not directly distributed onto the microscope slide manually. The cell structure is better preserved because the cells are immediately fixed. In addition, a cervical brush is used to collect the sample, which provides almost twice as many epithelial cells than other collection devices. [38]

Histopathology. Patients with abnormal Pap smear results who do not have a gross cervical lesion are usually assessed by colposcopy and colposcopic biopsy. After applying a 3% solution of acetic acid, the cervix is examined using bright filtered light with an increase of 10-15 times. [39]

HPV DNA detection using type-specific PCR. Type-specific PCR analyzes are based on sequence variations present in the E6 and E7 genes of HPV subtypes. Fourteen type-specific PCRs for high-risk HPV (HPV-16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58, -59, -66 and -68 ), which are targeted at approximately 100 bp in ORF E7. [40]

General primer PCR. In most PCR studies, consensus primers have been used to amplify a wide range of HPV types in a single PCR amplification. These primers target conserved regions of the HPV genome, such as the L1 capsid gene. Primers MY09 plus MY11 target 450 bp fragment within ORF L1 HPV. [41]

Hybrid capture analysis (Digene, Beltsville, MD) is the only kit currently approved by the FDA to detect HPV DNA in cervical samples. Hybrid capture analysis has been used in many studies, and a second-generation hybrid capture analysis version is currently widely used in clinical diagnostic laboratories. This is an antibody capture / solution hybridization / signal amplification analysis that uses chemiluminescence detection to qualitatively detect the presence of HPV. In this analysis, the DNA in the patient samples is first denatured and mixed with the pool of the RNA probe in a buffered solution in vitro. [42]

HPV 58 positive

The most informative method that allows you to directly judge the presence or absence of HPV type 58 in the body is PCR. This is a method by which the genotype of a virus in the blood is determined, or fragments thereof are detected. You can also determine the quantitative indicators of this virus in the body. With a hidden form of the course of the pathology, often only PCR allows you to diagnose an infection in the body.

Even if the DNA of the virus is very small in the blood, using special viruses, it doubles and even triples in the test sample, as a result of which it becomes visible and can be visualized upon examination. If you received a test positive for HPV type 58, this means that the virus persists in the blood, or an active course of the viral infection occurs. If there is no virus in the blood, the test will be negative. For further treatment, it is necessary to determine the quantitative indicators of the virus in the blood.

If we talk about quantitative indicators, the complete absence of viruses in the blood is considered the norm. But this is an ideal case, and it is extremely rare at present. Therefore, there are certain conventional norms of HPV 33 in the body, they differ in different countries. It mainly depends on climatic conditions.

Treatment

Most HPV-induced changes in cervical cells are transient, and 90% spontaneously regress within 12–36 months, since the immune system kills the virus. [43], [44]

Treatment is aimed at macroscopic (for example, genital warts) or pathological precancerous lesions caused by HPV. Subclinical genital HPV infection usually resolves spontaneously; therefore, special antiviral therapy is not recommended to eradicate HPV infection. Precancerous lesions are detected by screening for cervical cancer. HPV-related precancerous diseases should be treated based on existing guidelines. [45]

Treatment proceeds in two directions. On the one hand, it is, in fact, antiviral therapy aimed at eliminating the virus, reducing its activity and number. 

For the treatment of HPV type 58, various antiviral drugs are used: Anaferon, Arbidol, Groprinosin, Isoprinosine. For the treatment of genital forms, both in women and in men, suppositories are used, for example, kipferon, geneferon, viferon. Panavir gel and oxolin ointment are also used.

In addition to surgical and cyto-destructive procedures, several antiviral and immunomodulating agents may be prescribed.

Cidofovir is an acyclic nucleoside phosphonate derivative that has a broad spectrum of activity against DNA viruses and is used to treat CMV infections. [46] In vitro antiproliferative activity has been shown to be selective for rapidly proliferating HPV-infected cells. A 1% cidofovir gel was used topically without side effects every other day for 1 month to treat 15 women with severe CIN. [47] A full or partial response was observed in 80% of patients, which was evaluated by histology and detection of HPV DNA using PCR.

Podophyllin, a cytotoxic agent that stops metaphase mitosis (also used to treat genital warts), combined with vidarabine, a DNA polymerase inhibitor that inhibits HPV gene expression and cell growth in cervical cancer cell lines. [48] Expression of HPV-16 E6 and E7 gene products in normal cervical keratinocytes in vitro in the presence of podophyllin or vidarabine increased the sensitivity of these cells to apoptosis. Combined topical therapy using podophyllin and vidarabine ointments in 28 patients with mild to moderate CIN led to regression of lesions and successful eradication of HPV-16 or HPV-18 DNA in 81% of patients.

IFN and intravaginal 5-fluorouracil showed a variable response in clinical and in vitro studies. IFN-α is approved for the treatment of genital warts. The effects of IFN-α, IFN-β and IFN-γ were studied in some human carcinoma cell lines containing HPV-16 or HPV-18. The answer was seen in some cell lines, but not others. In HeLa HPV-18 cells, all IFNs suppressed transcriptional levels of the HPV E6 and E7 gene. In HPV-18 C-411 cells, IFN had no effect. In CaSki and HPK1A cells, only IFN-γ was effective. It is likely that since IFN-sensitive elements are likely to be suppressed by at least some oncogenic types of HPV, the usefulness of IFN therapy for cervical disease will be limited. [49]

On the other hand, it is a therapy aimed at preventing malignant neoplasms. To reduce the carcinogenicity of the virus, it is necessary to increase immunity. With a high level of immunity, the body itself will fight the infection, and will not allow malignant degeneration of tissues. If necessary, immunomodulators, immunostimulants are used. It must be remembered that excessive stimulation of the immune system can also be dangerous due to the fact that autoimmune aggression can develop in which the body attacks its own tissues and cells, destroying them.

Answering the question whether type 58 HPV can be cured, it is worth noting that, most often, drug treatment is effective only in the early stages of the pathology. You need to understand that the complete disappearance of all DNA fragments from the body is impossible to achieve. Once having been ill, DNA is stored in human blood forever. But if a person has undergone treatment, DNA in this case no longer provokes the disease, and moreover, does not become a factor predisposing to the development of cancer. Also, treatment will not allow the development of new condylomas or papillomas.

Often there is a need to remove these neoplasms. Today, laser removal methods are widely used. Laser evaporation and burning of warts is used. This is considered the safest method without causing complications. Risks and the likelihood of side effects are also significantly reduced. The recovery period is sharply reduced. The advantage of this procedure is that it can even be used to treat infections of the internal organs, to remove candidiasis and papillomas on the genitals.

Of course, for such an operation, it is necessary to consult a surgeon, or in specialized dermatological clinics where the operation will be performed. It is by no means necessary to carry out the removal yourself, because if something is done wrong, malignant degeneration of the wart can occur, which will lead to the development of cancer.

As a rule, non-invasive intraepithelial lesions identified only under a microscope are treated with superficial ablative procedures such as cryotherapy or laser therapy. These are outpatient office procedures and fertility is maintained. During cryotherapy, abnormal tissues and surrounding 5 mm are frozen with a supercooled probe. Tissue ablation with a carbon dioxide laser beam is as effective as cryotherapy, but the procedure is more expensive. Loop electrosurgical procedures are currently considered the preferred treatment for non-invasive squamous formations. In these procedures, an electrically charged wire is used to remove the transformation zone and the distal endocervical canal. It is cheaper than laser therapy and retains excised tissue for histological examination of regional status. After treatment of non-invasive foci of intraepithelial neoplasia with any method, the relapse rate reaches 31% with an average relapse time of 11.9 months. [50]

What to do if a HPV type 58 is detected?

The treatment is predominantly medical. Prescribe tablets, suppositories, various ointments, gels, creams. Vitamin and mineral complexes are also useful. Most often resort to antiviral and immunostimulating drugs. Sometimes there is a need for surgical operations, for example, if condylomas rise high above the surface of the body, if they were damaged, or there is a risk of their clamping, mechanical damage. If there is a risk of developing a cancerous tumor or malignant degeneration of condyloma, papilloma, surgery may also be required.

In the postoperative period, antibiotics, anti-inflammatory drugs, ointments, creams are used. In addition to treatment, you need to reconsider your lifestyle, include recreational activities in the regime of the day. You can try alternative recipes, herbal remedies, homeopathic remedies. Otherwise, if you do not know what to do, if you have found HPV type 58, you need to see a doctor and strictly follow his recommendations.

Prevention HPV type 58

Prevention is based on maintaining normal immunity, proper nutrition, and hygiene. It is important to lead a moral lifestyle: the presence of a permanent partner, protection from contacts with temporary partners, abstinence from unconventional and relationships, many partners, preventive treatment in the presence of infection in the sexual partner. You should periodically undergo consultations with an immunologist, gynecologist (urologist), take tests for viruses, latent infections. Periodically, you should drink courses of vitamin and, if necessary, immunostimulating agents. It is important to control the body for the presence of a parasitic infection, since it can also trigger the development of a viral infection, its activation. Periodically, you need to drink antiparasitic drugs.

The most important preventive measure is to be treated promptly when a viral infection is detected. Maintaining a high level of immunity is especially important, since the development of the disease is possible only with reduced immunity and impaired microflora.

The effectiveness of these vaccines mainly depends on the type, although some protection against the cross type has been observed, especially for the divalent vaccine (Cervarix ®, GlaxoSmithKline Biologicals). [51]Therefore, differences in the distribution of non-vaccine types (non-HPV16 / 18) may affect the development of next-generation vaccines. Prevention of more than 90% of HPV infections requires targeting at least 5 additional high-risk HPV subtypes of HPV-31, HPV-33, HPV-45, HPV-52 and HPV-58. [52]

Based on the results, HPV vaccination protects more than 70% of patients from high-grade lesions and cancer. However, the relatively high prevalence of HPV 58 has been found in studies conducted in various regions of Brazil,  [53], [54]as well as in other countries,  [55]emphasizing the importance of future vaccines for the inclusion of other HPV genotypes, in particular HPV 58, to increase the potential for the prevention of cervical cancer and other HPV-related diseases. Closer to 100%. [56]

Forecast

Often, HPV type 58 is the cause of genital warts. The places of their localization are mainly such areas as the labia, vulva, vaginal wall, and uterus. The cervix, the oral cavity, the anus and the areas around it. With a high degree of viral load and a sharp decrease in immunity, the formation of warts in the pubic and perineal regions can also be observed.

According to statistics, approximately 70% of the world's population is infected with the papilloma virus. Therefore,  HPV type 58  is one of the most common viruses. Approximately 60% of carriers of this virus remain carriers, and only 40% suffer from various forms of this infection. In about 8-10% of people, condylomas and papillomas develop into cancerous tumors. If the virus is detected in a timely manner, it can be prevented from being activated and kept in an inactive form, in which it will simply persist in the body, but will not cause disease. With the active form of the virus, choosing the right treatment, it can be transferred to a state of persistence. The main thing is not to self-medicate, otherwise the prognosis may be unpredictable.