Tablets from human papillomavirus. The best cure for papillomas: a list of drugs

- this is one of the most common viral diseases of the skin and mucous membranes, so the cure for papillomas remains very popular. Most often, therapeutic regimens include 3 main groups of drugs for: antiviral, immunomodulators, local necrotizing.

Antiviral

Using antiviral agents does not guarantee the complete eradication of it from the body, but allows you to significantly suppress its activity. To achieve positive results, complex treatment must necessarily include antiviral drugs for HPV.

Allokin-alpha

An antiviral drug based on an oligopeptide that is similar in pharmacological action to interferon alpha. These HPV injections effectively strengthen each link of immunity, but especially increase the activity of T-cells, which are the basis of the cellular link of a specific immune response. Due to this, the division of viral cells slows down, or they completely disintegrate.

Allokin-alpha is administered subcutaneously, after dissolving the contents of the vial in 1 ml of physiological sodium chloride solution. The treatment regimen for each patient is selected individually, focusing on a pure culture of the virus, but most often 1 injection is made every other day. For a full therapeutic course, on average, 6 injections are necessary.

Allokin-alpha is considered a fairly safe drug, since it does not have toxic, teratogenic and mutagenic effects, does not affect reproductive capabilities and does not cause allergic reactions.

Cycloferon

The drug is a low molecular weight compound that, upon contact with cells and tissues, causes the formation of interferon. This explains the wide spectrum of action of Cycloferon - antiviral, immunomodulatory and relieving inflammation. The medicine has not only injectable forms of release, but also comes in the form of tablets and liniment.

Cycloferon tablets for papillomas are taken half an hour before meals 1 time per day. At the same time, the tablet should not be chewed (the small size allows it to be swallowed whole) and washed down with half a glass of clean water without gas. The dose of Cycloferon depends on the age category of the patient:

• pediatric patients from 4 to 6 years of age are prescribed to drink 1 tablet (150 mg) at a time;
• older children (from 7 to 12 years old) are allowed to take 2-3 tablets (300-450 mg) at a time;
• adults and adolescents over 12 years of age are recommended to drink 3-4 tablets (450-600 mg) at a time.

The duration of therapy is determined by the attending physician, but in some cases it can be carried out up to 2.5 months. In addition, repeated courses may be prescribed, but only after 2-3 weeks. Injectable Cycloferon is administered intravenously or intramuscularly. The general scheme involves the first 5 injections every other day, and the next after 2 days. The course of treatment averages 10 injections.

Panavir

An antiviral drug of plant origin, the active ingredient of which is a high molecular weight polysaccharide from the class of hexose glycosides. The antiviral effect of Panavir is ensured by the ability of the active ingredient to inhibit the synthesis of viral DNA in pathological cells.

In addition, Panavir increases the production of interferon, which makes the body more resistant to various infections. The drug is available in the form of injections, gel for topical use and vaginal suppositories, spray for the oral cavity and intimate areas.

Treatment of HPV in women and men often includes the use of Panavir gel. This is especially appropriate after laser destruction of genital warts on the skin or mucous membranes of the genitals or perianal region. The medicine is applied in the morning and in the evening for 5 days before and 10 days after the removal of the formations. In addition, against the human papillomavirus, Panavir is administered parenterally 3 times a day and 2 times after 3 days.

Kagocel

This endogenous interferon synthesis stimulator does not directly relate to antiviral drugs for papillomavirus, but some doctors practice its use in the complex treatment of HPV. This is due to the fact that it causes the formation of late interferons in the human body, which combine leukocyte and fibroblast protection against the introduction of various viruses.

Doctors prescribe Kagocel tablets from the papillomavirus according to individual schemes for each patient, but quite often it is recommended to take it for 10 days: the first 5 days, 2 tablets 3 times a day, and then 1 tablet 3 times a day. In addition, the course is repeated three times.

Kagocel stimulates the production of endogenous interferons in almost all groups of body cells or tissues that are directly involved in the immune response to pathogen invasion.

Groprinosin

Antiviral drugs for papillomas include a very effective Groprinosin. This is an immunostimulating drug with an antiviral effect based on inosine pranobex.

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The active substance damages the genetic apparatus of viral particles, stimulates the activity of cells that capture and digest particles foreign to the body, promotes continuous renewal of lymphocytes and the formation of small peptide information molecules.

Regardless of the form of external manifestations of papillomavirus, the Groprinosin regimen is similar in most cases. Tablets are recommended to be taken orally 3-4 times a day at regular intervals. The tablet should be swallowed whole and washed down with a sufficient amount of clean water. But the duration of the course of treatment may vary and has its own characteristics:

• Groprinosin is usually taken for 5 days in a row, but if noticeable improvements do not occur, then it is recommended to continue treatment until a stable therapeutic effect appears. But if there is a need for an extended course, then after every 5 days of application, a week break is taken.
• In the treatment of genital warts, papillomas, cervical dysplasia or warts, the duration of therapy can be up to a month. If during this period it is not possible to completely suppress the virus, then after a 4-week break, treatment can be resumed.
• If the HPV patient often relapses, then he is prescribed to take Groprinosin for 5 months (takes 1 month, and then 1 rests).

The structural analogue of Groprinosin is Isoprinosine, which is also widely used to treat papillomas.

Immunomodulators

When the human papillomavirus begins to actively make itself felt, this clearly indicates a weakened immune system. Complex therapy of human papillomavirus in women and men usually includes taking drugs that stimulate the body's natural defenses. But it is wrong to choose such medicines for yourself, this is the prerogative of an immunologist, who relies on the results of a preliminary immunogram.

Polyoxidonium

An immunomodulatory medicine for human papillomavirus that contains azoximer bromide. Polyoxidonium is able to regulate the immune system, remove toxins from the body, inhibit the oxidation of organic compounds, and relieve inflammation to some extent.

Polyoxidonium is sold in pharmacies in the form of tablets, suppositories (rectal / vaginal) and lyophilisate for the preparation of a solution for injection. Each vial contains 3 or 6 mg of the active drug. Polyoxidonium can be administered intramuscularly or intravenously using a dropper. Treatment regimens vary depending on the diagnosis and severity of the pathological process.

For the treatment of papillomatosis that affects the reproductive system, Polyoxidonium vaginal suppositories are especially appropriate for women. The drug is prescribed to put 1 time per day at bedtime for 3 days in a row, and then the manipulation is performed every other day. In total, up to 20 suppositories may be needed for a full course. If there is such a need, then after 4 months the treatment can be repeated.

Derinat

Another medicine included in the complex treatment against papillomas is Derinat. It is an immunomodulator that activates both the cellular type of immune response, in which neither antibodies nor the complement system participate, and humoral (antibody formation) immunity. In addition, Derinat stimulates recovery processes and increases the body's resistance to infections.

The solution for injection is recommended to be injected into the gluteal muscle, and in rare cases subcutaneously. To reduce pain, it is recommended to inject slowly enough - 5 ml of Derinat should be administered within 120 seconds. And before starting the manipulation, the ampoule should be warmed to body temperature.

As a rule, against the background of the use of Derinat, it is possible to reduce the dosages of antiviral and antibacterial drugs, without loss of effectiveness. At the same time, after the therapeutic course, the remission period noticeably increases. How many days and with what intervals to inject Derinat is decided by the attending physician.

Likopid

From papillomas, the drug Likopid is actively used. The drug is produced in tablets, it does not have capsules or other form of release. Take the medicine inside on an empty stomach so that at least 30 minutes remain before a meal. If papillomatosis is localized in the cervix, then Likopid is prescribed to be taken orally at 10 mg 1 time per day for 10 days.

At the beginning of treatment, people taking this drug may develop a stable subfebrile condition (up to 37.9 ° C). But usually this phenomenon disappears on its own after a few days and does not require a break in treatment. In addition, at the beginning of taking Likopid, the symptoms of chronic or latent diseases may worsen.

Treatment of HPV in women is a rather complex process, including the use of many drugs and surgery. A common infection covers about 70% of the population. Most often, carriers of the human papillomavirus are women of reproductive age.

HPV is a group of small DNA-containing sexually transmitted viruses that cause pathological growths of epithelial tissue. There are more than 200 types of viruses, 29 of which contribute to the development of malignant transformation of epithelial cells and belong to the oncogenic class.

The presence of the virus manifests itself in the form of papillomas of various types and localization, as well as skin dysplasia. The presence of dysplasia is characteristic of the cervix, and in some cases becomes the cause of the development of oncological diseases of this organ.

Types of HPV in women.

According to the degree and localization of the lesion, the following types of HPV are distinguished:

• cutaneous varieties (affecting the skin)
• musocotropic varieties (causing damage to the mucous membranes)

Clinical manifestations of cutaneous HPV include:

1. Flat papillomas are not oncogenic. They are raised nodules of the correct form, with a diameter of 8-10 mm.
2. Pointed papillomas are benign formations in the form of a pink cockscomb, covered with a stratum corneum.
3. Filiform papillomas - formations on a thin stalk, 5-7 mm in size.

Musocotropic varieties include:

1. Bowenoid papulosis - neoplasms in the form of spots and plaques affecting the vaginal mucosa and perineal skin. Transmitted sexually.
2. Cervical dysplasia - changes in the epithelium in the vaginal part.
3. Condylomas are papillary warts on a stalk located in the anogenital region.

Stages and degrees of HPV in women

HPV in women has 3 stages of development:

The degrees of HPV in women are determined by the ability to cause malignant processes and are divided into:

1. Non-oncogenic degree - viruses are not capable of developing into malignant neoplasms, since their DNA does not have a predisposition to mutations.
2. Low oncogenic degree - virus stamps can threaten oncological processes, only if combined with other provoking factors.
3. A high oncogenic degree is the most dangerous strain of the virus, as it leads to the development of cancer.

HPV symptoms in women

Treatment of HPV in women (the drugs used during therapy are aimed at suppressing the infection) begins after the onset of symptoms. The papilloma virus infects the basal layer of the epithelium. The epithelial layer is infected by microdamages - chemical or bacterial.

In order for the infection to develop, a few particles of the virus are enough. After infection with HPV, skin cells cease to function normally, which leads to the development of various pathologies. The incubation (latent) period of HPV in women can last from several weeks to ten years.

At this stage, the symptoms of the disease are not expressed and it is difficult to recognize.

When immunity is weakened under the influence of adverse conditions, the virus is activated and provokes the onset of symptoms. Often, the papillomavirus affects the skin and mucous membranes in the anus and genitals, upper respiratory organs, oral cavity and eyelids.

Neoplasms that appeared as a result of the presence of HPV have a different size, can be single or multiple, with a different structure and shape.

Other symptoms that affect the general condition include:

• weakness, fatigue;
• enlarged lymph nodes;
• bleeding and discomfort after intercourse.

Causes of HPV in women

The reasons for the development of HPV in a woman's body are due to many factors - external and internal. External factors include environmental factors. To internal - physiological and genetic. Infection with pathology occurs through sexual and domestic contact, or at the stage of childbirth when passing through an infected birth canal.

One of the main reasons for the appearance of the disease is a decrease in the work of the immune system, which cannot cope in the fight against the virus.

Against the background of dysfunction of the immune system, a number of provoking factors arise:

• early onset of sexual activity, frequent change of partners;
• inflammatory diseases of the pelvic organs;
• long-term use of hormonal contraceptives;
• smoking;
• hypothermia and stress;
• medical manipulations: installation of intrauterine devices, abortions;
• pregnancy or postpartum period;
• hormonal disorders.

Diagnosis of HPV in women

HPV in women is diagnosed using laboratory, cytological, instrumental and morphological studies. Laboratory studies - the use of molecular and genetic methods for detecting the virus in cervical scrapings.

The most informative studies are:

1. PCR diagnostics is an accurate method for detecting infection at the genetic and molecular levels. It allows you to identify all oncogenic viruses in the body. For analysis, biomaterials are used:
   1. vaginal discharge;
   2. anal discharge;
   3. mucus from the pharynx.
2. DIGENE-test is an ultra-precise method that allows you to determine not only the presence of a virus, but also characterize it - to identify the degree of oncogenicity and concentration in the body. For research, a special brush is used that penetrates to the cervix. Through several scrolls of the instrument, vaginal discharge is collected. Then the brush is placed in a test tube with a special medium and tested in the laboratory.
3. PAP diagnostics - helps to see the cells of the uterus, changed under the influence of HPV. For the analysis, a scraping from the cervix is ​​​​used, which is subsequently examined. PAP diagnostics helps to identify signs of atypia, dysplasia, and the presence of malignant cells.

For cytological studies, material taken from the affected area of ​​the epidermis using a special device is used. Part of the test material is applied in a thin layer on degreased glass. The sample is then stained with drugs and the staining result is looked at, according to which the virus is assigned a specific class.

The most common classification according to Papanicolaou, according to which viral cells are divided into 5 classes. Instrumental methods include the procedure of colposcopy. The results of the method allow us to draw conclusions about the need for further diagnostics.

Colposcopy is aimed at examining the cervix. During the procedure, the organ is treated with a Lugol solution, after interaction with which the selected area changes color, indicating the presence of HPV cells. Morphological methods include histological examination of the biopsy material.

Biopsy of the cervix and sampling of the mucous membrane of the cervical canal are used for:

• when identifying HPV types with a high degree of oncogenicity;
• with obvious signs of pathology without HPV testing.

When to see a doctor

It is necessary to seek advice and medical help from a gynecologist and dermatovenereologist in such cases:

• the appearance of skin neoplasia (warts, papillomas, growths) of any kind and severity;
• discomfort and bleeding after intercourse;
• copious vaginal discharge of an unusual color with an unpleasant odor;
• burning sensation in the vagina.

The above symptoms are similar to the clinical pictures of many pathologies. Therefore, it is necessary to conduct a thorough physical examination to determine the causes of symptoms.

Prevention of HPV in women

Prevention of HPV in women is to follow the rules that will not allow infection with the virus, and as well as measures that help to detect the presence of pathology in a timely manner:

If the fact of the presence of HPV has been established, to minimize the progression of the virus, one should:

• identify HPV subtypes to exclude their oncogenicity;
• conduct regular (every 2 years) testing for oncocytology;
• conduct oncotesting;
• perform HPV DNA monitoring if necessary.

Treatment options for HPV in women

Treatment of HPV in women (drugs that provoke the destruction of the virus in the body have not been invented) is a complex process. Complex drug therapy can only introduce the virus into a latent state in which it is not capable of harming the body. However, HPV continues to remain in the blood.

Treatment of HPV in women occurs in 2 ways:

1. Surgical or hardware method - used to remove the external manifestations of HPV - papillomas, warts, condylomas.
2. Drug method - is used in the form of a scheme of drugs of different groups to eliminate symptoms and improve overall well-being.

Medications

The treatment of HPV in women involves the development of special regimens consisting of antiviral drugs, immunomodulators and local agents that help get rid of the external manifestations of the virus. Antiviral drugs have a therapeutic effect on the pathogenic microorganism and contribute to its suppression.

Medicines of this group are produced in different forms - tablets, suppositories, vaccines.

Antiviral drugs in the form of tablets include:

1. Acyclovir - has the ability to inhibit the virus and transfer it to a passive (latent) stage. It is used in the treatment of manifestations on the intracavitary organs and in the genital area. Dosage regimen: 200 g 5 times a day, every 4 hours. The duration of the course is 5 days with the possibility of extension in severe cases. Cost - 50 rubles.
2. Lavomax is an antiviral and immunomodulatory drug. The mechanism of action is to suppress the reproduction of viruses. Dosage regimen: 125 mg 1 time per day every other day. Heading dose - 20 tab. 125 mg. Cost - 130 rubles.
3. Isoprinosine - has immunostimulating activity and antiviral action. Fights genital HPV, laryngeal papillomas and warts. Dosage regimen: 6-8 tablets 3-4 times a day. The duration of treatment is from 5 to 14 days. The average cost is from 600 rubles.

Antiviral suppositories used when the vagina or cervix is ​​affected by pathogenic processes:

1. Genferon is a combined drug that has a local and systemic effect, manifested in the suppression of the virus with the help of interferon. Dosage regimen: vaginally 1 suppository, 2 times a day for 10 days. The average cost is 500 rubles.
2. Viferon is an antiviral and immunomodulating agent. Dosage regimen: 1 suppository 2 times a day. Duration of admission: 5 days. The average cost in pharmacies is 250 rubles.

For intramuscular injection, Ferrovir is used - an antiviral drug of natural origin. It is prescribed 5 ml 2 times a day for 14 days. Cost - from 2980 rubles. Immunomodulators are a group of drugs that enhance the protective function of the body.

They are used as part of complex therapy to prevent the development of complications:

1. Licopid is an activator of innate and acquired immunity, which enhances protection against viral infections. Take 10 mg 30 minutes before meals, 1 time per day. The duration of the course is 10 days. The average price for the drug is 250 rubles.
2. Immunomax - activates the parts of the immune system. Dosage regimen: administered intramuscularly as a solution in the amount of 200 IU. Injections are administered on days 1,2,3 and 8,9,10 of treatment once a day. Cost - 900 rubles.
3. Gepon is an immunomodulatory drug that has antiviral and anti-inflammatory effects. Dosage regimen: 10 mg orally 1 time per day. The duration of treatment is set individually.

To combat skin defects, the appearance of which provokes HPV, cytostatics and chemical coagulants are used, which have a local effect.

These include:

1. Podophyllin - has a burning and necrotic effect. Used to remove genital warts. It is applied externally in the form of a ready-made solution. The affected skin area must be treated 2 times a day, every 12 hours, for 3 days. Cost - 600-800 rubles.
2. Solcoderm - used for benign superficial skin lesions. Treatment with a solution is carried out under the guidance of medical staff. The procedure is carried out once. After that, the affected area of ​​\u200b\u200bthe skin acquires a dark shade and the growth cells die off. The cost of the drug is 800-1000 rubles.

Folk methods

Treatment of HPV in women (drugs do not always have the desired therapeutic effect) occurs using alternative medicine methods. The use of folk remedies is practiced as part of a comprehensive treatment and is aimed at eliminating papillomas and warts, strengthening the immune system. For these purposes, herbal decoctions and infusions, solutions and essential oils are used.

Traditional medicine recipes for skin neoplasia for local external use:

1. Application of vinegar essence.
   Acetic acid at a concentration of 70% is applied to the affected area with a cotton swab. The procedure is repeated 2-3 times a day for a week. A wart or papilloma is affected by acid, becomes covered with a white growth and disappears.
2. Application of iodine solution.
   Iodine has a drying and antiseptic effect and is used to remove small warts and papillomas. A solution of iodine is dripped onto the lesion once a day for 2 weeks. At the end of the manipulation, the neoplasm should be eliminated.
3. The use of tincture of celandine.
   A solution for cauterization is prepared from the juice of a crushed plant and alcohol, in a ratio of 2: 1. The resulting solution is applied to the papilloma or wart 3 times a day. The duration of the course is 3 weeks. The use of celandine leads to the death and elimination of pathological formations.
4. The use of essential oils.
   Essential oils contribute to the destruction of the shells of growths. For these purposes, thuja, sea buckthorn or tea tree oils are used. To prepare the solution, a mixture of castor oil with one of the presented types is used. The resulting mixture is applied to the affected area 2 times a day until it disappears completely.

Traditional medicine recipes to strengthen immunity:

• Mix 1 tbsp. l. dry herbs: lemon balm, horsetail, plantain, nettle. Take 1 tbsp. l. the resulting mixture, pour 200 ml of boiling water and boil for 15 minutes over low heat. Leave the decoction for about 3 hours. Take 50 ml 1 time per day. Duration of admission - 7 days.
• 2 tbsp. Spoons of needles pour 100 ml of water and bring to a boil. Hold on low heat for about half an hour and insist. Take 2 tbsp. spoon 3 times a day.

Other methods

In addition to therapeutic treatment, in the fight against HPV, surgical hardware methods are used to eliminate skin lesions.

Papillomas, warts and condylomas are eliminated with:

1. Electrocoagulation- removal of surface formations using a special apparatus that generates electric waves. The electric knife cuts off the growths and at the same time cauterizes the vessels, as a result of which the pathological tissues are destroyed. The duration of the procedure is about 3-5 minutes. The average cost is 1000 rubles.
2. Cryodestruction- cauterization of neoplasms using liquid nitrogen. It has a low temperature (-190C), which allows you to freeze the problem area, clog the vessels of the affected area and block the access of oxygen to the cells. This leads to the formation of a thermal burn and necrosis of the tissues of the papilloma or wart. The cost of the procedure is 1000 rubles.
3. radio wave surgery- a method in which an apparatus with high-frequency radio wave radiation is used, which has a detrimental effect on pathogenic tissues. In this case, the excision process occurs without contact with the skin area. The flow of radio waves with the help of thermal energy penetrates into the affected area and affects it. The cost of the procedure is 1500-3000 rubles.
4. laser removal- a method in which the removal of pathological formations of the skin occurs with the help of a beam of laser beams. The tissues of the formation evaporate and a scab forms in their place. The procedure lasts 2 minutes. Complete healing of the treated area occurs after 1 week. Cost - 650-1300 rubles. depending on the size of the neoplasm.

Treatment of HPV in women (drugs and hardware surgery does not always improve) with the development of cervical dysplasia is carried out using invasive surgical methods.

These include:

1. Knife conization is the removal of areas of the mucosa of an organ in which the process of cancerous degeneration of cells has already begun.
2. Removal of the cervix is ​​carried out when the pathological process spreads deep into the cervical canal or if oncology is suspected. The operation takes place with the help of knife amputation by using a scalpel.

Possible Complications

HPV can lead to the development of a number of complications. Conventionally, they can be divided into 2 groups:

The first group includes:

• the risk of the transition of benign formations to malignant in the presence of oncogenic types of the virus;
• the risk of developing cervical cancer when diagnosing organ dysplasia;
• the likelihood of laryngeal papilloma growing into a tumor that causes attacks of suffocation;
• the risk of developing cancer of the stomach, organs of the respiratory system and intestines.

The second group of complications include:

• frequent mechanical damage to papillomas, which provoke minor bleeding and the development of inflammatory processes;
• suppuration of the wound after removal of the papilloma due to pathogenic microorganisms that have penetrated into it;
• the likelihood of large scars at the site of removal of large neoplasms.

Treatment of HPV in women is favorable, provided that the pathology is diagnosed in a timely manner. A set of measures, consisting of the use of drugs, hardware and invasive therapy, significantly improves the general condition of the body, but does not affect the complete elimination of the infection from the body.

Video about HPV

"It's healthy to live" about HPV:

Treatment of the human papillomavirus is carried out only after a medical examination. The reason for going to a specialist is often characteristic growths, which are the main signal of the development of the disease.

The human papillomavirus is manifested by characteristic formations on the body

Can papillomavirus be cured?

There are two common myths about HPV therapy:

1. The papilloma virus is completely curable.
2. It is impossible to get rid of this infection, it always leads to cancer and death.

The wording itself - "cure the virus" - in this case is incorrect. It is impossible to kill the strains and completely remove them from the body, but you can stop their activity or cure the disease, the appearance of which was provoked by pathogenic microorganisms.

Papillomavirus (HPV) is not always harmful to human health. Only certain types of papillomavirus present a high oncogenic risk (16 and 18). It is because of them that cancers appear.

The treatment regimen must also be drawn up by a specialist; in most cases, surgical intervention is required.

In total, there are more than 600 strains of papilloma, which are divided into 3 groups:

• harmless;
• causing warts;
• microorganisms that cause cancer.

Symptoms manifest themselves during periods of weakening of the immune system or occur against the background of stress or the development of diseases. A carrier of the virus can transmit the infection to other people through physical contact and not even know it. On his own, a person is unable to determine the type of microorganisms, and, accordingly, to apply the necessary drugs.

Which doctor treats papillomavirus infection?

It is necessary to contact a specialist who treats the area where neoplasms (warts) have appeared. There is no universal doctor involved in papilloma therapy.

In women and men, papillomavirus infection can appear in the following places:

• oral cavity (you need to contact your dentist);
• intimate area (treatment will be handled by a gynecologist or urologist);
• eyelids (ophthalmologist).

Gynecology deals with the treatment of neoplasms in the vagina and in the cervical region. In women, the virus often manifests itself in these places.

Human papillomavirus treatment methods

Self-treatment of the papilloma virus is a useless and risky exercise, which is likely to lead to disastrous consequences. Some drugs can relieve the general symptoms of an infection, but competent therapy still requires a trip to a specialist.

Warts are removed by surgery or laser. In some cases, they disappear without third-party intervention.

Medical treatment

Treatment of the virus requires the selection of medications that can restore the protective functions of the immune system and overcome the disease itself.

injections

Injections are administered intravenously. Injections are prescribed strictly after visiting a specialist. The following drugs are used for therapy:

1. Cycloferon. The medicine is prescribed to every second patient with HPV. The drug is especially effective for medium-oncogenic viruses. Cost: about 350 rubles.
2. Interferon alfa. A drug for raising immunity and combating dangerous microorganisms. It has anti-inflammatory and antiproliferative effects. Cost: about 120 rubles.
3. Panavir. A herbal remedy that helps increase the body's resistance to strains. The price of the drug starts from 110 rubles.
4. Ingaron. Solution for intramuscular injection. Stimulates the immune system and fights pathogens. Cost: about 130 rubles.

All drugs from this list are immunomodulators, that is, they affect the immune system. This property is very important for the treatment of all types of papillomavirus.

Tablets against papillomavirus

Tablets that are prescribed for HPV therapy:

1. Isoprinosine. The drug affects the immune system and has an antiviral effect. Price: about 1000 rubles.
2. Likopid. This drug is an effective immunomodulator. Price: from 800 rubles.
3. Lavomax. Antiviral tablets. Price: about 300 rubles.
4. Alpizarin. Herbal antiviral and antibacterial drug. Available in the form of tablets and ointment, which is also used to treat papilloma. The ointment is applied to the warts. The cost of the drug: about 200 rubles.

Candles

Candles are used in cases where viral papilloma manifests itself in the intimate area. These drugs are used to treat growths that form on the cervix, genitals, and in the vagina. The most effective suppositories:

• Genferon - about 500 rubles;
• Betadine - from 400 rubles;
• Viferon - the approximate price is 280 rubles.

Candles are the main medicines for the treatment of genital papilloma. They have an antiviral and immunomodulatory effect, fight edema, and eliminate warts. Suppositories are not recommended for use in children under 7 years of age and pregnant women.

Ointments for HPV

Ointments with regular use can eliminate growths. Treatments for HPV include:

1. Oxolinic ointment. Often used to destroy warts in intimate places. The tool effectively fights viruses and does not dry out the skin. Price: 30 rubles.
2. San Feng Zhong. Ointment of Chinese origin, has a burning effect. It is easiest to buy it on the Internet. Cost: about 200 rubles.
3. Stefalin. Quite an expensive ointment, 8 ml cost about 4,000 rubles. The drug is fast and effective. This ointment is able to remove moles and papillomas in 14-30 days (depending on the degree of damage).

Salicylic ointment can also be used for therapeutic purposes. It has a drying effect, kills germs and viruses, fights inflammation.

vitamins

Vitamins are used to restore immunity and promote health. They reduce the body's susceptibility to pathogenic microorganisms. It is vitamins that help fight the cause of the disease. Patients are advised to take such vitamin complexes:

• Aevit (price about 50 rubles);
• Complivit (cost about 150 rubles);
• Alphabet (price from 250 rubles).

These medicines contain several beneficial substances, due to which they have a beneficial effect on the entire body. The specialist may prescribe other drugs after the examination.

What other means are used to eliminate papilloma,.

Alternative treatment

Folk recipes are used to eliminate growths. The most common and affordable method of destroying warts is to lubricate them with potato juice. This method can be used for 30-40 days. Potato juice is also used to eliminate neoplasms in the intimate area.

Lemon and Vinegar Tincture

Lemon zest mixed with 100 ml of vinegar helps well against the virus. The medicine should be left in a cool, dry place for 7 days. After that, the tincture can be applied 2-3 times a day, lubricating the warts with it. The course of treatment takes from 2 weeks.

Experts do not advise the use of traditional methods without prior medical consultation. Most types of HPV are treated by any public clinic, which you can always turn to for help.

Fir oil and celandine

Fresh stems and flowers of celandine must be mixed with fir oil. These components help get rid of growths, have an antiviral effect. Apply the mixture directly. Dandelion juice can be used as an additional ingredient. The course of treatment: from 10 to 40 days (depending on the degree of damage).

The cheapest and easiest option is to lubricate the warts with ammonia. This method is only suitable for adults. Alcohol should not be used in the genital area and on mucous membranes. Not an isolated case was noted when the use of this folk method led to extensive peeling and irritation of the skin. The advantage of ammonia is a quick action. Treatment takes from several days to 2 weeks.

Prevention

1. Use of a condom. The contraceptive is not able to provide 100% protection against HPV, but it reduces the risk of infection several times.
2. Vaccination. Many people are afraid to get papilloma vaccines, but this fear is unfounded and stupid. Vaccination can protect against the most aggressive (oncogenic and moderately oncogenic) types of the virus.
3. Healthy lifestyle. This item includes a healthy diet, giving up bad habits and avoiding stressful situations. Papillomas are constantly in the human body, but they manifest themselves only during periods of a fall in the immune and nervous systems.

Vitamin complexes can be used for prevention.

Tablets from papillomas are among the most popular drugs. This is because the human papillomavirus (HPV) is one of the most common on Earth. According to studies, about 60% of people are infected with it.

The effect of papillomavirus on the human body

Science knows about 600 varieties of HPV. Some of them provoke the appearance of warts and genital warts, while others can cause malignant tumors. The virus is embedded in the DNA of epithelial cells, causing their pathological growth. Infection occurs through household or sexual contact.

The main symptom of the disease are warts, warts and other neoplasms that appear on the skin and mucous membranes of the hands, feet, face, neck, chest, and genitals. Growths can also occur on internal organs, for example, on the walls of the esophagus or intestines, in the renal pelvis, on the trachea, vocal cords, and ureter.

With HPV, unpleasant symptoms may be absent for a long time. The duration of the latent period sometimes reaches several years. The first signs of the disease appear in patients with a weakened immune system, namely: in people who have suffered severe infectious diseases, have undergone antibiotic treatment or surgery. The risk group includes people living in conditions of constant stress, pregnant and lactating women, HIV carriers, people with alcohol and drug addiction.

The main ways to deal with the disease

The key to effective disease control is proper treatment. Many people, having discovered neoplasms in themselves, are in a hurry to buy medications and start using them at home. However, self-medication can lead to serious complications up to the degeneration of benign neoplasms into malignant ones. To prevent this, you need to see a doctor.

At the appointment, the dermatovenereologist will examine the growths, conduct a biopsy and transfer the resulting material for histological analysis. He can refer the patient to laboratory tests, the purpose of which is to determine a specific strain. It depends on the results of the tests which tablets from the human papillomavirus the doctor will prescribe to the patient. The selection of medicines is carried out individually for each patient, depending on the type of virus present in his body, as well as taking into account the general state of his health.

Therapy against the human papillomavirus should be comprehensive, it is carried out in several directions at once. Treatment is carried out using the following means:

1. antiviral drugs that reduce the intensity of the impact of HPV on the patient's body;
2. immunomodulators that increase a person's immunity and allow him to more successfully fight the disease;
3. ointments and creams, with which the removal of growths is carried out.

In the conditions of an outpatient clinic or a cosmetology room, hardware methods for removing neoplasms can be used, for example, cryodestruction, laser removal, electrocoagulation, surgical removal of formations or with the help of a radio knife.

Features of the use of tablets for papillomavirus

Many patients seek to treat papillomas on the body with pills because they are the easiest to use. But it should be remembered that only antiviral and immunomodulatory drugs are produced in tablet form, that is, those drugs that improve the condition of the body and prevent the appearance of new warts, but do not eliminate existing growths. To get rid of papilloma and prevent the appearance of new formations, you need to take pills and at the same time use creams, ointments.

It must be remembered that it is impossible to completely get rid of papillomavirus infection, but the right remedy can improve immunity and suppress the reproduction of the virus. You can take such drugs only as prescribed by a doctor, because different strains of HPV are sensitive to different antiviral drugs, and only a doctor can determine which ones are suitable for a particular patient.

An obligatory part of complex therapy is the intake of immunomodulators, they increase the body's defenses in case of recurrent infections. Their main active ingredient is purified Interferon, which is obtained from human blood cells. It is these cells that are produced in a healthy person when pathogens enter the body. Interferon has a similar effect: it prevents the reproduction of HPV, as it suppresses the production of its proteins. Some Interferon preparations have an antiviral effect, for example, Acyclovir, Viferon.

It is necessary to drink immunomodulators carefully, because they can activate those parts of the immune system that are already active, and at the same time have a depressing effect on those parts whose activity is insufficient. And this will lead to an imbalance in the body. Only a doctor can choose the right immunomodulator.

Properly carried out drug therapy leads to a decrease in the activity of viruses, stabilization of the immune system, and the disappearance of itching in the area of ​​neoplasms. The growths themselves can decrease in size and even disappear completely.

Isoprinosine, Groprinosine

From papillomas on the body, Isoprinosine, which belongs to the group of antiviral agents, is excellent. It is able to directly affect HPV, suppress its development by blocking the synthesis of dihydropteroate synthetase. At the same time, Isoprinosine stimulates the protective functions of the body, activates the synthesis of immunoglobulins and leukocytes, thereby contributing to the complete destruction of affected cells.

The drug is available in the form of tablets, each of which contains 500 mg of the active substance - inosine pranobex. The treatment regimen is selected by the doctor individually for each patient, taking into account the type of virus, age and weight of the patient. Adults, as well as children over 12 years of age, are most often prescribed medication according to the standard scheme: 1-2 tablets 4 times a day. They need to be washed down with plenty of water.

The duration of the therapeutic course varies from 2 weeks to 1 month. Then you need to take a break of 30 days and repeat the therapy 2 more times. The use of Isoprinosine is allowed for children from 3 years old, the dosage for them is calculated depending on body weight: 500 mg of inosine pranobex per day per 10 kg of the child's weight. This dose should be divided into 3 doses.

This medicine enhances the effect on the body of other immunomodulatory and antiviral agents that are used to treat papillomas. Therefore, Isoprinosine is considered an ideal drug for complex therapy. In addition, it can be prescribed after surgical removal of genital warts to prevent the recurrence of the disease. A possible side effect of taking the drug is a violation of the digestive system, in particular the liver.

Groprinosin is an analogue of Isoprinosine, its advantage lies in a milder effect on the patient. Therefore, this medication is often prescribed to children, the elderly, patients suffering from cardiovascular diseases.

Its main active ingredient is magniferin, extracted from a plant called kopeck. Magniferin destroys the DNA of the virus. Each tablet contains 10 mg of this substance. You need to start taking Alpizarin on the first day of the recurrence of the disease.

Since the medicine is made from natural ingredients, even children can drink it. Dosage for babies - 1 tablet 3 times a day, and for adults - 2 tablets 3 times a day. Taking the medication is not associated with eating. The duration of treatment should be 3 weeks, and in case of recurrence of the disease - 4 weeks. Side effects of taking the medication include digestive disorders, fatigue, and allergies.

rimantadine

This is a powerful drug that ensures the destruction of the outer shell of the papillomavirus. Available in powder form for children, as well as tablets recommended for use by adult patients. It is widely used to prevent the recurrence of the disease after surgical removal of growths. Also indicated for use as a prophylactic after contact with an HPV carrier.. In such cases, the medicine should be taken once a day for 14 days.

Rimantadine is contraindicated in patients with intolerance to its components, as well as with severe pathologies of the kidneys, liver, gastrointestinal tract. Not accepted during pregnancy, lactation. Side effects are rare, these include indigestion, tachycardia, increased nervous excitability. These symptoms disappear within a few hours after discontinuation of the drug.

Other medications

Treatment of papillomavirus can also be carried out with other medicines that demonstrate high efficiency and safety of use. These include:

1. Acyclovir. Available in the form of tablets, ointments, creams. It is a synthetic analogue of a purine base, it has an immunostimulating effect, and also blocks the synthesis of viral DNA, thereby preventing the reproduction of pathogens. Acyclovir can be used by children from 2 years old, the standard regimen is 5 times a day. In severe forms of the disease, it is possible to increase the dosage to 2 pieces at a time. Contraindications to use are allergies to the components of the drug, as well as lactation. It should be taken with caution in case of renal failure, pregnancy.
2. Cycloferon. A drug that stimulates the synthesis of interferon and increases the body's defenses. Used to treat papillomavirus, as well as other serious diseases, such as HIV. The dosage is determined by the strain of the virus present in the patient's body. Cycloferon can be addictive, so it is used only as directed by a doctor, for a limited amount of time.
3. Galavit. Increases the body's defenses, stops the reproduction of HPV, eliminates inflammation. Drink 4 times a day. Contraindications are individual intolerance, pregnancy, age up to 12 years.
4. Arbidol. This drug from papillomavirus not only has a detrimental effect on the infection, but also increases local immunity. Due to this, the medicine reduces the risk of infection with other strains of HPV. Arbidol is recommended to be used after contact with an infected person (drink 0.2 mg 1 time per day for 14 days). After surgery, the drug should be consumed for 3-5 days, 0.5 g 4 times a day. A possible side effect is an allergic reaction. Arbidol is not recommended to be taken simultaneously with preparations containing umifenovir, because these substances enhance each other's action.
5. Likopid. It has an immunostimulating effect, and also helps fight papillomavirus infection, fungi, and pathogenic microorganisms. Likopid enhances the therapeutic effect of other HPV drugs, it has no contraindications and can be used to treat young children. The recommended dosage is 1 tablet three times a day, the duration of treatment is 10-14 days. Then you need to take a break of 10 days and repeat the treatment.

The maximum therapeutic effect can be achieved with the combined use of antiviral and immunomodulatory drugs, as well as local agents that ensure the removal of papillomas.

Catad_tema Papillomavirus infection - articles

Recommendations for patients with papillomavirus infection in the absence of its clinical manifestations

"MEDICAL ADVICE"; Gynecology and dermatovenereology; No. 3; 2009; pp. 12-18.

M.A. Gomberg, Doctor of Medical Sciences, Professor, A.M. Soloviev, Candidate of Medical Sciences, Associate Professor, MGMSU, Moscow

Recently, human papillomavirus infection has attracted particular attention due to the role of this group of viruses in the development of cancer. In 2008, the Nobel Prize in Medicine recognized evidence that certain types of human papillomavirus (HPV) can cause cervical cancer. According to Handley J.M., et al. (1994), HPV lesions include: clinical forms - anogenital warts (genital warts, warts vulgaris), symptomatic intraepithelial neoplasia in the early stages in the absence of dysplasia (flat warts); subclinical forms - asymptomatic intraepithelial neoplasia in the absence of dysplasia; latent forms (lack of morphological or histological changes against the background of HPV DNA detection).

Treatment of anogenital HPV lesions, according to existing principles for the management of patients with clinical manifestations associated with HPV, should be directed to the destruction of papillomatous foci that occur at the site of virus introduction by one method or another. In all the main recommendations for the management of patients with HPV infection - CDC, European recommendations, WHO recommendations, including the recommendations of the RCEF, this approach is given.

We wrote in detail about the methods of treating anogenital warts caused by the human papillomavirus in No. 11-12 of the Medical Council magazine for 2008.

The role of human papillomaviruses (HPV) in the development of many benign and malignant neoplasms of the skin and mucous membranes is beyond doubt. It is believed that all 500 thousand. cases of cervical cancer diagnosed annually in the world are caused by genital HPV infection (Bulletin Word Health Organization, 2007).

Various clinical guidelines and protocols describe in detail the methods of treating the clinical manifestations of HPV, but the issue of the so-called virus carrier or asymptomatic isolation of the virus is bypassed. Moreover, the issue of doctor's tactics in case of asymptomatic isolation of the virus in an HPV patient is given little attention not only in practical recommendations, but also in the research literature.

We offer our approach to this problem.

First of all, we proceed from the fact that our duty is to put the interests of the patient at the forefront. If he is alarmed by the presence of HPV and wants to get rid of this infection, we should try to calm him down and discuss all the treatment options currently available. Otherwise, it will be difficult for us to count on his confidence.

We believe that such a discussion should consist of 3 parts.
1. Informing the patient about the nature of the course and consequences of the infection.
2. Methods for the prevention of cervical cancer (if the virus is detected in women).
3. Possibilities of influencing HPV in order to eliminate it.

1. INFORMING THE PATIENT

At the first visit, it is necessary to tell the person about the possible risks associated with HPV infection. However, counseling should be carried out very carefully so as not to provoke the development of psychoneurosis and cancerophobia in a person.

A patient with identified HPV should be aware of his potential infectivity for uninfected persons, so he should be advised to use a condom during sexual intercourse and be sure to inform his sexual partner about the virus.

Patients should be informed that HPV may spontaneously disappear. It is known that younger people are more likely to lose the virus over time than people over 25 years of age.

2. PREVENTION OF CERVICAL CANCER (WHEN THE HUMAN PAPILLOMA VIRUS IS DETECTED IN WOMEN)

If HPV is detected in a patient under the age of 26, then vaccination can be recommended to prevent cervical cancer and severe dysplasia. There are 2 vaccines available on the Russian market - Gardasil and Cervarix. From the point of view of preventing cancer and severe dysplasia, their effectiveness is almost the same and close to 100%. According to experts, the vaccine is effective in preventing cancer, regardless of whether a woman is infected with the virus or not. At the same time, it is emphasized that vaccines have a preventive rather than a therapeutic effect - at present, there is no reliable data on their effect on the elimination of HPV that has already entered the body of a woman.

All women infected with HPV should have a colposcopic examination, including staining with Lugol's solution or acetic acid solution, as well as Pap cytology tests. The frequency of examinations is discussed with the gynecologist, depending on the degree of oncogenicity of the detected viruses and the results of colposcopy and cytology. Cytological studies should be carried out at least once every 6 months. For women over 26, this approach is practically the only way to prevent cervical cancer.

There are publications on the effectiveness of the Russian drug indinol for the prevention of cervical cancer in women infected with HPV. However, placebo-controlled studies have not been conducted.

3. EFFECTS ON HPV

The most controversial is the question of the impact on the isolation of the virus, so we will dwell on it in more detail. The doctor, of course, must inform the patient that at present there are no methods that can reliably and with a high degree of probability eliminate the virus from the body.

The need for therapeutic measures is discussed individually with each patient. It is advisable that the doctor decides on treatment to eliminate HPV in the absence of clinical manifestations only after the patient has signed an informed consent, in order to avoid possible subsequent misunderstandings.

Theoretically, given the localization of the virus in epithelial cells and the fact that there is a constant desquamation of the epithelium, it can be assumed that HPV can disappear along with old epithelial cells. Apparently, this explains the cases of spontaneous disappearance of HPV. Meanwhile, it is obvious that the elimination of HPV from the body with much greater efficiency can be achieved with the activation of antiviral immunity, which inhibits the reproduction of HPV and its introduction into other cells. It is possible to prove the possibility of achieving such a result in practice only by conducting appropriate special studies.

Potentially there are 3 ways of infection: from mother to child (transplacental; during childbirth, including by caesarean section; possibly through saliva or breast milk), through transmission of the virus by airborne droplets or contact household routes. It is believed that HPV infection is transmitted mainly through sexual contact, which explains its high prevalence among the sexually active population. In particular, 6.2 million new cases of genital HPV infection are diagnosed annually in the United States (Steinbrook R., 2006).

Increasing the functional effectiveness of antiviral immunity is the main way that can presumably help eliminate the virus from the body or reduce its activity. This can be achieved by both non-specific and specific methods.

Non-specific include various ways to strengthen the body's defenses, the so-called healthy lifestyle: proper nutrition, preventive intake of vitamins, dietary supplements.

A separate issue is homeopathic treatment. But since these methods are often mentioned in the popular science literature, we will not comment on them within the framework of this article.

We will dwell in more detail on the drugs mentioned in our article published in the journal Medical Council No. 11-12, 2008, p. 54-61. It mentions a group of drugs that are used in the treatment of clinical manifestations of human papillomavirus infection in combination with destructive methods. The effectiveness of adding additional therapy to destruction methods shows that one can expect an independent action of immune preparations on antiviral immunity, which will be sufficient to eliminate the virus in situations where destruction is not necessary due to the absence of growths. Since the goal of combined treatment is both the elimination of clinical manifestations by means of destruction and the suppression of the virus by means of immunotherapy, it can be used in the management of patients infected with HPV in the absence of clinical manifestations.

INTERFERONS

It has been established that the use of interferons reduces the amount of viral DNA (according to PCR) in patients in lesions.

Currently, girls and women aged 9 to 26 years, as well as boys and boys aged 9 to 17 years, are allowed to use the quadrivalent recombinant vaccine "Gardasil", developed for the prevention of diseases associated with HPV-6 - 11, -16 and -18 types.

Interferon is used topically and systemically (subcutaneously, intramuscularly, intravenously or rectally).

In most studies, the low efficacy of external use of interferon in the presence of clinical manifestations was shown, and encouraging results were obtained in the treatment of patients with subclinical foci of HPV infection and cervical neoplasia (CIN).

According to various authors, with systemic use of alpha-interferon at a dose of 1.5 to 3 million IU intramuscularly or subcutaneously every other day for 4 weeks as monotherapy, 11-100% of patients experience complete disappearance of warts, which indicates a possible inhibitory effect interferon preparations for HPV.

With the systemic use of interferons, side effects are usually flu-like conditions, the severity of which depends on the dose received. These side effects can be reduced by taking non-steroidal anti-inflammatory drugs.

It is considered possible to self-disappearance of HPV. It is known that younger people are more likely to lose the virus over time than people over 25 years of age.

A wide range of interferons from various manufacturers, both domestic and foreign, is presented on the Russian market - geneferon, viferon, kipferon, reaferon, roferon-A, intron A, realdiron, etc. It is preferable to prescribe recombinant rather than human interferons.

Of the drugs registered for use in the treatment of human papillomavirus infection, the following can be mentioned:

When prescribing interferons, one must take into account not only frequent adverse reactions, but also the fact that their administration can suppress the synthesis of one's own endogenous interferons. Therefore, in the absence of clinical manifestations, interferons are used only when the results of a study of the immune status indicate the appropriateness of such an appointment. It should also be noted the high cost of high-quality interferon preparations.

IMMUNOTROPIC DRUGS

It is possible to influence antiviral immunity with the help of endogenous interferon inducers and other immunity activators. There are many immunoactive drugs on the Russian pharmaceutical market that, according to the manufacturer's instructions or researchers' recommendations, can be used for the combined treatment of anogenital warts (in combination with various destructive methods). Based on this, they can be recommended for antiviral therapy in the absence of clinical manifestations.

Gepon is a synthetic oligopeptide consisting of 14 amino acid residues, belongs to the group of immunomodulators. The drug is indicated to increase the effectiveness of immune protection against infections, treatment and prevention of opportunistic infections caused by bacteria, viruses or fungi. Gepon has an immunopharmacological and antiviral effect:

In patients with a weakened immune system, Gepon:

So, for example, after removal of HPV lesions by any destructive method, Gepon applications (from 3 to 6 applications every other day) can speed up the healing process and reduce the level of recurrence. Systemically, the drug is used at a dose of 2 mg orally 3 times a week. The course can be repeated with an interval of 1 week [Soloviev A.M., 2003].

Isoprinosine (inosine pranobex) is an antiviral agent with immunomodulatory properties. The drug, inducing the maturation and differentiation of T-lymphocytes and T1-helpers, potentiating the induction of lymphoproliferative response in mitogenic or antigen-active cells, normalizes the deficiency or dysfunction of cellular immunity. Isoprinosine modulates the cytotoxicity of T-lymphocytes and natural killers, the function of T 8 suppressors and T 4 helpers, and also increases the amount of immunoglobulin G and complement surface markers. The drug increases the synthesis of interleukin-1 (IL-1) and interleukin-2 (IL-2), regulates the expression of IL-2 receptors, significantly increases the secretion of endogenous γ-interferon and reduces the production of interleukin-4 in the body. Isoprinosine enhances the action of neutrophilic granulocytes, chemotaxis and phagocytosis of monocytes and macrophages. In addition, it has a direct antiviral effect, inhibiting the synthesis of viruses by incorporating inosine-orotic acid into the polyribosomes of a virus-affected cell and disrupting the attachment of adenylic acid to viral mRNA. One of the indications for the use of the drug are infections caused by the human papillomavirus: genital warts, papillomavirus infection of the vulva, vagina and cervix (as part of complex therapy).

For women over 26 years of age, a cytological examination of the cervical mucosa, carried out 2 times a year, is almost the only way to prevent cervical cancer.

The literature describes various schemes and results of the use of isoprinosine.

For HPV infections, isoprinosine 3 g/day (2 tablets 3 times daily) as an adjunct to topical therapy or surgery for 14-28 days in low-risk patients or 5 days/week consecutively for 1 -2 weeks per month for 3 months for high risk patients.

It is known about the foreign experience of using inosine pranobex as a therapy that complements the destruction of anogenital warts. The drug was prescribed 1 g 3 times a day for 14-28 days.

In the work of Zabelev A.V. et al. (2005) showed the disappearance of atypical epithelium in women with HPV-associated low-grade squamous intraepithelial lesions after courses of isoprinosine treatment. The drug was prescribed 1 gram 3 times a day for 5 days, 3 courses with an interval of 1 month. A study by Sun Kuie Tay (1996) showed similar results - an improvement in the morphological picture of the vulvar epithelium. Inosine pranobex was prescribed 1 g 3 times a day for 6 weeks. A positive effect was achieved in 63.5% of patients, while in the placebo group, only 16.7%. Prilepskaya V.N. reports the termination of HPV isolation in 65.6% of patients after combination therapy (isoprinosine + destruction of foci) with low-grade CIN. (2007). When using only the destruction of foci, this result was achieved in 46.9% of patients. Isoprinosine was prescribed 7-10 days before the destruction, 1 g 3 times a day for 5 days. In the study of Shevnina I.V. (2009) showed similar results - the cessation of HPV isolation in 77% of patients with combined therapy of women with CIN and anogenital warts. Isoprinosine was prescribed 1 g 3 times a day for 10 days, then 0.5 g 3 times a day for 20 days.

In 2008, the Astra program was developed and implemented - an all-Russian multicenter program for monitoring, summarizing and generating statistical reporting on the features and results of using isoprinosine in the treatment of HPV-associated diseases in routine medical practice. The study involved 6191 patients (5896 women and 295 men) [Kostava M.N. et al., 2009]. Patients who participated in the study were treated in accordance with the identified diseases. Isoprinosine was included in the complex of treatment. In the presence of only genital warts of the vulva and vagina, monotherapy with isoprinosine was performed. This drug was also used to treat 58 patients with CIN I-II, localized in a limited area of ​​the exocervix, fully accessible for colposcopy, without damage to the cervical canal. In the absence of a positive effect, adequate excision of the affected tissue was performed. Recommended therapeutic doses of isoprinosine corresponded to the severity of human papillomavirus epithelial damage. When genital warts were detected in the vulva and vagina, the drug was prescribed at 50 mg/kg/day for 5 days in 3 courses with a break of 1 month. With cytological and histological data corresponding to CIN I-II, isoprinosine was used at 50 mg/kg/day, 10 days a month, 3 courses with a break of 1 month. In subclinical forms of HPV lesions of the epithelium, the drug was administered at a dose of 50 mg/kg/day, from 10 to 21 days (1 course). Before treatment, koilocytosis was detected in 1367 patients, and after treatment - in 71 patients, with a normal colposcopic picture. Treatment of genital warts was effective in 91% of patients, combined treatment of CIN I - in 90%, combined treatment of CIN II - in 82%, treatment of subclinical HPV infection - in 91% of patients, respectively [Kostava M.N. et al., 2009].

Promising is the use of an activator of antiviral immunity - immunomax - acid peptidoglycan with a molecular weight of 1000-40000 kDa. The drug was isolated from plants by a complex of biochemical methods, including ultrafiltration and chromatography. The sterile preparation Immunomax is a lyophilized powder of 200 IU in vials for injection. It is known to be used in combination with any of the destructive methods in the clinical manifestations of HPV infection. Patients are removed genital warts and simultaneously prescribed intramuscular injections of immunomax 200 units 1 time per day on the 1st, 2nd, 3rd, 8th, 9th and 10th days of treatment [Perlamutrov Yu.N. et al., 2003]. In 68% of patients, immediately after the end of treatment, there is no recurrence of warts, and after additional sessions of destruction, the effectiveness of treatment reaches 98% (with a follow-up of at least 3 months) [Perlamutrov Yu.N. et al., 2003].

To solve the problem raised in this article, it is interesting to stop detecting HPV from lesions during the ongoing combination therapy using immunomax. When conducting a virological examination of patients before treatment, HPV was detected in the lesions on average in 70%. After the combined treatment during the control observation in 45% of patients, the cessation of HPV isolation was noted [Perlamutrov Yu.N. et al., 2003]. The results obtained indicate that immunomax therapy affects antiviral immunity and leads to the cessation of not only relapses, but also the isolation of HPV from lesions. In this regard, in the future, immunomax can be used not only for the treatment of genital warts, but also to prevent virus shedding in patients without clinical manifestations of infection.

ANTIVIRAL DRUGS WITH IMMUNOMODULATING ACTION

Panavir is a plant polysaccharide obtained from the plant Solanum tuberosum, belongs to the class of high molecular weight hexose glycosides of complex structure with a molecular weight of 1000 kD. Currently, in Russia, it is one of the most popular drugs used for antiviral therapy. Moreover, the treatment of papillomavirus infection is only one of the indications for its use.

After a single injection of Panavir, the level of leukocyte interferon increases by 2.7-3 times, which corresponds to the effect of therapeutic doses of interferon [Kolobukhina et al., 2005].

Inhibition of viral protein synthesis and increase in cell viability in the presence of viruses in cell culture, decrease in viral titers in cell culture and in animal experiments, increase in the latent period for the development of an experimental infection in vitro and in vivo, mitogenic activity in the reaction of blast transformation of lymphocytes, the ability to induce leukocyte interferon -gamma and -alpha in healthy volunteers are characteristic features of the spectrum of antiviral activity of Panavir [Kungurov N.V. et al., 2006]. Thus, it cannot be ruled out that Panavir can have not only an immunomodulatory, but also a direct antiviral effect. Such an action of Panavir is described in relation to the herpes simplex virus (HSV), when in vitro it suppressed the expression of very early, early and late HSV viral proteins [Kushch A.A., 2008]. According to the results of various studies, Panavir demonstrated the presence of a cytoprotective effect and a significant decrease in the infectious activity of viruses. In addition, the drug has a modulating effect on the synthesis of interferon in the body and increases the viability of infected cells. Panavir is prescribed intravenously at 200 mcg three times during the first week with an interval of 48 hours and twice during the second week with an interval of 72 hours, 5 injections per course. In suppositories for rectal use, it is used at intervals of 24 hours, per course - 5-10 suppositories. The gel for local and external use is applied in a thin layer to the affected areas of the skin or mucous membrane without rubbing 5 times a day. The duration of treatment is 4-5 days. The course of treatment can be extended up to 10 days. The use of panavir in the form of a gel can be recommended to eliminate HPV in situations where there are no clinical manifestations, and the virus is detected on the skin. There are reports of the successful appointment of Panavir in the clinical manifestations of HPV infection, as well as in the subclinical course of HPV infection, both as an additional immunotherapy to the destruction, and as a monodrug. At the same time, not only the disappearance of clinical manifestations is noted, but also the cessation of HPV isolation. So, for example, in 19 out of 21 patients (90.5%), when examined 3, 6 and 12 months after the end of the combination therapy of clinical manifestations of HPV, the cessation of isolation of HPV types 16 and 18 from the mucous membrane of the cervical canal was noted [Kungurov N.V. et al., 2006].

Increasing the functional effectiveness of antiviral immunity is the main way that can presumably help eliminate the virus from the body or reduce its activity.

The effectiveness of the drug in relation to the termination of viral excretion is associated with the prevalence of the neoplastic process [Ivanyan A.N. et al., 2004]. So, after complex treatment in patients with the 1st degree of prevalence of the process, the virus was not detected in 90.5%, with the 2nd degree - in 71.1%, with the 3rd degree - in 39.6%, with 4 th degree - in 9.4% of cases. Significant reduction in viral load from 398.2 RLU to 176.2 RLU (p<0,05) через 1 месяц после окончания монотерапии панавиром ВПЧ-инфекции отмечает Мелехова Н.Ю. (2005).

Studies of the antiviral activity of Panavir are ongoing in order to establish a target that explains its high antiviral activity, as well as to expand the indications for its use. But even now we can say that it is one of the most promising antiviral agents with a proven immunomodulatory effect.

CONCLUSION

In this article, we started a discussion about the advisability of trying to eliminate papillomavirus infection in the absence of its clinical manifestations. The current guidelines for monitoring such patients may not satisfy those who would like to receive qualified help in eliminating this infection. Therefore, we propose a 3-stage management strategy for such patients: counseling, cytological control in women, and the use of antiviral drugs with immunomodulatory effects.