1/31 Kingsley Human Papillomavirus (HPV)

Question 1

HPV structure

Answer 1

• dsDNA
• naked, non-enveloped virus

Question 2

HPV - two major capsid proteins

Answer 2

L1 major and L2 minor

Question 3

Since HPV is a naked virus, it can:

Answer 3

Survive on surfaces for a long time, withstand many conditions

Question 4

L1 capsid binds to:

Answer 4

• Syndecan-1
• Laminin-332 (laminin-5)
• alpha 6 (a6B4) integrin

Question 5

HPV entry is via:

Answer 5

Clathrin or caveolin-mediated endocytosis (receptor mediated endocytosis)

Question 6

HPV entry via L1/L2 induces ______ to expose _____

Answer 6

conformational change; furin binding site

Question 7

____ endosomal endoprotease cleaves ____. This exposes ____

Answer 7

Furin; L2; nuclear localization sequence (NLS)

Question 8

HPV replication is promoted via what proteins?

Answer 8

Early proteins E6 and E7

Question 9

HPV early E6 protein also binds (inactivates):

Answer 9

p53 tumor suppressor

Question 10

HPV early E7 protein also binds (inactivates):

Answer 10

Rb (retinoblastoma)

Question 11

L1 major is a:

Answer 11

Pentamer

Question 12

L2 minor is a:

Answer 12

Hexamer

Question 13

HPV can inactivate p53 and Rb which allows ____ bypass. The proteins responsible are termed _____

Answer 13

G1/S; viral oncogenes

Question 14

True or false: HPV virus is not cytolytic

Answer 14

True

Question 15

HPV virus is released by:

Answer 15

Degeneration of desquamating cells

Question 16

HPV strains can be found in:

Answer 16

cutaneous or mucosal areas

Question 17

Skin warts mainly caused by:

Answer 17

HPV 1-4

Question 18

Skin (epithelial) warts are mainly found on what parts of the body?

Answer 18

Hands and feet (common in children, young adults)

Question 19

Which HPV strains are associated with high-risk mucosal/genital infection?

Answer 19

16 and 18

also 31, 45, and others

Question 20

Which HPV strains are associated with low-risk infection?

Answer 20

6 and 11

Question 21

Regarding HPV, high or low risk means:

Answer 21

Likeliness of developing cancer as a result of HPV infection

Question 22

HPV high risk strains are ____

Answer 22

Oncogenic

Question 23

______ cause 70% of cervical cancers

Answer 23

HPV16 and HPV18

Question 24

____ cause ____% of viral anogenital warts

Answer 24

HPV6 and HPV11; 90-95%

Question 25

True or false: HPV is also found in the oral cavity

Answer 25

True

Question 26

HPV strains in oral cancer may harbor:

Answer 26

high risk HPV 16 and HPV18

Question 27

True or false: HPV is also found in breast cancers

Answer 27

True

Question 28

HPV strains in breast cancer may harbor:

Answer 28

high risk HPV 16 and HPV18

Question 29

How does HPV end up in breast cancers?

Answer 29

Oral HPV transmitted from partner (males > 90%)

Question 30

Patients with ____ are at higher risk for HPV infection, such as _____

Answer 30

Immunodeficiency; T-cell deficiencies

Question 31

One of the earliest clinical signs of HPV infection in an immunocompromised individual

Answer 31

Warts on hands

Question 32

In HIV patients, most frequent site of oral squamous cell carcinomas is:

Answer 32

Tongue

Question 33

Epidermodysplasia verruciformis is also known as:

Answer 33

Lewandowsky-Lutz dysplasia

Question 34

Epidermodysplasia verruciformis is a ____ disease that causes ____ as a result of infection by ____

Answer 34

autosomal recessive disease; tree-like lesions; HPV5 and HPV8

Question 35

HPV viral cofactor

Answer 35

Zinc

Question 36

Epidermodysplasia verruciformis

A mutation on ____ in the ____ genes leads to ____

Answer 36

Chromosome 17; EVER1/2 genes; lack of regulation of zinc in nucleus

Zinc is HPV viral co-factor

Question 37

Cervical cancer screening involves:

Answer 37

Papanicolaou-stained (Pap) smear

Question 38

What HPV vaccines are available?

Answer 38

• Gardasil (Merck) quadrivalent
• Gardasil 9vHPV (nine-valent)

Question 39

HPV Quadrivalent vaccine includes what HPV strains?

Answer 39

6, 11 (low risk); 16, 18 (high-risk)

Question 40

HPV nine-valent vaccine includes what HPV strains?

Answer 40

6, 11, 16, 18, 31, 33, 45, 52, 58

Question 41

Gardasil 9vHPV includes _____ for expanded use up to 45 years old

Answer 41

31, 33, 52, 58 (part of nine valent)

Question 42

HPV vaccine reduces ____ % of cervical cancer

Answer 42

90%

Question 43

Most important factor in reduction of cervical cancer

Answer 43

Age of HPV vaccination

Question 44

_____ reduction in oral HPV infections with only one dose

Answer 44

88%

Question 45

____ reduction in oral HPV infections with three doses

Answer 45

99%

Question 46

Only ___ of dentists felt comfortable discussing HPV vaccination

Answer 46

51%