Case Study: HPV

Question 1

What does HPV stand for and what virus is it ?

Answer 1

Human Papilloma Virus is a DNA virus

Question 2

How many types of HPV viruses are there?

Answer 2

Over 100

Question 3

Where does HPV infection occur?

Answer 3

Infects epithelial basal cells via micro-abrasians by receptor mediated or clathrin coated endocytosis

Question 4

How does HPV cause infection?

Answer 4

Inserts DNA into host cells and codes for 10-200 viral genomes

Question 5

HPV is a common STI, How can HPV be spread?

Answer 5

Vaginal
Anal
Oral sex
Skin-Skin contact

Question 6

How long does it take for symptom to occur?

Answer 6

Most infections do not cause symptoms and are naturally cleared by the body within two years

Question 7

How long does it take for HPV infection to develop?

Answer 7

10-20 years to develop cancer.

Question 8

What is the most common form of HPV-associated cancer amongst women?

Answer 8

Cervical cancer

Question 9

What is the most common form of HPV-associated cancer amongst men?

Answer 9

Oropharyngeal cancer(cancer of the back of the throat, including the base of the tongue and tonsils)

Question 10

State the Cancers and % Association with HPV

Answer 10

Cervical 90%
Anal 90%
Vulval 70%
Oropharnyx 70%
Penile 60%

Question 11

What numbers are the High Risk types for cervical cancer

Answer 11

16
18
31
33
45

Question 12

Type 16 and 18 cause what % of cancerns in the cervic?

Answer 12

70% - biggest age weighted loss of life

Question 13

How does HPV cause cancer?

Answer 13

Cancer is caused by affecting the p53 Protein which is a Tumor supressor protein. If DNA is damaged the p52 can activate DNA repair proteins and stop cell growth by prevention cell cycle to S phase

Question 14

How is cancer caused?

Answer 14

Uncontrolled cell division

Question 15

How does HPV cause cancer?

Answer 15

• HPV contains genes E6 and E7 that act as oncogenes.
• Cancer occurs when these genes accidentally becomes integrated in a cells DNA
• E6 genes produces the E6 protein that binds and to and inactivates p53. E6 also promotes the degradation of p53
• Without active p53 cell division is unctrolled hence a cancer

Question 16

What are HPV and Cancer Risk Factors?

Answer 16

Smoking
Co-infection with HIV or hepatitis
- Depressed immune system for other reasons

Question 17

How can HPV be prevented?

Answer 17

• Condoms can reduces infection but skin to skin contract can still mean it is transmitted
• Vacinations

Question 18

What kind of Vaccine are there for this and what ages?

Answer 18

Cervarix - Girls 9-26 for HPV 16 and 18 which cause cancer

Gardasil - Girls and Boys 9-26 years of age. Saves 6,11 and 16,18

Gardasil 9 - Girls, Boys ages 9-15. Causes 16,18,31,33,45,52,58

Question 19

What are the side effects to the vaccination?

Answer 19

A headache
Dizziness
Aching muscles
Redness and soreness around the site of the injection
Slightly raised temperature
Feeling and being sick stomach pain
Diarrohea
Itching and a skin rash

Question 20

Why are vaccinations not that high

Answer 20

Due to the moral impact of vaccinating children against a sexually transmitted disease and of adverse side effects have meant that uptake of the vaccination is not as high as it should be to create herd immunity.

Lack of education is also an issue

Question 21

Is HPV Vacinations Safe?

Answer 21

Based off evidence both HPV vaccines are safe

Question 22

Extra key points:

Answer 22

Screening and vaccinations are reducing rates of cervical cancer.

• Oral cancer are increasing.
• Vaccination would complement screening programmes and eventually reduce need and cost of screening

To achieve herd immunity in men high vaccination rates in men and women needed