HPV (Exam 2) Flashcards
Human Papilloma Virus (HPV) causes
warts
How many types of HPV cause genital HPV?
30 out of 150 types
How is HPV spread
sexual contact
mother to fetus
how long after contact do genital warts appear?
6 weeks to 8 months
Three main regions of HPV
early
late
long control
early region
encodes the transformation and immortalization potential
Late region
two capsid genes
long control region
contains all the cis-regulatory elements
HPV is the most
common sexually transmitted diseases worldwide
2 subcategories of HPV
genital warts
cervical dysplasia
the papillomaviruses are part of the
papovaviridae family of DNA tumor viruses
In 1942
the Pap smear was invented
in 1951
HeLa cell line with HPV
in 1975
Zur Hausen hypothesizes HPV causes cervical cancer
in 1982
first HPVs cloned
in 1989
E7 binds RB
in 1990
E6 binds p53
in 1995
FDA approves the first diagnostic test
in 2006,
FDA approves vaccine for HPV
Papilloma virus genome is
circular covalently close dsDNA about 8 kbp
55 nm in diameter
HPV has extreme specificity for
infection of epithelial cells
HPV infection normally results in
hyper proliferation of the host cell
may lead to transformation and immortalization (cancer)
HPV is the commonest cancer in
Sub-Saharan Africa and parts of South America
genital warts
soft, moist or flesh colored in genital area
condylomata acuminata
where do genital warts appear in women and men?
women: vulva, cervix, vagina, anus
men: scrotum, penis
life cycle of HPV
infection of the host cell –> DNA released in nucleus –> numerous cellular transcription factors interact with non-coding viral regulatory region (LCR) –> transcription of 2 hpv-16 transforming early genes (E6 and E7)
p53 and RB are
tumor suppressor proteins
Which main HPV types cause papillary condylomas
6 and 11
Which main types of HPV are considered high risk and have been found in cervical and other lower genital tract cancers
16, 18, 31 and 33
HPV 16 and 18
cause the most cases of cervical cancer
HPV types are very
similar in homology (DNA relatedness)
cytology (Pap smear)
cells under a microscope
has great specificity but sensitivity is only 51%
pap testing has
decreased the incidence and mortality of cervical cancer
for adolescents under 21,
do not screen
cervical cancer is rare
for young women 21 to 29 years old
screen every 3 years
prevalence is 50%, cancer rates are low
for women 30-65 years old,
screen with cytology every 3 years or screen every 5 years with hrHPV contesting
cancer prevalence increases to 24/100,000 after age 30
for women over 65 years old,
do not screen
transformation zone is smaller with less exposure to HPV
what age should cervical cancer screening start?
25 years old
people between ages 25 and 65
should get a primary HPV test done every 5 years or a Pap test every 3 years
hologic diagnostic
detects 14 high risk HPV
amplify target, shuffle through DNA and RNA
roche diagnostic
multiplex real time PCR
detects 14 high risk
Taq man probes
HPV treatment for warts
podofilox gel
imiquimod cream
chemical treatments
cryotherapy
laser therapy
electrosurgery
surgery
interferon
cure for HPV
NO CURE :(
you carry the virus for life
How does HPV cause cancer
it integrates into the host genome and produces E6 and E7 proteins –> malignant transformation occurs
E6 and E7 proteins
E6 binds and degrades p53
E7 binds and degrades retinoblastoma
Gardasil
target HPV types 16 and 18 (cancer)
targets HPV types 6 and 11 (warts)
how many doses of the HPV vaccine are required and at what time intervals?
3 doses
T- 0
T - 1 month
T - 6 months
early vaccination of HPV is
more effective than later vaccination
are patients protected when they get the vaccine and have already had an abnormal pap?
NO!!! (sorry)
Merck vaccine
HR-HPV 16 and 18 (70% cervical cancers)
LR-HPV 6 and 11 (90% warts)
GSK vaccine
HR-HPV 16 and 18 (70%)
vaccination for HPV 16 and 18 will
reduce abnormal cytologies
reduce cases of CIN
Three types of HPV vaccines available and the types they go after
GlaxoSmithKline (Ceravix) - 16 and 18
Merck (Gardasil) - 6, 11, 16, 18
Gardasil 9 - 6, 11, 16, 31, 33, 45, 52, and 58
How many cervical cancers are prevented by bivalent and quadrivalent vaccines?
71%
How many cervical cancers are prevented by nanovalent vaccines?
90%
when is routine vaccination for HPV recommended?
at 11-12 years old (only 2 doses are needed)
after 15 3 doses are needed
when is the completion of the HPV series recommended by?
age 26
which HPV vaccination is recommended for men?
Gardasil quadrivalent
Gardasil administration of 3 doses
0, 2 and 6 months
Gardasil recommendations for ages to get the series
women: ages 9 through 26
men: age 9 through 26
prevention of genital warts
abstinence and condom use
2 opportunities to prevent cervical cancer
prophylactic HPV vaccination
cervical screening and treatment
HPV infection is responsible for
approximately 91% of anal cancers
which type of HPV is the most common high risk type among individuals with or without HIV
16
most common area affected by HPV
squamo-columnar junction
what is the significance of HPV infection?
cervical cancer, genital warts, anal cancer
why is a vaccine for HPV challenging?
there are so many types of HPV (150)
who should be vaccinated for HPV?
mostly women, but males also
from ages 9 - 26
