HPV, Warts, and Cervical Cancer

Question 1

What can persistent infection with HPV cause, and how is persistent infection defined?

Answer 1

Persistent infection with HPV can lead to cancer development. The detection of the same HPV type two or more times over 1 year is defined as a persistent infection.

Question 2

What are four risk factors for HPV infection?

Answer 2

Multiple sexual partners
Early age of sexual activity (under age 20)
History of genital warts
Immunosuppressive disorders such as HIV/AIDS

Question 3

What are the two major routes of transmission of HPV?

Answer 3

Sexual contact (Intercourse, oral-genital, manual-genital)

Non-sexual contact (Mother to newborn, fomites - underwear/gloves/etc)

Question 4

What DNA structure does HPV have?

Answer 4

Double stranded DNA

Question 5

What are the major proteins of HPV?

Answer 5

Outer capsid protein: Capsid protein L1
Inner capsid protein: Capsid protein L2
Histone proteins

Question 6

Where do most cervical cancers arise from?

Answer 6

~99% of HPV associated cervical cancers arise within the transformation zone, an area of immature metaplasia between original and current squamocolumnar junction. At the inferior tip of the cervix.

Question 7

What percentage of head and neck cancers are associated with HPV and what cells do they arise from?

Answer 7

25% of head and neck cancers are associated with HPV infection. These cancers arise from the squamous cells in the mouth and throat region. This is the 6th most common cancer in the US, and has a less than 50% survive rate.

Question 8

What is the molecular pathology associated with the HPV E6 gene?

Answer 8

The HPV E6 gene causes the degradation of p53. p53’s normal function is to detect DNA damage and cellular stress and responds by initiating cell cycle arrest or apoptosis. Degradation of p53 by HPV E6 allows for the proliferation of cells with DNA damage, leading to cancerous growth.

Question 9

What is the molecular pathology associated with the HPV E7 gene?

Answer 9

The HPV E7 gene causes the degradation of the RB protein. RB protein normally functions to inhibit cell cycle progression and cellular proliferation. Degradation of this protein leads to the transcription of many cell cycle promoting genes such as cyclins and PCNA.

Question 10

What is the typical progression of HPV associated cervical cancer?

Answer 10

Normal tissue
ASCUS - Atypical Squamous Cell of Undetermined Significance
LSIL - Low grade Squamous Intraepithelial Lesion
HSIL - High grade Squamous Intraepithelial Lesion
Carcinoma

Question 11

What are three pathways that lead to

Answer 11

asdf