Lecture 6: Papilloma Virus

Question 1

Most common STI in the world

Answer 1

HPV

Question 2

HPV
-genome
-envelope
-transmission

Answer 2

Human papilloma virus
-dsDNA, circular
-no envelope
-direct contact (sexual, fomites, birth canal)
many infections asymptomatic, but virus still shed
anal cervical cancers the most

Question 3

HPV have tropism for

Answer 3

Squamous epithelial cells
-virus enters through small cutes/infects basal layers or mucous membrane- replicates locally
-infectious virions are only produced in the outermost epithelial cells

Question 4

Pathogenesis for HPV?

Answer 4

Binding to the BM triggers infection of adjacent basal cells- ensures infection of the only cells that divide

Question 5

Cell proliferation of HPV occurs where?
When do Koliocytes appear?

Answer 5

Basal cells
Cell proliferation= dividing cells (entry and uncoating occur)
Koliocytes appear during genome replication and virion maturation

Question 6

Characteristic CPE of HPV are

Answer 6

Koliocytes (clear holes surrounding shrunken nuclei)

Question 7

Pathognomic for HPV infection

Answer 7

Koliocytes

Question 8

What are the Low-risk types for HPV ?

Answer 8

Types 6 and 11
-condylomata acuminata
(Genital warts or benign lesions)
-all= types 6, 11, 42, 43, 45

Question 9

What are the high-risk types for HPV

Answer 9

High-risk types 16, 18, 31, and 33 (everything else)
=cervical cancer
= high risk for anogenital, oral, and oropharyngeal squamous cell carcinoma

Question 10

Genital warts are characterized as what type of HPV

Answer 10

Types 6 and 11

Question 11

Hand warts are characterized as what type of HPV

Answer 11

Types 2 and 4

Question 12

Plantar warts are characterized as what type of HPV

Answer 12

HPV 1

Question 13

Flat (face) warts are characterized as what type of HPV

Answer 13

HPV 3, 10

Question 14

Oral warts are characterized as what type of HPV

Answer 14

HPV 6, and 11. Sometimes HPV 16
= oral condylomata
=oral warts in/around the mouth
-Filiform wart

Question 15

Multifocal epithelial hyperplasia
-manifestations
-type

Answer 15

Heck’s disease “what the heck”
-cobblestone appearance
-HPV 13, and 32 (high-risk)

Question 16

Laryngeal warts
-what is it
-types

Answer 16

Recurrent respiratory papillomatosis (laryngeal papillomatosis)
-rare
-papillomas restrict the airways
mother with genital warts can give child this
-HPV 6, and 11

Question 17

Conjunctival papilloma

Answer 17

-HPV 6, and 11 and sometimes 16
-generally benign

Question 18

Oropharyngeal cancer
-type
-manifestations

Answer 18

-oropharyngeal cancer squamous cell carcinoma
HPV 16
Generally occurs at the base of the tongue and tonsil, but also the larynx

Question 19

How does HPV cause cancer?
What are the 3 proteins that are considered oncogenes?

Answer 19

-HPV DNA integrates into cellular DNA causing loss of normal cell cycle
-E5: stabilizes epidermal growth factor receptor
-E6 & E7: prevent function of tumor suppressor proteins (high risk HPV’s)

Question 20

Treating HPV

Answer 20

Most warts will regress spontaneously over time (treatment does not eliminate infection and warts can recur)
-chemical solutions, (salicylate acid)
-physical methods, (laser, cryotherapy)
-immune stimulation, (IFN)
-antivirals (cidofovir = for immunocompromised patients)
-vaccine ( Gardasil 9)

Question 21

Preventing HPV

Answer 21

Gardasil 9
-Types 6, 11,
-Types 16, 18, 31, 35, 45, 52, 58

Question 22

What HPV types cause skin warts

Answer 22

HPV 1,2,4

Question 23

Gold standard for diagnosing HPV

Answer 23

-PCR
you can also diagnose with a pap smear

Question 24

How long does it take for warts to become present in HPV ?

Answer 24

3-4 months
-infected cells are stimulated to divide, causing a thickening of the skin.