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Human Papillomavirus (HPV), Diagnosis and Treatment

April 10, 2024Lab TestsVirology

Table of Contents

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  • Human Papillomavirus (HPV)
        • What sample is needed for Human Papillomavirus (HPV)?
        • What are the indications for Human Papillomavirus (HPV)?
        • How will you define Human Papillomavirus (HPV)?
        • How will you define the pathophysiology of the Human Papillomavirus (HPV)?
        • How will you classify Human papillomavirus (HPV) and its relation to various diseases?
        • What is the incubation period of Human Papillomavirus (HPV)?
        • What is the structure of the Human Papillomavirus (HPV)?
        • Give a summary of the features of Human Papillomavirus (HPV)?
        • How will Human Papillomavirus (HPV) spread?
        • What are the signs and symptoms of Human Papillomavirus (HPV)?
        • What is the classification of the Human papillomavirus and its relation to diseases?
        • How will you describe the epidemiology of Human Papillomavirus (HPV)?
      • How will you diagnose Human Papillomavirus (HPV)?
        • How will you treat Human Papillomavirus (HPV)?
        • What are the complications of human papillomavirus?
        • How will you prevent Human Papillomavirus (HPV)?
      • Questions and answers:

Human Papillomavirus (HPV)

What sample is needed for Human Papillomavirus (HPV)?

  1. The sample can be taken with an Endocervical swab.
  2. Take a biopsy sample from the affected tissue.

What are the indications for Human Papillomavirus (HPV)?

  1. Isolation of the Human papillomavirus.

How will you define Human Papillomavirus (HPV)?

  1. This virus is double-stranded DNA without an envelope.
  2. Papova means papillomavirus, polyomavirus, causing perinuclear vacuolization.
  3. >50 strains of Human papillomavirus are described.
  4. The most common clinical manifestations are warts (skin) and condyloma (in the genital area).
  5. This double-stranded DNA virus infects the squamous epithelium and gives a spectrum of diseases of the skin, respiratory system, and genital tract, from warts to dysplasia to carcinoma.

How will you define the pathophysiology of the Human Papillomavirus (HPV)?

  1. Human papillomavirus (HPV) belongs to the Papovaviridae family.
    1. This is also called the wart virus.
  2. It measures 44 to 55 nm.
    1. This is a double-stranded DNA virus.
    2. This is icosahedral, and no envelope.
  3. This virus can cause the infection of:
    1. Hands, feet, arms, and forehead.
    2. Larynx.
    3. Genitalia.
      1. In the case of cervical lesions, HPV types 6 and 11 are associated with low-grade malignancy.
      2. HPV types 31, 33, and 35 are seen in low-grade malignancies.
      3. HPV types 16 and 18 are found in high-grade malignancies.
  4. Various types of warts/lesions are:
    1. Verruca plantaris are caused by HPV-1.
    2. Verruca Vulgaris is caused by HPV-2.
    3. Condyloma acuminatum is caused by HPV-6, 11.
    4. laryngeal papilloma is caused by HPV-6, 11.
    5. Cervical and laryngeal dysplasia/carcinoma is caused by HPV-16, 18, 31, 33.
  5. Papillomaviruses are tropical for the epithelial cells of the skin and mucous membranes.
    1. Viral nucleic acid can be found in basal stem cells.
  6. This virus causes cervical and squamous cell carcinoma of the head and neck.
  7. Biological and molecular studies show that the disease progresses slowly.
  8. HPV-16 and 18 are considered to be high-risk viruses for cancers.
    1. HPV-31 is classified as an intermediate-risk virus.
    2. HPV-6, 11 are considered low-risk viruses for cancers.

How will you classify Human papillomavirus (HPV) and its relation to various diseases?

Type of papilomavirus Disease
  • HPV-1, 2
  • Common warts
  • HPV-1
  • Plantar warts
  • HPV-3
  • Flate wart
  • HPV-3, 7
  • Butcher wart
  • HPV-6, 11, 30, and a few others
  • Respiratory system
  • HPV-28, 29
  • Verruciformis
  • HPV-6, 11, 42, 43, 44
  • Genital area with low-risk
  • HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68
  • Genital area with high-risk
  • HPV-3, 5, 8, 9, 10, 12, 14, 15, 17, 19, 20, 21, 22, 23, 24, 25
  • Epidermodysplasia

What is the incubation period of Human Papillomavirus (HPV)?

  1. Warts take 1 to 8 months once the virus settles in the area.
  2. Genital warts develop after 1  to 3 months.
  3. The wart is more common in children and young adults. These are uncommon in older adults.

What is the structure of the Human Papillomavirus (HPV)?

  1. Papillomaviruses are non-enveloped viruses without a lipid layer, with a capsid consisting of protein.
  2. It contains a large genome of 8 kb. This genome is very complex.
  3. There is double-stranded DNA in a circular shape.
  4. The papillomavirus is slightly larger in size, measuring roughly 52 to 55 nm.
Human Papillomavirus (HPV): Papilloma virus structure

Human Papillomavirus (HPV): Papilloma virus structure

Give a summary of the features of Human Papillomavirus (HPV)?

Parameters Characteristic features
  • Virus structure
  1. No, envelop
  2. Icosahedral
  • size of the virus
  • Average 55 nm
  • Structure
  1. Circular
  2. Double-stranded DNA
  • Oncogenic potential
  • It is present
  • Outcome of infection
  • It forms a benign tumor (Wart)
  • Target area
  • Epithelial surface
  • Genome transformed cells
  1. It is not integrated into the wart
  2. It is integrated into carcinomas
  • Type of papillomavirusus
  • Human papillomavirus >70 types are involved
  • Pathological lesions
  1. Skin warts
  2. Genital warts
  3. Laryngeal papilloma
  4. Cervical carcinoma
  • Where it is found
  • Papillomavirus found in cows and rabbits

How will Human Papillomavirus (HPV) spread?

  1. Human Papillomavirus (HPV) spreads :
    1. In genitalia through sexual contact (unprotected anal, vaginal, or oral sex).
    2. Transmission of cutaneous HPV is by direct contact, skin to skin (handshakes or hugs).
    3. This may spread during pregnancy (mother to baby, labor, and nursing).
    4. Some people have no symptoms but can spread the disease through sexual contact.

What are the signs and symptoms of Human Papillomavirus (HPV)?

  1. It is dependents on the area involved:
    1. Warts are tender when these are irritated.
    2. Warts are seen on hands, feet, arms, forehead, larynx, and genitalia.
    3. Anal warts cause itching called venereal wart Condylomata.
  2. Different kinds of warts are:
    1. Skin wart. Non-plantar warts are usually associated with HPV-2.
    2. Plantar warts. HPV-1 is associated with warts on the sole of the foot.
    3. Flat warts.
    4. Genital condyloma.
    5. Laryngeal papilloma.
  3. Palmer warts are sensitive to pressure.
    1. HPV-associated sexually transmitted genital lesions are becoming more common.
  4. Cervical cancers in women are common worldwide and a major cause of death in developing countries.
    1. HPV-6 and 11 are associated with low-grade cervical dysplasia (CIN I and II).
    2. HPV-16 and 18 are seen in 80% to 95% of high-grade cervical dysplasia (CIN III) and some cases of carcinoma of the penis.
    3. HPV-16 is also associated with squamous cell carcinoma in situ of the anogenital area skin (Bowen’s disease) and invasive carcinoma of the anal area.
  5. The majority of cervical, penile, and valvular cancers carry HPV-DNA.
    1. These lesions show HPV-16 and HPV-18, and these types are more common.
Human Papillomavirus (HPV) lesions

Human Papillomavirus (HPV) lesions

What is the classification of the Human papillomavirus and its relation to diseases?

Type of Human papillomavirus Clinical presentations The outcome of the infection
  • HPV-1
  • Plantar warts
  • Benign lesion
  • HPV-2
  • Common warts
  • Benign lesion
  • HPV-3, 10, 28
  1. Epidermodysplasia verruciform
  2. Flat warts
  • These are rarely malignant
  • HPV-5, 8
  • Epidermodysplasia verruciform in patients with cell-mediated immune deficiency
  • 30% progress to malignant change
  • HPV-6, 11
  1. Laryngeal papilloma
  2. Dysplasia
  3. Anogenital condylomas
  4. Intraepithelial neoplasm grade 1 and grade 11
  • There is a low malignant potential
  • HPV-7
  • Hand warts in meat animal handlers
  • These are benign lesions
  • HPV-12, 17, 20
  • Epidermodysplasia verruciform
  • Progress to malignancy
  • HPV-9, 14, 15, 19-25, 36, 40
  • Epidermodysplasia verruciform
  • Some of these may progress to carcinoma
  • HPV-13, 32
  • There is oral focal epithelial hyperplasia
  • May progress to carcinoma
  • HPV-16, 18, 31, 33, 35, 39
  1. There is high-grade dysplasia
  2. Laryngeal carcinoma
  3. Esophageal carcinoma
  4. Genital carcinoma
  1. There is a high correlation with:
    1. Genital carcinoma
    2. Oral carcinoma
  • HPV-26, 27, 29
  • Cutaneous warts
  • Doubtful relation
  • HPV- 30, 40
  • Laryngeal carcinoma
  • Malignant potential
  • HPV-37
  • Keratoacanthoma
  • Benign lesion
  • HPV-41, 42
  • Genital warts
  • Benign lesion

How will you describe the epidemiology of Human Papillomavirus (HPV)?

  1. This may become chronic and may last many years or lifelong.
  2. In the USA, this disease is very common; roughly 3 million cases are reported.
    1. Another reference says 80 million cases in the USA, according to the CDC.
    2. 14 million people, including teenagers, will suffer from this infection each year.

How will you diagnose Human Papillomavirus (HPV)?

  1. Diagnosis is made with immunohistologic stains or nucleic acid DNA probes on cervical biopsy.
    1. A cervical biopsy gives more positive results than a cervical scraping smear.
  2. It can find the virus in Papanicolaou stain cells of the cervical smear.
    1. Or can advise liquid-based cytology.
  3. PCR for detection of HPV.
  4. HPV DNA hybridization technology.

How will you treat Human Papillomavirus (HPV)?

  1. Warts need surgical excision.
  2. Also, can try electro-dissection.
  3. Can use acid.
  4. It can freeze with liquid nitrogen.
  5. Sometimes, it may disappear without any treatment.

What are the complications of human papillomavirus?

  1. The most common complication is cervical cancer in females. It is found in 90% of cases.
  2. This is also found in cancers of the vulva, penis, anal canal, and head and neck.

How will you prevent Human Papillomavirus (HPV)?

  1. Avoid contact with HPV-positive patients.
    1. Condom use can prevent infection.
  2. The vaccine can be recommended to prevent HPV (for genital warts and cervical cancers).
    1. HPV vaccine Cervarix prevents types 16 and 18.
    2. These types are 70% of the cause of cervical cancers.
    3. All boys and girls must be vaccinated at 11 or 12 years old.

Questions and answers:

Question 1: What is the nature of Human papillomavirus.?
Show answer
Human papillomavirus is a DNA virus.
Question 2: What is the main complication of human papillomavirus?
Show answer
The main complication is cervical cancer.

 


Possible References Used
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Comments

DF Reply
September 27, 2021

The viral structure used is HIV not HPV.

Dr. Riaz Reply
September 27, 2021

Please see now the structure.
https://labpedia.net/human-papillomavirus-hpv/

Dr. Riaz Reply
September 29, 2021

Thanks for pointing the mistake, and it is corrected.

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