Human Papillomavirus (HPV), Diagnosis and Treatment
Human Papillomavirus (HPV)
Sample for Human Papillomavirus (HPV)
- The sample can be taken with an Endocervical swab.
- Take a biopsy sample from the affected tissue.
Indications for Human Papillomavirus (HPV)
- Isolation of the Human papillomavirus.
Definition of Human Papillomavirus (HPV)
- This virus is double-stranded DNA without an envelope.
- Papova means papillomavirus, polyomavirus, causing perinuclear vacuolization.
- >50 strains of Human papillomavirus are described.
- The most common clinical manifestation is warts (skin), and condyloma (in the genital area).
- 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.
Pathophysiology of Human Papillomavirus (HPV)
- Human papillomavirus (HPV) belongs to the Papovaviridae family.
- This is also called the wart virus.
- It measures 44 to 55 nm.
- This is a double-stranded DNA virus.
- This is icosahedral, and no envelope.
- This virus can cause the infection of:
- Hands, feet, arms, and forehead.
- In the case of cervical lesions, HPV types 6 and 11 are associated with low-grade malignancy.
- HPV types 31, 33, and 35 are seen in low-grade malignancies.
- HPV types 16 and 18 are found in high-grade malignancies.
- Various types of warts/lesions are:
- Verruca plantaris are caused by HPV-1.
- Verruca Vulgaris is caused by HPV-2.
- Condyloma acuminatum is caused by HPV-6, 11.
- laryngeal papilloma is caused by HPV-6, 11.
- Cervical and laryngeal dysplasia/carcinoma is caused by HPV-16, 18, 31, 33.
- Papillomaviruses are tropical for the epithelial cells of the skin and mucous membranes.
- Viral nucleic acid can be found in basal stem cells.
- This virus causes cervical cancers and squamous cell carcinoma of the head and neck.
- Biological and molecular studies show that the disease progress slowly.
- HPV-16 and 18 are considered to be high-risk viruses for cancers.
- HPV-31 is classified as an intermediate-risk virus.
- HPV-6, 11 are considered low-risk viruses for cancers.
Human papillomavirus (HPV) classification and its relation to various diseases:
|Type of papilomavirus||Disease|
|HPV-1, 2||Common warts|
|HPV-3, 7||Butcher wart|
|HPV-6, 11, 30, and a few others||Respiratory system|
|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|
The incubation period of Human Papillomavirus (HPV):
- Warts take 1 to 8 months once the virus settles in the area.
- Genital warts develop for 1 to 3 months.
- The wart is more common in children and young adults. These are uncommon in older adults.
Structure of the Human Papillomavirus (HPV):
- Papillomaviruses are non-enveloped viruses without a lipid layer, with a capsid consisting of protein.
- It contains a large genome of 8 kb. This genome is very complex.
- There is double-stranded DNA in a circular shape.
- The papillomavirus is slightly larger in size, measuring roughly 52 to 55 nm.
Mode of the spread of Human Papillomavirus (HPV):
- Human Papillomavirus (HPV) spreads :
- In genitalia through sexual contact (unprotected anal, vaginal, or oral sex).
- Transmission of cutaneous HPV is by direct contact, skin to skin (handshakes or hugs).
- This may spread during pregnancy (mother to baby, labor, and nursing).
- Some people have no symptoms but can spread the disease through sexual contact.
Signs and symptoms of Human Papillomavirus (HPV):
- It is dependents on the area involved:
- Warts are tender when these are irritated.
- Warts are seen on hands, feet, arms, forehead, larynx, and genitalia.
- Anal warts cause itching called venereal wart Condylomata.
- Different kinds of warts are:
- Skin wart. Non-plantar warts are usually associated with HPV-2.
- Plantar warts. HPV-1 is associated with warts on the sole of the foot.
- Flat warts.
- Genital condyloma.
- Laryngeal papilloma.
- Palmer warts are sensitive to pressure.
- HPV-associated sexually transmitted genital lesions are becoming more common.
- Cervical cancers in women are common worldwide and a major cause of death in developing countries.
- HPV-6 and 11 are associated with low-grade cervical dysplasia (CIN I and II).
- 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.
- 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.
- The majority of cervical, penile, and valvular cancers carry HPV-DNA.
- These lesions show HPV-16 and HPV-18, and these types are more common.
Classification of the Human papillomavirus and its relation to diseases:
|Type of Human papillomavirus||Clinical presentations||The outcome of the infection|
|HPV-3, 10, 28||
|HPV-12, 17, 20||
|HPV-9, 14, 15, 19-25, 36, 40||
|HPV-16, 18, 31, 33, 35, 39||
|HPV-26, 27, 29||
|HPV- 30, 40||
Epidemiology of Human Papillomavirus (HPV):
- This may become chronic and may last many years or lifelong.
- In the USA, this disease is very common; roughly 3 million cases are reported.
- Another reference says 80 million cases in the USA, according to CDC.
- 14 million people, including teenagers, will suffer from this infection each year.
Summary of the Human Papillomavirus (HPV) features:
|size of the virus||Average 55 nm|
|Outcome of infection||It forms a benign tumor (Wart)|
|Genome transformed cells||
|Type of papillomavirusus||
|Where it is found||
Diagnosis of Human Papillomavirus (HPV):
- Diagnosis is made with immunohistologic stains or nucleic acid DNA probes on cervical biopsy.
- A cervical biopsy gives more positive results than a cervical scraping smear.
- It can find the virus in Papanicolaou stain cells of the cervical smear.
- Or can advise liquid-based cytology.
- PCR for detection of HPV.
- HPV DNA hybridization technology.
Treatment of Human Papillomavirus (HPV):
- Warts need surgical excision.
- Also, can try electro-dissection.
- Can use acid.
- It can freeze with liquid nitrogen.
- Sometime it may disappear without any treatment.
The complication of human papillomavirus:
- The most common complication is cervical cancer in females. It is found in 90% of cases.
- This is also found in cancers of the vulva, penis, anal canal, and head and neck.
Prevention of Human Papillomavirus (HPV):
- Avoid contact with HPV-positive patients.
- Condoms use can prevent infection.
- The vaccine can be recommended to prevent HPV (for genital warts and cervical cancers).
- HPV vaccine Cervarix prevents types 16 and 18.
- These types are 70% cause of cervical cancers.
- All boys and girls need to be vaccinated at the age of 11 or 12 years.
Questions and answers:
Question 1: What is the nature of Human papillomavirus.?
Human papillomavirus is a DNA virus.
Question 2: What is the main complication of human papillomavirus?
The main complication is cervical cancer.
The viral structure used is HIV not HPV.
Please see now the structure.
Thanks for pointing the mistake, and it is corrected.