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HPV

MT

Morgan Toledo

Transcript

Human Papillomavirus (HPV)

Pathophysiology

Human Papillomavirus (HPV) infection starts at the basal cell layer of stratified squamous epithelial cells. "Infection stimulates cellular proliferation in the epithelium and infected cells display a broad spectrum of changes, ranging from benign hyperplasia to dysplasia to invasive carcinoma. To effectively replicate, HPV must utilize the host cellular machinery. During the process, the viral protein product encoded by E6 binds to the p53 tumor suppressor gene product, which results in the premature degradation of the p53 protein. The E7 protein binds to a tumor suppressor protein—the retinoblastoma protein—and inhibits its function. These protein products mediate much of the virus’ oncogenic potential and their production represents a key difference between the low- and high-risk strains of HPV" (Hahn & Spach, 2018).

(Johnson & Johnson, 2018)

(Warde Medical Laboratory, n.d.)

  • Low-risk types such as HPV 6 and 11 are typically associated with genital warts.
  • Types like 16, 18, 31, 33, and 45 are considered to be high risk because of their association with cervical dysplasia and cervical cancer (Kipp & Porth, 2015).

Signs and Symptoms

Most people with HPV do not know they are infected because they never develop symptoms or health problems.

For some, the first sign are genital warts. They may appear on the genitals as well as the hands and feet.

Women may find out they have HPV when they get an abnormal Pap test result.

Others may only find out once they develop more serious problems from HPV, such as cancer (CDC, 2019).

(Garden OB/GYN, 2019)

If HPV becomes cancer, then there may be some symptoms.

Penile cancer might show symptoms like changes in color or thickness of the skin of the penis, or, a painful sore might develop on the penis.

Anal cancer might cause anal bleeding, pain, itching, discharge, or changes in bowel habits.

Vulvar cancer might show symptoms like changes in color/thickness of the skin of the vulva, chronic pain, itching, or, a lump may develop.

Throat cancer might cause a sore throat, ear pain that does not go away, constant coughing, pain or trouble swallowing or breathing, weight loss, or a lump or mass in your neck (Planned Parent Federation of America, 2019).

Examples of Genital Warts caused by HPV

(Medicine Net, n.d.)

  • Contrary to popular belief, HPV is not

spread exclusively through vaginal sexual

intercourse. It can also be spread by anal and oral sex,

however, the vaginal and anal routes are the most

common modes of transmission (CDC, 2019).

Facts

Transmission

(Hoppe, 2019)

  • The infected party usually shows no signs or symptoms, contributing to the ease of spreading the disease. They can spread the disease without showing evidence of having it.
  • Lesbian women can still contract HPV because HPV can still be spread by other skin to skin contact. HPV has been discovered in women who have never had intercourse with a male (American Sexual Health Association, n.d.).

  • HPV can even be transmitted with the use of condoms because it can be spread by skin to skin contact. The exposed skin not covered by a condom such as the vulva, scrotum, anus and base of the penis can spread the HPV virus (American Health Association, 2019).

  • Currently, no diagnostic test can tell healthcare providers if a male has HPV. There is no way to tell if the male can spread the virus to future partners.

  • It may take years for HPV to be detected on a Pap smear, so even regular screenings do not exclude the possibility of spreading HPV. This contributes to the spreading of HPV, because women may falsely believe they don't have it (Bernstein, 2016).

Video

"If you are an individual who has had sexual contact, which even could be open mouth kissing, you could have contracted the virus" (Michigan Medicine, 2011).

HPV Infection Prevention

Prevention

1. Abstaining from sexual activity is the most reliable method for preventing genital HPV infection (CDC,2015).

2. Limiting the numbers of sex partners and correctly using condoms

3. Getting vaccinated

4. Having a healthy lifestyle which includes:

  • Exercising regularly
  • Eating a healthy diet
  • Seeing your doctor regularly
  • Getting regular Pap Smears if you are a female

(Banner Health, 2019)

Vaccination

Vaccination

The HPV vaccine helps protect against certain types of HPV that can lead to cancer or genital warts. According to the CDC:

• Among teen girls, infections with HPV types that cause most HPV cancers and genital warts have dropped 86 percent.

• Among young adult women, infections with HPV types that cause most HPV cancers and genital warts have dropped 71 percent.

• Among vaccinated women, the percentage of cervical precancers caused by the HPV types most often linked to cervical cancer has dropped by 40 percent (CDC, 2019).

Who should get the HPV Vaccine?

(Center for Disease Control and Prevention, 2019)

Is the HPV Vaccination Safe?

"Over 12 years of monitoring and reserch have shown that the HPV vaccine is very safe and effective. Like all vaccines, there is ongoing monitoring of the HPV vaccine to ensure it is safe and effective"(CDC,2019).

(UChicago Medicine, 2016)

(Michigan Medicine, 2011)

Statistics

Over 40 distinct types of HPV can infect the genital tract (CDC , 2018).

Per the CDC, "HPV is so common that nearly all sexually active men and women get the virus at some point in their lives" & "79 million Americans, most in their late teens and early 20s, are infected with HPV" (2018).

Statistics

About 14 million people become newly infected each year (CDC, 2019)

Vaccination

Effectiveness

The HPV vaccine decreased the prevalence of HPV significantly from 2003–2006 (the pre-vaccine era) to 2011–2014 in specimens from females aged 14–19 years (from 11.5% to 3.3%) and 20–24 years (from 18.5% to 7.2%) (Center for Disease Control and Prevention, 2019).

Vaccinate early!

Cancer Stats

Females could significantly reduce risk for cervical cancer due to HPVs. The figure at left illustrates the major impact of vaccination on teen and young adult females.

The CDC recommends by age 11 due to increased immune response and less risk of exposure (2018).

Authors:

Presented by

Courtney Carmichael

Jacqueline Buchanan

Morgan Toledo

Hafid Khatri

Ivette Tabor

Courtney Carmichael - Pathophysiology

Jacqueline Buchanan - Signs & Symptoms

Morgan Toledo - Transmission

Hafid Khatri - Prevention

Ivette Tabor - Statistics

References

References

American Sexual Health Association. (n.d.). HPV Myths & Facts. Retrieved from http://www.ashasexualhealth.org/stdsstis/hpv/hpv-myths-facts/.

Banner Health. (2019). Pap Smear Chart. Retrieved from https://www.bannerhealth.com/healthcareblog/articles/2019/june/how-often-should-i-get-a-pap-smear

Bernstien, J. (2016, January). Why is HPV so Confusing? Retrieved from https://www.kmobgyn.com/blog/entryid/32/why-is-hpv-so-confusing-.

Center for Disease Control and Prevention(CDC). (2015, June). Human Papillomavirus (HPV) Infection. Retrieved from https://www.cdc.gov/std/tg2015/hpv.htm.

Centers for Disease Control and Prevention (CDC). (2018). Sexually Transmitted Disease Surveillance 2018. Retrieved from https://www.cdc.gov/std/stats18/other.htm#ref31

Center for Disease Control and Prevention (CDC). (2019, August 20). STD Facts - Human papillomavirus (HPV). Retrieved from https://www.cdc.gov/std/hpv/stdfact-hpv.htm.

Center for Disease Control and Prevention (CDC). (2019, August). Vaccinating Boys and Girls. Retrieved from https://www.cdc.gov/hpv/parents/vaccine.html

Centers for Disease Control and Prevention (CDC) (2019, August). National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Retrieved from https://www.cdc.gov/std/hpv/stdfact-hpv.

Forbes. (2019, February) Photo of HPV vaccine and syringe. Retrieved from https://www.forbes.com/sites/peterubel/2019/02/19/insurers-are-not-paying-enough-for-hpv-vaccines-and-our-kids-are-paying-the-price/#1b5dfd16ac29

Garden OB/GYN. (2019). Normal Vs Abnormal Pap Smear. Retrieved from https://www.gardenobgyn.com/blog/pap-smear

Hahn, A. W., & Spach, D. H. (2018, November 6). Disease 10. Human Papillomavirus Infection. Retrieved from https://www.std.uw.edu/go/pathogen-based/hpv/core-concept/all.

Hoppe, D. (2019). Modes of Hpv Transmission. Retrieved from https://drdianahoppe.com/human-papilloma-virus-hpv-almost-half-of-all-u-s-adults-over-18-years-old-have-it/

How is Hpv Spread?. (2011). Retrieved from https://www.youtube.com/watch?v=lAF-QUZS0No

HPV prevention and vaccine information. video. Retrieved from https://www.youtube.com/watch?v=ZCVVk5n7hbM

Johnson, J., & Johnson, J. (2018). HPV / Genital Warts: Symptoms, Testing, Treatment, Facts & FAQs. Retrieved from https://std-symptoms.com/hpv-genital-warts.

Kipp, B. H., & Porth, C. (2015). Study guide for Porths essentials of pathophysiology: concepts of altered health states (4th ed.). Philadelphia: Wolters Kluwer.

Medicine Net. (n.d.). Genital Warts. Retrieved from https://www.medicinenet.com/image-collection/genital_warts_hpv_picture/picture.htm

Planned Parent Federation of America Inc. (2019). What are the symptoms of HPV?

Retrieved from https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hpv/what-are-symptoms-hpv

Simmons Cancer Institute. (2018, June) HPV by the numbers. photo. Retrieved from https://www.siumed.edu/cancer/highlights/hpv-vaccine-safe-my-child.html

To Help Everyone. (n.d.). 6 Reasons to Get HPV Vaccine for Your Child. photo. Retrieved from https://tohelpeveryone.org/6-reasons-to-get-hpv-vaccine-for-your-child/

UChicago Medicine. (2016). Hpv Vaccine Image. Retrieved from https://www.uchicagomedicine.org/forefront/cancer-articles/2016/january/leading-us-cancer-centers-urge-hpv-vaccination-for-the-prevention-of-cancer

Warde Medical Laboratory. (n.d.). Archived Issues. Retrieved from http://www.wardelab.com/14-1.html.

Center for Disease Control and Prevention(CDC)(June, 2015).Human Papillomavirus (HPV) Infection.Retrieved from https://www.cdc.gov/std/tg2015/hpv.htm.