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HPV

Introduction

We live in the world where we share our space with wide variety of organisms lie plants, animals and microorganisms. Microorganisms are ubiquitous in nature, includes bacteria, virus and fungi etc. which are not visible with our naked eye. Virus is a small size infectious agent containing genetic material and needs a host for its multiplication.

            Papilloma virus belongs to the family of papilloma viridae which means non enveloped DNA viruses. Depending upon the types, these viruses are known to infect bird, fish, turtles, snakes and mammals. Depending upon the type of papilloma virus symptoms ranges from asymptomatic to appearance of benign tumors known as warts. These warts sometimes become cancerous like in HPV 16 and HPV 18. Papilloma viruses are host and tissue tropic and are rarely transmitted between species. Papilloma viruses were first identified in 20th century when it was shown that skin warts, or papillomas could be transmitted between individuals by filterable infectious agents.

            Human Papilloma virus is an infection that occurs when papilloma virus infects humans. It is mostly transmitted by having sex with someone who has infection. In most cases, HPV is harmless and cures by itself. But in some cases, it can lead to cancer or genital warts.

            In 1980, Harald Zur Hausen, discovered the link between HPV and cervical cancer for which he was awarded Nobel prize in 2008 in physiology and medicine. There are around 40 types of the virus which can be transmitted through sexual contact. Having sex with multiple partners may also lead to HPV infection. There is more chance of getting infection who are immunosuppressive, having low immunity because our body loses its ability to fight with infectious agents.

Causative Agent

There are two types of HPV infection based on risk, low risk and high risk. HPV 6 and HPV 11 are the examples of low-risk HPV virus. It will cause warts in skin, mouth, and anal region including genitals. Warts are the small structures which will resemble like crystals and they are fleshy in nature.

High risk group of HPV includes HPV 16 HPV 18 which are involved in cervical cancers.

Human papilloma virus is a virus which consists of DNA as a genetic material and small in size. They do not contain any envelope. There are various types of epithelial tissue in body but HPV will bind to the stratified epithelium where the virus can undergo multiplication. The infection can occur very slowly as it does not show any symptoms in the initial days.

Spread

Every virus will have various roots of entry, which are called as portals of entry.  Though this virus is causing infection on skin, it can spread through direct contact. And it can spread through sexual contact. And it can be infected from person to person by wounds. Sexual intercourse with the infected person lead to infection. There is another possibility of infection which is pregnant mother to the fetus.

Factors Involved in HPV Infection:

There various factors which can contribute to the spread of HPV infection:

  • Multiple partners: sex with multiple partners may lead to the infection. The probability of infection will be increased as the number of partners increase.

  • Age: warts will occur in various age groups based on their exposure when it takes the younger generation like children, they will show warts on skin and other regions where young adults who are exposed to sexual intercourse will have genital warts. 

  • Gender: Women are more prone to the infection as around 80% of women are affected by anyone type of HPV, and they cannot know it because it does not show any symptoms. In women it can lead to cervical cancer so women are more prone than men.

  •  Immunosuppressive people: people who do not have proper immunity or having low immunity may lead to the infection. People, live in the areas where nutrition deficiency is there, may lead to immunity deficiency. HPV infection is more in low- and middle-income regions of the world. When the people are affected by HIV or those who have undergone organ transplantation, given with immunosuppressive drugs, are more prone to HPV infection.

Symptoms

The virus will infect many people but does not show any symptoms. So most of the patients will not feel that they have infection. To check out the fact, the patient regularly has to take medical tests. Genital warts which will not produce pain or discomfort in many people so they do not think that they have problem but when it becomes severe, it leads to cervical cancer. Some people will frequently get infections over their life time. They are more prone to the cancer.

There are various types of cancers basses on types of warts and their location. The cancers are cervical, anal, vaginal, penile, oropharyngeal based on infection.

Incubation period : Approximately the incubation period is about 1-20 months(around 2-3months), it is very difficult to determine the source because it takes a lot of time to see first wart on the body.

Prevalence 

The virus mostly affects people who are nutrition deficient and have low immunity. It is more prevalent in the countries which has low and middle income. As most of them lack knowledge about immunity and sex education. And there is a problem in those countries that they will not have proper guidance from physicians and no proper screening of infection so it leads to severe consequences. In Africa there is a region called, Sub-saharan region in which human immuno- deficiency virus is more prevalent, there is HPV is more prevalent due to immunodeficiency.

Among females, 86%of 14-19years age group is affected and 71%of 20-24 years group women are affected.

In US it is transmitted through sexual intercourse among young individuals, According to the reports, around 79 million people are infected. After vaccinations are introduced into the field, the number of infections are reduced. Around 12%of women are infected by virus in the world.

HPV 16 type of virus is more prevalent in Asian countries.

HPV

[picture source: WHO/ICO information centre, on HPV and cervical cancer ; DE SANJOSE, S. et.al.LANCET INFECT.DIS.7 453-459(2007)]

Vaccine

Gardasil, Gardasil9 and Ceravix are the vaccines which are prepared to prevent or control HPV types. They are more effective on HPV 16 and HPV 18.

Treatment: There is no particular treatment available for the HPV infection when it does not show any symptoms. But the treatment is only given to the symptoms based on severity.

Prevention: It is better to prevent the disease than to cure. So it is advisable to take pap smear test for women so that they can find out the presence of abnormal cells. It is also suggested that to have proper diet with nutritional values, maintaining hygienic conditions such as washing hands. Most important advice is to avoid multiple sex partners, participating in unprotected sex will save from infection. So that it is important to create awareness on sex education since high school days can prevent disease.

This virus cannot be controlled by sanitizers or disinfectants so, to control this virus, immunity and proper sexual behavior is more important.

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Reference

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