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Human Papillomavirus (HPV) Wed, Nov 21 2007 Tanjung Jaya, Indonesia The Virus • Papovaviridae • infect skin and mucous membrane • entry through clathrin mediated endocytosis to basal epithelia from micro-abrasions Epidemiology • modes of transmission is skin to skin, mucous membrane contact • perinatal transmission (rare) causing respiratory papillomatosis • 45% women at age 20-24, anyone sexually active is at risk HPV types • >100 subtypes, 30-40 STD • high-risk type HPV 16, 18, 35, 45 – leads to cervical, vulva, vaginal cancer and other genitalia cancer including in men • low-risk type HPV 6, 11 –causes genital warts • cutaneous HPV 1,2 –skin warts • HPV type 16 and 18 cause nearly 70% of cases of cervical cancer • HPV type 6 and 11 cause approx. 90% of genital warts • Both 4 types cause 35-50% of all low grade cervical, vaginal and vulvar lesions Diagnosis • abnormal PAP smear • HPV DNA testing (problemexpensive, cannot distinguish active or latent) • acetic acid-warts more visible Treatment and Prevention • common skin and genital warts will regress spontaneously/ months/ years due to immune response • common warts also can be eliminated using lasers • vaccine Gardasil from Merck – approved June 2006 and Cervarix from GlaxoSmithKline –approved May 2007 • ‘trick’ body into thinking that there is HPV infection thus generates immune response • vaccine does not cure HPV, it prevents thus not suitable for infected patient, but not 100% prevention • best prevention = vaccine + PAP smear annually (depends) HPV in Malaysia • cervical cancer is 2nd most common cancer in women • Gardasil has been approved during October 2006 • MSD collaborate with OGSM to spearhead ‘Tell Someone’ campaign • small figures for those who undergoes PAP smear each year Reference • • • • HPV http://alpha.montclair.edu/~Williamss4/diagnosis.htm http://udel.edu/~jlaverty/Human%20Papilloma%20Virus.html#Pathogene sis__Symptoms http://en.wikipedia.org/wiki/Human_papilloma_virus#HPV_testing Cervical cancer is preventable 2007 http://www.redorbit.com/news/health/884330/cervical_cancer_is_preventa ble/index.html ‘Tell Someone’ campaign in Malaysia http://www.msdmalaysia.com/content/corporate/about/news/2007/TellSomeone.html Indonesia ‘Tree Man’ http://news.yahoo.com/s/nm/20071122/lf_nm_life/indonesia_tree_man_d c_1