WHAT IS HPV? Human pappiloma virus is double stranded dna virus that infect the epithelial cells of skin and mucous. The epithelial surface includes all areas covered by skin and/or mucous such as the cervix,vagina,penis,anus,mouth,throat,tounge and tonsil. Reffered to papillomavirus as certain type may cause bening, skinwarts or papilloma. Human pappiloma virus is the most commom viral infection of reproductive tract. Hpv is sexually transmitted but penetrative sex is not required for transmission. Skin to skin genital contact is a well recogonised mode of transmission. There are many type of hpv and many do not cause problemes. Hpv infection usually clear up without any intervention within a few month after acquisition and about 90% clear within 2 year. A all proportion of infection with certain types of hpv can persist and progress to cervical cancer. PATHOGENSIS Establishment of HPV infection requires damage to the surface epithelium, which allows the virus access to the immature cells in the basal layer epithelium. Normally mature squamous cells are arrested in the g1 phase of the cell cycle but they continue to actively progress throughthe cell cycle when infected with HPV which uses the host cell dna synthesis machinery to replicate its own genome.Normal cells have basal epithelial cells, intermediate cells, superficial cells. HPV doesn’t infect superficial cell there should be break in surface epithelium so it has an acess to the basal cells. So once it infect the basal cell the dna of the hpv enter in the nucleus and it doesn’t integrate into the host chromosome it remain as a circular episomal dna . as the cell proliferate it also proliferate and it produces viral protein E1,E2. AS the proliferation increases it produces E1,E2,E3,E4,E5,E6,E7. Then finally it start producing L1 and L2 protein this re capsid protein . once they are produced the viral assembly occurs and the virions are released outside

1. P R E S E N T E D B Y
S H R A D D H A D U B E Y
R O L L N O - 3 9 4
M S C P A R T - 1 M I C R O B I O L O G Y
HUMAN PAPILLOMA VIRUS
AND CERVICAL CANCER

2. WHAT IS HPV?
• HUMAN PAPILLOMAVIRUS [HPV] IS A DOUBLE
STRANDED DNA VIRUS THAT INFECTS THE
EPITELIAL CELL OF SKIN AND MUCOS.
• THE EPITHELIAL SURFACE INCLUDES-
CERVIX,VAGINA,PENIS,ANUS,MOUTH,THROAT,TOUN
GE, AND TONSIL
• REFFERED TO PAPILLOMAVIRUS –AS CERTAIN
TYPE MAY CAUSE BENINGN SKIN WART, OR
PAPILLOMA

3. INTRODUCTION
• HPV IS THE MOST COMMON VIRAL INFECTION OF
THE REPRODUCTIVE TRACT
• SEXUALLY TRANSMITTED
• SEX IS NOT REQUIRED FOR TRANSMISSION---SKIN
TO SKIN GENTITAL CONTACT ----MODE OF
TRANSMISSION
• HPV CLEAR WITHIN—2YEARS
• HPV CAN PRESIST AND PROGRESS TO CERVICAL
CANCER

4. NOBLE PRIZE
• PROF. HARALD ZUR HUSEN WON NOBEL PRIZE IN
2008 FOR HIS DISCOVERY OF HPV CAUSING
CERVICAL CANCER.

5. VIROLOGY
• HPV
• PAPOVAVIRIDIAE
FAMILY
• SMALL,NON-
ENVELOPED,ds DNA
• 72 SIDED
ICOSAHEDRAL
• CIRCULAR,ds DNA
OF APPX. 7,900BP

6. TRANSMISSION
• HPV PASSES EASILY BETWEEN SEXUAL
PARTNERS,IT CAN BE TRANSMITTED THROUGH
THE FOLLOWING;
• INTIMATE SKIN TO SKIN CONTACT
• VAGINAL PENILE SEX
• PENILE ANAL SEX
• PENILE ORAL SEX
• VAGINAL ORAL SEX
• USE OF SEX TOYS OR OTHER
• *CONDOMS AND DENTAL DAMS CAN LOWER THE
CHANCE OF HPV TRANSMISSION—DO NOT
PREVENT IT COMPLETELY

7. HPV CAUSES SEVERAL TYPE OF
CANCER.
HPV
CERVICAL
ORAL
PENILE
VAGINAL
VULVAR
ANAL

8. HPV TYPES
HPV
HIGH RISK
16,18,31,33,35,
39,45,52,58
LOW RISK
6,11,42,43
44

9. RISK FACTOR FOR HPV PERSISTENCE
AND DEVELOPMENT OF CERVICAL
CANCER
• `HPV TYPE-ITS ONCOGENICITY
• IMMUNE STAUS
• CO-INFECTION WITH OTHER SEUALLY
TRANSMITTED AGENT—HERPES
SIMPLEX,CHLAMDIA,GONORRHOEA
• PARITY
• TOBACCO SMOKING

10. CERVICAL CANCER

11. WHAT CAUSES CERVICAL CANCER
• HPV CAUSES ABOUT 91% OF CERVICAL CANCER .
• NORMAL IMMUNE SYSTEM– 15 TO 20 YEARS
• WEAKEND IMMUNE SYSTEM– 5 TO 10 YEARS

12. SYMPTOMS
• SYMPTOMS INCLUDE---- ABNORMAL OR
IRREGULAR VAGINAL BLEEDING, PAIN DURING
SEX,OR VAGINAL DISCHARGE
• ABNORMAL BLEEDING SUCH AS
BLEEDING BETWEEN REGULAR MENSTRUAL
PERIOD
BLEEDING AFTER SEXUAL INTERCOURSE
BLEEDING AFTER MENOPAUSE
• PELVIC PAIN NOT RELATED TO MENSTRUAL CYCLE
• HEAVY,UNUSUAL DISCHARGE,FOUL ODOR
• INCREASED URINARY FREQUENCY
• PAIN DURING URINATION

13. STRUCTURE

14. PATHOGENESIS

15. • ABILITY OF HPV TO ACT AS CARCINOGEN DEPENDS
UPON THE VIRAL E6 AND E7 WHICH INTERFERS
WITH THE ACTIVITY OF TUMOR SUPPRESSOR
PROTEIN THAT REGULATES CELL GROWTH AND
SERVIVAL

18. CERVICAL INTRAEPITHELIAL
NEOPLASIA
• CERVICAL PRECANCERS: HAVE BEEN CLASSIFIED
DEPENDING UPON THE PRESENCE OF ATYPICAL
CELLS IN DIFFERENT LAYERS OF SQUAMOUS
EPITHELIUM IN TWO WAY i.e DYSPLASIA/ CIN
• MILD DYSPLASIA/CIN1
• MODERATE DYSPLASIA/CIN II
• SEVERE DYSPLASIA /CIN III

20. INTERAEPITHELIAL AND INVASIVE
SQUAMOUS NEOPLASIA

21. SCREENING
• HPV DNA TESTING FOR HIGH RISK HPV TYPE
• VISUAL INSPECTION WITH ACETIC ACID
• CONVENTIONAL [PAP] TEST AND LIQUID BASED
CYTOLOGY

22. PAP TEST
ALSO CALLED AS PAPANICOLAOUS TEST OR
CERVICAL CYTOLOGY
• TO DECT EARLY CANCER OF THE CERVIX

23. PREPARATION
• PATIENT MUST BE ADVISE TO MAKE AN
APPOINTMENT OTHER THAN DURING
MENSTRUATION.
• BEFORE APPOINTMENT
AVOID INTERCOURSE FOR 2 DAYS
REFRAIN FROM DOUCHING FOR 1 DAY
AVOID THE USE OF VAGINAL MEDICATION FOR
ATLEAST 48HRS.

24. PROCEDURE
• UNDRESS COMPLETELY OR ONLY FROM THE
WAIST DOWN.
• LITHOTOMY POSITION. HEELS REST IN SUPPORT.
• INSERT SPECULUM INTO VAGINA.
TAKE SAMPLE FROM CERVICAL CELLS USING A SOFT
BRUSH AND SPATULA

25. LIQUID BASED CYTOLOGY[LBC]
• CYTOATHOLOGY.
• SAMPLE IS DEPOSITED ---PRESERVATIVE LIQUID.
• UK CHANGED SCREENING METHOD FROM PAP
TEST TO LBC IN 2008

26. RESULT

27. VISUAL INSPECTION WITH ACETIC
ACID[VIA]
• VIA IS A TECHNIQUE FOR THE DETECTION OF
PRECANCEROUS OR CANCEROUS LESSION IN
CERVIX
• SIMPLE, LOW COST METHOD,PRESENTING
IMMEDIATE RESULT.
• GLACIAL (WATER FREE) ACETIC ACID OR
HOUSEHOLD ACETIC ACID.

28. VACCINATION
• GARDASIL—2006---TARGET 4 STRAIN 6,11,16,18
• CERVARIX MARKETED BY GLAXO SMITH KLINE---
TARGET STRAIN 16,18

29. CONCLUSION
• HPV INFECTION IS COMMON?
• HPV CAN INFECT BOTH MALE AND FEMALE?
• DOES MOST HPV INFECTION CAUSE CANCER?
• HIGH RISK HPV INFECTION THAT PERSISE CAN
CAUSE CANCER?

30. REFERENCE
• https://www.cancer.gov/about-cancer/causes-
prevention/risk/infectious-agents/hpv-and-cancer
• https://www.cdc.gov/cancer/hpv/basic_info/index.htm
• https://clinmedjournals.org/articles/ijccr/international-journal-
of-cancer-and-clinical-research-ijccr-6-125.php?jid=ijccr
• https://www.thelancet.com/journals/lancet/article/PIIS0140-
6736(13)60022-7/fulltext
• https://www.who.int/news-room/fact-sheets/detail/human-
papillomavirus-(hpv)-and-cervical-cancer
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC145302/

31. THANKYOU