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HUMAN PAPILLOMA VIRUS Dr.Abdulrahman Lotfy Preventive Medicine Jahra Hospital
HPV-THE VIRUS HPV-THE INFECTIOUS DISEASE HPV-THE CARCINOGEN HPV/CANCER-THE VACCINE
HPV-THE VIRUS
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HPV-THE INFECTIOUS DISEASE
Human Papillomavirus Types and Disease Association
Human Papilloma Virus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HPV-Associated Disease
HPV Types-Low & High Risk ,[object Object],[object Object],[object Object],[object Object],13 % 53%
Pathology and Pathogenesis ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Modes of Transmission
HPV Epidemiology ,[object Object],[object Object],[object Object],[object Object]
Epidemiology  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology –cont. ,[object Object],[object Object],[object Object]
Infections present with ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Manifestation of HPV ,[object Object],[object Object],[object Object]
Women: Genital warts usually start to appear appear on the vulva, in the vagina, on the cervix, or in the anal area
In men, they appear on the foreskin, head or shaft of the penis, and in the anal area, urethra, and scrotum
Rare skin warts ,[object Object]
HPV – Sexual Transmission ,[object Object],[object Object]
Symptoms of HPV ,[object Object],[object Object],[object Object],[object Object],Pap Test Hybrid Capture II HPV
SUPERFICIAL (Flat) WARTS
PLANTAR WARTS
GENITAL CONDYLOMAS
INTERNAL WARTS Also includes Laryngeal warts  (not shown here)
COLORECTAL CONDYLOMAS
Pap Smear – Cervical Cancer ,[object Object],[object Object],[object Object]
TREATMENT: Low Grade Lesions ,[object Object],[object Object],[object Object],[object Object]
TREATMENT: High Grade Lesions ,[object Object],[object Object],[object Object],[object Object]
TREATMENT: Genital Warts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HPV-THE CARCINOGEN
93% of all cervical neoplasia cases test are positive for HPV making it the leading the third leading killer among women Cancer: Predominant types: Co-factors: Skin carcinomas HPV-5, 8 U.V., genetic? Lower genital tract cancers HPV-16, 18, 31, 33 ??? Malignant transformation of respiratory papillomas HPV-6, 11 X-rays
Cervical – HPV infection ,[object Object],[object Object],[object Object],[object Object]
HPV infections predisposes to Cervical Cancer
CANCER CERVIX
HPV/Cancer-THE VACCINE
Human Papillomavirus Vaccine ,[object Object],[object Object],[object Object],[object Object]
Risk with different types of viruses 30, 31, 33, 35, 39, 45, 51 and 53 6, 11, 40, 42 – 44, 54, 61,70, 72 and 81
HPV Vaccine Efficacy* *Among 16-26 year old females.  CIN – cervical intraepithelial neoplasia; AIS – adenocarcinoma  in situ
HPV Vaccine Efficacy ,[object Object],[object Object],[object Object]
Routine  HPV Vaccination  Recommendations ,[object Object],[object Object],[object Object],MMWR  2007;56(RR-2):1-24
HPV Vaccination Schedule ,[object Object],[object Object],[object Object],[object Object]
Efficacy of Gardasil HPV induced lesions Cervical Cancer & Precancers (Grade 2/ 3) 1 Vulvar/ Vaginal Precancers (Grade 1- 3) 2 Genital Warts 2 Protection by QHPV 98% 100% 99% 1. The Future II Study Group. Lancet 2007; 369: 1861–68  2.Garland SM et al. New Engl J Med. 2007;356:1928–1943.
HPV Vaccine Special Situations * ,[object Object],[object Object],[object Object],[object Object],[object Object],* Vaccine can be administered
HPV Vaccine Adverse Reactions ,[object Object],[object Object],[object Object],[object Object],*similar to reports in placebo recipients (9%)
Syncope Following Vaccination ,[object Object],[object Object],[object Object],[object Object]
HPV Vaccine Contraindications and Precautions ,[object Object],[object Object],[object Object],[object Object]
HPV Vaccination During Pregnancy  ,[object Object],[object Object],[object Object],MMWR  2007;56(RR-2):1-24
HPV Vaccine  Storage and Handling ,[object Object],[object Object],[object Object],[object Object]
[object Object]

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