Infectious Diseases in an Age of Change The Impact of Human Ecology and Behavior on Disease Transmission (1995) / Chapter Skim
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Genital Human Papillomavirus Infection
Genital Human Papillomavirus Infection
Pages 157-170
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From page 157... ...
induce benign epithelial lesions of the internal and external genitalia and are closely associated with several ano-genital malignancies, especially cervical cancer. HPVs have long been recognized as the etiologic agents of genital and nongenital warts.
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From page 158... ...
EV is a rare skin condition in which patients develop widespread, chronic nongenital cutaneous HPV lesions (9~. Almost one-half of the known HPV types have been identified principally in EV patients.
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From page 159... ...
The apparent importance of these biochemical activities is underscored by finding that the RB and p53 genes are mutationally inactivated in cervical cancer cell lines that lack HPV, while these genes are wild type in HPV-containing lines (32-34~. Much of the recent epidemiological data linking HPVs and cervical cancer comes from analysis of the relationship between HPV infection and the development of precursor lesions in the cervix.
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From page 160... ...
Many lesions are inapparent, fewer exfoliated cells are obtained from penile swabs making HPV DNA detection difficult, and biopsies are seldom obtained. Nevertheless, a strong correlation between genital HPV infection in men and CIN in their regular partners has been documented (43, 44~.
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From page 161... ...
, and HPV DNA has been identified in normal genital epithelium (56~. The high prevalence of inapparent HPV infection makes it unclear whether treatment of clinically apparent infection, in the absence of other measures, would have an impact on the rate of genital HPV infection.
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From page 162... ...
, since persistence might indicate a constitutive inability to recognize critical viral determinants. Perhaps the most encouraging experimental vaccine results come from studies of immunoprophylaxis induced by the major and minor structural viral proteins L1 and L2.
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/163 s' 1 ~ ~ ~ .> 1 1 ~ V ° i ~ i= To o sat U)
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From page 164... ...
, tins ooservanc~n ~u~u either that high-risk HPVs inefficiently self-assemble or that the L1 gene from the HPV16 prototype strain might contain one or more mutations that prevented efficient particle assembly. The latter possibility was given serious consideration, since the HPV16 genome from prototype strain had been molecularly cloned from a cervical cancer, which presumably did not make virus particles.
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From page 165... ...
The reactivity of patients infected with low-risk HPV types 6 and 11 was similar to that of uninfected controls [9% (1/11~l, which suggests that the HPV16 ELISA does not recognize antibodies directed against the virions of low-risk HPV types. Thirty-eight percent of patients who were DNA positive for high-risk HPV types 18 (5/13)
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From page 166... ...
A subset of genital HPVs, designated high-risk types, are preferentially associated with high-grade dysplasias and carcinomas. About 90% of cervical cancers contain high-risk HPV DNA, most often HPV16.
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From page 167... ...
& zur Hausen, H
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From page 168... ...
Natl. Cancer Inst.
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From page 169... ...
Genital Human Papillomavirus Infection /169 L M., Grindlay, G
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