Human Papillomavirus

Excerpt

The Human Papillomavirus (HPV) is the initiating force behind multiple epithelial lesions and cancers, predominantly cutaneous and mucosal surfaces.

There are more than 100 subtypes of HPV. Individuals with persistent HPV infection and those who have multiple sexual partners are at very high risk for acquiring more HPV subtypes. The current classification of HPV infection is as follows:

1. Non-genital (Cutaneous)

2. Mucosal or anogenital

3. Epidermodysplasia verruciformis (EV)

The clinical lesions may be visibly obvious, but in some cases (latent lesions) may require testing for viral DNA. The majority of HPV infections are latent, and most clinical lesions present as warts rather than a malignancy.

Today, HPV has been implicated as a cause of laryngeal, oral, lung, and anogenital cancer. Subtypes 6 and 11 are low risk and usually present with the formation of condylomata and low-grade precancerous lesions. HPV subtypes 16 and 18 are high risk and are responsible for high-grade intraepithelial lesions that progress to malignancies. It is important to understand that HPV alone does not cause cancer but requires triggers like smoking, folate deficiency, UV light exposure, immunosuppression, and pregnancy.