|Human Papilloma Viruses|
Classification and external resources
EM of papillomavirus
Papillomaviruses are a diverse group of DNA-based viruses that infect the skin and mucous membranes of humans and a variety of animals. Papillomaviruses were first identified in the early 20th century when it was shown that skin Warts or Papillomas could be transmitted between individuals A DNA virus is a Virus that has DNA as its Genetic material and replicates using a DNA-dependent DNA polymerase. The mucous membranes (or mucosae; singular mucosa) are linings of mostly endodermal origin covered in Epithelium, which are involved in Approximately 130 human papillomavirus (HPV) types have been identified.
Some HPV types can cause warts while others may cause a subclinical infection resulting in precancerous lesions. All HPVs are transmitted by skin-to-skin contact and/or by fomites. A fomite is any inanimate object or Substance capable of carrying Infectious organisms (such as Germs or Parasites and hence transferring
About 30-40 HPV types are typically transmitted through sexual contact and infect the anogenital region. Some sexually transmitted HPVs may cause genital warts. Genital warts (or Condyloma, Condylomata acuminata, or venereal warts) is a highly contagious Sexually transmitted However, other HPV types which may infect the genitals do not cause any noticeable signs of infection.
Persistent infection with a "high-risk" subset of sexually transmitted HPVs — different from the ones that cause warts — may lead to potentially precancerous lesions and can progress to invasive cancer. HPV infection is a necessary factor in the development of nearly all cases of cervical cancer. Cervical cancer is Malignant Cancer of the Cervix uteri or cervical area 
A cervical Pap smear is used to detect cellular abnormalities. The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in Gynecology This allows targeted surgical removal of condylomatous and/or potentially precancerous lesions prior to the development of invasive cervical cancer. Although the widespread use of Pap testing has reduced the incidence and lethality of cervical cancer in developed countries, the disease still kills several hundred thousand women per year worldwide. HPV vaccines Gardasil and Cervarix, which block initial infection with some of the most common sexually transmitted HPV types may lead to further decreases in the incidence of HPV-induced cancer. Human papillomavirus (HPV vaccine is a Vaccine that targets certain strains of Human papillomavirus associated with the development of Cervical Gardasil ( Merck & Co) is a Vaccine against certain types of Human papillomavirus (HPV Cervarix is a Vaccine against certain types of the Human papillomavirus (HPV 
Estimates of prevalence vary from 14% to 90%.  One reason for the difference is that some studies report women who are currently infected, while other studies report women who have ever been infected. 
Genital HPV is the most common sexual transmitted infection in the United States. According to the National Cervical Cancer Coalition (NCCC), 11% of American women do not have regular cervical cancer screenings; women who do not have cervical cancer screenings on a regular basis dramatically increase their chances of developing cervical cancer. About 14,000 women in the United States are diagnosed with cervical cancer disease each year, and more than 3,900 women die in the United States each year from this disease.
One study found that, during 2003–2004, at any given time, 26. In Epidemiology, the prevalence of a Disease in a Statistical population is defined as the total number of cases of the disease in the population at a given 8% of women aged 14 to 59 were infected with at least one type of HPV. This was higher than previous estimates. 15. 2% were infected with one or more of the high-risk types that can cause cancer. However only 3. 4% were infected with one or more of the four types prevented by the Gardasil vaccine, which was lower than previous estimates. Gardasil ( Merck & Co) is a Vaccine against certain types of Human papillomavirus (HPV 
|Age (years)||Prevalence (%)|
|14 to 19||24. 5%|
|20 to 24||44. 8%|
|25 to 29||27. 4%|
|30 to 39||27. 5%|
|40 to 49||25. 2%|
|50 to 59||19. 6%|
|14 to 59||26. 8%|
It was estimated that in the year 2000, there were approximately 6. 2 million new HPV infections among Americans aged 15-44; of these, an estimated 74% occurred to people between ages 15-24.  Of the STDs studied, genital HPV was the most commonly acquired. 
Genital HPV infection is very common, with estimates suggesting that most (>50%) sexually active women will become infected with one or more of the sexually transmitted HPV types.  The American Social Health Association reported estimates that about 75% of sexually active Americans will be infected with HPV at some point in their lifetime.  According to the Centers for Disease Control (CDC), by the age of 50 more than 80% of American women will have contracted at least one strain of genital HPV. The Centers for Disease Control and Prevention (or CDC) is an agency of the United States Department of Health and Human Services based in unincorporated 
The HPV lifecycle strictly follows the differentiation program of the host keratinocyte. The keratinocyte is the major cell type of the epidermis, making up about 90% of epidermal cells It is thought that the HPV virion infects epithelial tissues through micro-abrasions, whereby, the virion associates with putative receptors such as alpha integrins and laminins, leading to entry of the virions into basal epithelial cells through clathrin-mediated endocytosis and/or caveolin-mediated endocytosis depending on the type of HPV. A virus (from the Latin virus meaning Toxin or Poison) is a sub-microscopic infectious agent that is unable In biology and medicine epithelium is a tissue composed of cells that line the cavities and surfaces of structures throughout the body Integrins are Cell surface receptors that interact with the Extracellular matrix (ECM and mediate various intracellular signals. Laminin is the major non-collagenous component of the Basal lamina, such as those on which cells of an Epithelium sit The basal lamina is a layer of extracellular matrix on which Epithelium sits and which is secreted by the epithelial cells Clathrin is a Protein that is the major constituent of the 'coat' of the clathrin- Coated pits and coated Vesicles formed during Endocytosis Receptor-mediated endocytosis (RME also called clathrin-dependent endocytosis, is a process by which cells internalize molecules ( Endocytosis) by the inward budding Caveolins are a family of proteins that are involved in receptor independent endocytosis At this point, the viral genome is transported to the nucleus by unknown mechanisms and establishes itself at a copy number between 10-200 viral genomes per cell. In classical genetics the genome of a Diploid Organism including Eukarya refers to a full set of chromosomes or genes in a Gamete, thereby A sophisticated transcriptional cascade then occurs as the host keratinocyte begins to divide and become increasingly differentiated in the upper layers of the epithelium. Transcription is the synthesis of RNA under the direction of DNA The viral oncogenes, E6 and E7, are thought to modify the cell cycle so as to retain the differentiating host keratinocyte in a state that is amiable to the amplification of viral genome replication and consequent late gene expression. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. E6 in association with host E6 AP (associated protein), which has ubiquitin ligase activity act to ubiquitinate p53 leading to its proteosomal degradation. E7 (inoncogenic HPV's) acts as the primary transforming protein. E7 competes for pRb binding, freeing the transcription factor E2F to transactivate its targets, thus pushing the cell cycle forwards. The retinoblastoma protein (abbreviated pRb or Rb) is a Tumor suppressor Protein that is dysfunctional in many types of Cancer E2F is a group of genes that codifies a family of Transcription factors (TF in higher Eukaryotes. All HPV can induce transient proliferation, but only 16 and 18 can immortalise cell intes (in vitro). It has also been shown that HPV 16 and 18 cannot immortalise primary rat cells alone, there needs to be activation of the ras oncogene. In the upper layers of the host epithelium, the late genes L1 and L2 are transcribed/translated and serve as structural proteins which encapsidate (Encapsidation is the process of incorporating a nucleic acid sequence (e. g. , a vector, or a viral genome) into a viral particle) the amplified viral genomes. Virions can then be sloughed off in the dead squames of the host epithelium and the viral lifecycle continues. In Anatomy, squamous epithelium (from Latin squama, "scale" is an Epithelium characterised by its most superficial layer consisting
The concern about life-long recurrences may be based on a misconception rather than a myth. It is true that at present there is no cure for genital human papillomavirus. As a virus, it will remain in the infected person's cells for an indefinite time--most often in a latent state, but occasionally producing symptoms or disease.
Recent studies from the Albert Einstein College of Medicine and from the University of Washington suggest that HPV may eventually be cleared, or rooted out altogether, in most people with well functioning immune systems. It appears that in some cases the virus does remain in the body indefinitely, producing symptoms if the immune system weakens.
Once cells are invaded by HPV, a latency (quiet) period of months to years may occur. The latency period means the HPV virus is in an incubation period. Having sex with a partner whose HPV infection is in the incubation period still leaves one vulnerable to becoming infected. HPV virus can last from 3 months to 2 years without visible changes, making it difficult for an infectee to establish the source of infection.
Over 100 different HPV types have been identified and are referred to by number.
|Common warts||2, 7|
|Plantar warts||1, 2, 4|
|Flat warts||3, 10|
|Anogenital warts||6, 11, 42, 43, 44, 55 and others|
|Genital cancers||16, 18, 31, 33, 35, 39, 45, 51|
|Epidermodysplasia verruciformis||more than 15 types|
|Focal epithelial hyperplasia (oral)||13, 32|
|Oral papillomas||6, 7, 11, 16, 32|
About a dozen HPV types (including types 16, 18, 31 and 45) are called "high-risk" types because they can lead to cervical cancer, as well as anal cancer, vulvar cancer, and penile cancer. A wart (also known as verruca) is generally a small rough Tumor, typically on hands and feet but often other locations that can resemble a Cauliflower A plantar wart (also verruca plantaris or commonly known as verruca) is a Wart caused by the Human papillomavirus (HPV occurring on the Verruca plana, also known as a "flat Wart " is a reddish-brown or flesh-colored slightly raised flat-surfaced well-demarcated papule of 2 to 5 mm in diameter Genital warts (or Condyloma, Condylomata acuminata, or venereal warts) is a highly contagious Sexually transmitted Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Epidermodysplasia verruciformis (also called Lewandowsky-Lutz dysplasia or Lutz-Lewandowsky epidermodysplasia verruciformis) is an extremely rare Autosomal Focal epithelial hyperplasia (Heck's disease is an oral infection caused by a Virus similar to the wart-producing Papillomavirus. Cervical cancer is Malignant Cancer of the Cervix uteri or cervical area Cervical cancer is Malignant Cancer of the Cervix uteri or cervical area Anal cancer is a type of Cancer which arises from the Anus, the distal orifice of the Gastrointestinal tract. Vulvar cancer, a malignant invasive growth in the Vulva, accounts for about 4 % of all gynecological cancers and typically affects women in later life Penile cancer is a malignant growth found on the skin or in the tissues of the Penis.  Several types of HPV, particularly type 16, have been found to be associated with oropharyngeal squamous-cell carcinoma, a form of head and neck cancer. The term head and neck cancer refers to a group of biologically similar cancers originating from the upper aerodigestive tract including the Lip, Oral cavity (  HPV-induced cancers often have viral sequences integrated into the cellular DNA. Some of the HPV "early" genes, such as E6 and E7, are known to act as oncogenes that promote tumor growth and malignant transformation. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. Malignant (from the Latin roots mal- = "bad" and -genus = "born" is a medical term used to describe a severe and progressively worsening disease
The p53 protein prevents cell growth in the presence of DNA damage primarily through the BAX domain, which blocks the anti-apoptotic effects of the mitochondrial BCL-2 receptor. p53 (also known as protein 53 or tumor protein 53) is a Transcription factor encoded by the TP53 gene In addition, p53 also upregulates the p21 protein, which blocks the formation of the Cyclin D/Cdk4 complex, thereby preventing the phosphorylation of RB and, in turn, halting cell cycle progression by preventing the activation of E2F. p53 (also known as protein 53 or tumor protein 53) is a Transcription factor encoded by the TP53 gene Cyclin-dependent kinase inhibitor 1A (p21 Cip1, also known as CDKN1A, is a human Gene. The Cyclin D/Cdk4 complex is a compound structure of Cyclin D and Cdk4, regulated by the GATA-1 Transcription factor. E2F is a group of genes that codifies a family of Transcription factors (TF in higher Eukaryotes. In short, p53 is a tumor suppressor gene that arrests the cell cycle when there is DNA damage. The E6 and E7 proteins work by inhibiting tumor suppression genes involved in that pathway: E6 inhibits p53, while E7 inhibits p53, p21, and RB. p53 (also known as protein 53 or tumor protein 53) is a Transcription factor encoded by the TP53 gene p53 (also known as protein 53 or tumor protein 53) is a Transcription factor encoded by the TP53 gene Cyclin-dependent kinase inhibitor 1A (p21 Cip1, also known as CDKN1A, is a human Gene.
An infection with one or more high-risk HPV types is believed to be a prerequisite for the development of cervical cancer (the vast majority of HPV infections are not high risk); according to the American Cancer Society, women with no history of the virus do not develop this type of cancer. The American Cancer Society ( ACS) is the "nationwide community-based voluntary health organization dedicated to However, most HPV infections are cleared rapidly by the immune system and do not progress to cervical cancer. Because the process of transforming normal cervical cells into cancerous ones is slow, cancer occurs in people who have been infected with HPV for a long time, usually over a decade or more. 
Sexually transmitted HPVs also cause a major fraction of anal cancers and approximately 25% of cancers of the mouth and upper throat (known as the oropharynx) (see figure). Anal cancer is a type of Cancer which arises from the Anus, the distal orifice of the Gastrointestinal tract. The latter commonly present in the tonsil area and HPV is linked to the increase in oral cancers in non-smokers.  Engaging in anal sex or oral sex with an HPV-infected partner may increase the risk of developing these types of cancers. Anal sex most often refers to the sex act involving insertion of the Penis into the Rectum. Oral sex refers to sexual activities involving the use of the Mouth, and may include use of the Tongue, Teeth, and Throat, in order 
Some HPV infections can cause warts, which are noncancerous skin growths. Infection with these types of HPV causes a rapid growth of cells on the outer layer of the skin.  Types of warts include:
Genital warts are quite contagious, while common, flat, and plantar warts are much less likely to spread from person to person. All warts can spread from one part of your own body to another. 
Genital or anal warts (condylomata acuminata or venereal warts) are the most easily recognized sign of genital HPV infection. Genital warts (or Condyloma, Condylomata acuminata, or venereal warts) is a highly contagious Sexually transmitted Although a wide variety of HPV types can cause genital warts, types 6 and 11 account for about 90% of all cases. 
Most people who acquire genital wart-associated HPV types clear the infection rapidly without ever developing warts or any other symptoms. People may transmit the virus to others even if they don't display overt symptoms of infection. However, in the vast majority of cases, this is not a cause for concern if proper tests are routinely administered.
HPV types that tend to cause genital warts are not the same ones that cause cervical cancer. However, since an individual can be infected with multiple types of HPV, the presence of warts does not rule out the possibility of high risk types of the virus also being present.
HPV types 6 and 11 can cause a rare condition known as recurrent respiratory papillomatosis, in which warts form on the larynx or other areas of the respiratory tract. Laryngeal papillomatosis, also known as recurrent respiratory papillomatosis, is a rare medical condition, caused by an HPV infection of the throat 
In very rare cases, HPV may cause epidermodysplasia verruciformis in immunocompromised individuals. Epidermodysplasia verruciformis (also called Lewandowsky-Lutz dysplasia or Lutz-Lewandowsky epidermodysplasia verruciformis) is an extremely rare Autosomal The virus, unchecked by the immune system, causes the overproduction of keratin by skin cells, resulting in lesions resembling warts or cutaneous horns. Cutaneous horns, also known by the Latin name cornu cutaneum, are unusual Keratinous Skin tumors with the appearance of horns or sometimes of 
Infection with cutaneous HPVs is ubiquitous.  Some HPV types, such as HPV-5, may establish infections that persist for the lifetime of the individual without ever manifesting any clinical symptoms. Like remora suckerfish that hitchhike harmlessly on sharks, these HPV types can be thought of as human commensals. Remoras or suckerfish are elongate brown Fish in order Perciformes and family Echeneidae. Sharks ( Superorder Selachimorpha) are a type of Fish with a full cartilaginous Skeleton and a highly streamlined body In Ecology, commensalism is a kind of symbiotic relationship between two organisms where one benefits and the other is not significantly harmed or helped (like a bird Other cutaneous HPVs, such as HPV types 1 or 2, may cause common warts in some infected individuals. Skin warts are most common in childhood and typically appear and regress spontaneously over the course of weeks to months. About 10% of adults also suffer from recurring skin warts. All HPVs are believed to be capable of establishing long-term "latent" infections in small numbers of stem cells present in the skin. Stem cells are cells found in most if not all multi-cellular Organisms. Although these latent infections may never be fully eradicated, immunological control is thought to block the appearance of symptoms such as warts. Immunological control is likely HPV type-specific, meaning that an individual may become immunologically resistant to one HPV type while remaining susceptible to other types.
A large increase in the incidence of genital HPV infection occurs at the age when individuals begin to engage in sexual activity (see figure). The great majority of genital HPV infections never cause any overt symptoms and are cleared by the immune system in a matter of months. As with cutaneous HPVs, immunity is believed to be HPV type-specific. Some infected individuals may fail to bring genital HPV infection under immunological control. Lingering infection with high-risk HPV types, such as HPVs 16, 18, 31 and 45, can lead to the development of cervical cancer or other types of cancer.  In addition to persistent infection with high-risk HPV types, epidemiological and molecular data suggest that co-factors such as the cigarette smoke carcinogen benzo[a]pyrene (BaP) enhance development of certain HPV-induced cancers. 
High-risk HPV types 16 and 18 are together responsible for over 65% of cervical cancer cases.  Type 16 causes 41 to 54% of cervical cancers, and accounts for an even greater majority of HPV-induced vaginal/vulvar cancers, penile cancers, anal cancers and head and neck cancers. 
According to the Centers for Disease Control, "At least 50% of sexually active people will get HPV at some time in their lives. The Centers for Disease Control and Prevention (or CDC) is an agency of the United States Department of Health and Human Services based in unincorporated " All women who have had sex are encouraged to get a regular pap smear to detect cellular abnormalities caused by HPV and help prevent cervical cancer. The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in Gynecology 
The HPV vaccine Gardasil protects against the two strains of HPV that cause 70% of cervical cancer cases, and two strains of HPV that cause 90% of genital warts. Gardasil ( Merck & Co) is a Vaccine against certain types of Human papillomavirus (HPV The CDC recommends that girls and women between the ages of 11 and 26 be vaccinated. 
Although genital HPV types are sometimes transmitted from mother to child during birth, the appearance of genital HPV-related diseases in newborns is rare. Perinatal transmission of HPV types 6 and 11 can result in the development of juvenile-onset recurrent respiratory papillomatosis (JORRP). Laryngeal papillomatosis, also known as recurrent respiratory papillomatosis, is a rare medical condition, caused by an HPV infection of the throat JORRP is very rare, with rates of about 2 cases per 100,000 children in the United States.  Although JORRP rates are substantially higher if a woman presents with genital warts at the time of giving birth, the risk of JORRP in such cases is still less than 1%.
Most people become infected with various cutaneous HPV types during childhood. Papillomaviruses have a sturdy outer protein shell or "capsid" that renders them capable of lingering in the environment for long periods of time. For the leaf bug see Miridae. A capsid is the protein shell of a virus. Avoiding contact with contaminated surfaces, such as the floors of communal showers or airport security lines, might reduce the risk of cutaneous HPV infection. Treating common warts soon after they first appear may also reduce the spread of the infection to additional sites.
Genital HPV infections may be distributed widely over genital skin and mucosal surfaces, and transmission can occur even when there are no overt symptoms. Several strategies should be employed to minimize the risk of developing diseases caused by genital HPVs:
Certain types of sexually transmitted HPVs can cause cervical cancer. Cervical cancer is Malignant Cancer of the Cervix uteri or cervical area Persistent infection with one or more of about a dozen of these "high-risk" HPV types is an important factor in nearly all cases of cervical cancer. The development of HPV-induced cervical cancer is a slow process that generally takes many years. During this development phase, pre-cancerous cells can be detected by regular cervical cytology Papanicolaou screening, colloquially known as "Pap" smear testing. Georgios N Papanikolaou (or George Papanicolaou; Γεώργιος Παπανικολάου) ( May 13, 1883 &ndash February 19, The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in Gynecology The Pap test is an effective strategy for reducing the risk of invasive cervical cancer. The Pap test involves taking cells from the cervix and putting them on a small glass slide and examining them under a microscope to look for abnormal cells. This method is 70% to 80% effective in detecting HPV-caused cellular abnormalities. A more sensitive method is a “Thin Prep,” in which the cells from the cervix are placed in a liquid solution. This test is 85% to 95% effective in detecting HPV-caused cellular abnormalities. The last Pap test method is mainly used on women over 30. It is a combination Pap-HPV DNA test. If this test comes back negative women can usually wait 3 years before having the test done again. Detailed inspection of the cervix by colposcopy may be indicated if abnormal cells are detected by routine Pap smear. Colposcopy is a medical diagnostic procedure to examine an illuminated magnified view of the Cervix and the tissues of the Vagina and Vulva. A frequently occurring example of an abnormal cell found in association with HPV is the koilocyte. Koilocytes are a type of dysplastic squamous cell found in potentially precancerous cervical Lesions They have the following characteristics (See figure. ) The American College of Obstetricians and Gynecologists states that the newer liquid based cytology methods (Thinprep and Surepath) may miss 15-35% of CIN3's and cancer. The American College of Obstetricians and Gynecologists ( ACOG) is a Professional association of Medical doctors specializing in Obstetrics and
The Center for Disease Control (CDC) recommends that women get a Pap test no later than 3 years after their first sexual encounter and no later than 21 years of age. The Centers for Disease Control and Prevention (or CDC) is an agency of the United States Department of Health and Human Services based in unincorporated Women should have a Pap test every year until age 30. After age 30, women should discuss risk factors with their health care provider to determine whether a Pap test should be done yearly. If risk factors are low and previous Pap tests have been negative, most women only need to have tests every 2-3 years until 65 years of age (Centers for Disease Control 2005). All women are encouraged to get a yearly pap smear solely to detect cellular abnormalities caused by HPV. The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in Gynecology 
Since the Pap test was developed there has been a 70% decrease in cervical cancer deaths over the last 50 years. Pap smear testing has proven to be one of the most successful screening tests in the history of medicine.
A study published in April 2007 suggests that the act of performing a Pap smear produces an inflammatory cytokine response, which may initiate immunologic clearance of HPV, therefore reducing the risk of cervical cancer. Cytokines are a category of signalling Proteins and Glycoproteins that like Hormones and Neurotransmitters, are used extensively in cellular Women who had even a single Pap smear in their history had a lower incidence of cancer. "A statistically significant decline in the HPV positivity rate correlated with the lifetime number of Pap smears received. "
It has been suggested that Pap smear screening for anal cancer might be of benefit for some sub-populations of gay men. 
An HPV test detects certain types of human papillomavirus (HPVs), depending on the test. A method for detecting the DNA of high-risk HPVs has recently been added to the range of clinical options for cervical cancer screening. Deoxyribonucleic acid ( DNA) is a Nucleic acid that contains the genetic instructions used in the development and functioning of all known In March 2003, the US FDA approved a "hybrid-capture" test, marketed by Digene, as a primary screening tool for detecting high-risk HPV infections that may lead to cervical cancer. A human papillomavirus ( HPV) is a Papillomavirus that infects the skin and Mucous membranes of Humans Approximately 130 HPV types have been This test was also approved for use as an adjunct to Pap testing, and may be ordered in response to abnormal Pap smear results.
When patients are screened with both HPV testing and Pap testing the sensitivity reaches 100%. HPV testing can diagnose CIN 2-3 among women older than 30 years.  The sensitivity of HPV testing alone was 94. 6% and specificity was 94. 1%. For patients at similar risk to those in this study (0. 4% had CIN 2-3), this leads to a positive predictive value of 6. The positive predictive value, or precision rate, or post-test probability of disease, is the proportion of patients with positive test results who are correctly diagnosed 0% and negative predictive value of 100. The negative predictive value is the proportion of patients with negative test results who are correctly diagnosed 0% (click here to adjust these results for patients at higher or lower risk of CIN 2-3).
The CDC states on its "STD Facts-HPV Vaccine" page that "An HPV test or a Pap test can tell that a woman may have HPV, but these tests cannot tell the specific HPV type(s) that a woman has. "
In Australia, a self-sampling HPV DNA test - that women can do at home using an ordinary tampon - is being marketed by Tam Pap. It has been approved by the Therapeutic Goods Administration for distribution in Australia. The Therapeutic Goods Administration or TGA is the regulatory body for therapeutic goods (including medicines medical devices gene technology and blood products in Australia
Genital warts are the only visible sign of HPV in men, and can be identified with a visual check of the genital area. These visible growths, however, are usually the result of non-carcinogenic HPV types. Vinegar solutions have been used to identify flat warts (with limited success) by making them more distinct, but most providers have found this technique helpful only in moist areas, such as the female genital tract. 
On June 8, 2006, the US Food and Drug Administration approved Gardasil, a prophylactic HPV vaccine which is marketed by Merck. Human papillomavirus (HPV vaccine is a Vaccine that targets certain strains of Human papillomavirus associated with the development of Cervical Events 68 - The Roman Senate accepts emperor Galba. 536 - St Silverius becomes Pope (probable Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Gardasil ( Merck & Co) is a Vaccine against certain types of Human papillomavirus (HPV Human papillomavirus (HPV vaccine is a Vaccine that targets certain strains of Human papillomavirus associated with the development of Cervical Merck & Co Inc ( also known as Merck Sharp & Dohme or MSD outside the USA and Canada, is one of the largest Pharmaceutical companies The vaccine trial, conducted in adult women with a mean age of 23, showed protection against initial infection with HPV types 16 and 18, which together cause 70% of cervical cancers, and can cause other cancers, such as anal cancer. Anal cancer is a type of Cancer which arises from the Anus, the distal orifice of the Gastrointestinal tract. The vaccine also protects against HPV types 6 and 11, which cause 90 percent of genital warts.
GlaxoSmithKline is seeking approval for a prophylactic vaccine known as Cervarix targeting HPV types 16 and 18. GlaxoSmithKline plc () is a United Kingdom -based pharmaceutical, biological and Healthcare Company. Cervarix is a Vaccine against certain types of the Human papillomavirus (HPV
Gardasil vaccine is delivered in a series of three shots over six months at a cost of approximately $360 (US dollars). The CDC recommends that girls and women between the ages of 11 and 26 be vaccinated, though girls as young as 9 may benefit.  Females not yet sexually active can be expected to receive the full benefit of vaccination.
HPV vaccine is made up of proteins from the outer coat of the virus (HPV). There is no infectious material in this vaccine. There is also no thimerosal, a mercury based preservative, in the HPV vaccine. Thiomersal ( INN) (C9H9HgNaO2S commonly known in the United States as thimerosal, is an Organomercury compound (approximately  This vaccine has been tested in over 11,000 females (ages 9-26 years) around the world. These studies have shown no serious side effects. The most common side effect is soreness at the injection site. CDC, working with the FDA, will continue to monitor the safety of the vaccine after it is in general use. 
The vaccine does not appear to protect against HPV types that females are infected with at the time of vaccination. However, females already infected with one or more vaccine HPV types before vaccination would be protected against disease caused by the other vaccine HPV types covered by the vaccine. Therefore, although overall vaccine effectiveness would be lower when administered to females who have been sexually active, and would decrease with age and likelihood of HPV exposure with increasing number of sex partners, the majority of females in this age group will derive at least partial benefit from vaccination. The vaccine will not have any therapeutic effect on existing HPV infection or cervical lesions. 
Since the current vaccine will not protect women against all the HPV types that cause cervical cancer, women should continue to seek Pap smear testing, even after receiving the vaccine. Cervical cancer screening recommendations have not changed for females who receive HPV vaccine. 
Both men and women are carriers of HPV.  Possible benefits or efficacy of vaccinating men are being studied.
Carcinogens from tobacco and second-hand smoke are concentrated in the cervix, increasing rate of dysplasia by four to five times, and doubling the risk of cervical cancer. Smoking cessation is the effort to stop smoking Tobacco products The term carcinogen refers to any substance Radionuclide or radiation that is an agent directly involved in the promotion of Cancer or in the fatation of its propagation Tobacco is an Agricultural product recognized as an addictive drug processed from the fresh Leaves of plants in the genus Nicotiana. 
The Centers for Disease Control and Prevention says that "While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer, an HPV-associated disease. The Centers for Disease Control and Prevention (or CDC) is an agency of the United States Department of Health and Human Services based in unincorporated "
According to Marcus Steiner and Willard Cates in the New England Journal of Medicine, "the protection that condoms offer cannot be precisely quantified. " However, in a study reported in the same issue, of 82 female university students followed for eight months, the incidence of genital HPV infection was 37. 8 per 100 patient-years among women whose partners used condoms for all instances of intercourse, compared with 89. 3 per 100 patient-years in women whose partners used condoms less than 5% of the time. The researchers concluded that "Among newly sexually active women, consistent condom use by their partners appears to reduce the risk of cervical and vulvovaginal HPV infection. "
Thus, condom use may reduce the risk that infected individuals will progress to cervical cancer or develop additional genital warts. Planned Parenthood recommends condom use to reduce the risk of contracting HPV. Planned Parenthood is the collective name of organizations worldwide who are members of the International Planned Parenthood Federation (IPPF 
Ongoing research has suggested that several inexpensive chemicals might serve to block HPV transmission if applied to the genitals prior to sexual contact.  These candidate agents, known as topical microbicides, are currently undergoing clinical efficacy testing. A microbicide is any compound or substance whose purpose is to reduce the infectivity of microbes such as Viruses or bacteria. A recent study indicates that some sexual lubricant brands that use a gelling agent called carrageenan can inhibit papillomavirus infection in vitro. Personal lubricants are specialized Lubricants which serve during sexual intercourse to reduce Friction with the Vagina, the Anus, or other Carrageenans or carrageenins (ˌkærəˈgiːnənz are a family of linear sulphated Polysaccharides extracted from red Seaweeds The name is derived from In vitro ( Latin: within the glass refers to the technique of performing a given experiment in a controlled environment outside of a living Organism  See Carrageenan#Sexual lubricant and microbicide for details. Carrageenans or carrageenins (ˌkærəˈgiːnənz are a family of linear sulphated Polysaccharides extracted from red Seaweeds The name is derived from
Clinical trials are needed to determine whether carrageenan-based sexual lubricant gels are effective for blocking the sexual transmission of HPVs in vivo. In vivo ( Latin: within the living means that which takes place inside an organism.
Higher levels of vegetable consumption were associated with a 54% decrease risk of HPV persistence.  Consumption of papaya at least once a week was inversely associated with persistent HPV infection. 
There is weak evidence to suggest a significant deficiency of retinol can increase chances of cervical dysplasia, independently of HPV infection. Retinol (Afaxin, the animal form of Vitamin A, is a fat-soluble vitamin important in vision and Bone growth A human papillomavirus ( HPV) is a Papillomavirus that infects the skin and Mucous membranes of Humans Approximately 130 HPV types have been A small (n~=500) case-control study of a narrow ethnic group (native Americans in New Mexico) assessed serum micro-nutrients as risk factors for cervical dysplasia. Subjects in the lowest serum retinol quartile were at increased risk of CIN I compared with women in the highest quartile. Retinol (Afaxin, the animal form of Vitamin A, is a fat-soluble vitamin important in vision and Bone growth Cervical intraepithelial neoplasia ( CIN) also known as cervical dysplasia is the potentially Premalignant transformation and abnormal growth ( Dysplasia 
However, the study population had low overall serum retinol, suggesting deficiency. A study of serum retinol in a well-nourished population reveals that the bottom 20% had serum retinol close to that of the highest levels in this New Mexico sub-population. 
Risk of type-specific, persistent HPV infection was lower among women reporting intake values of vitamin C in the upper quartile compared with those reporting intake in the lowest quartile. Vitamin C or L-ascorbate is an Essential nutrient for a large number of higher primate species a small number of other Mammalian 
HPV clearance time was significantly shorter among women with the highest compared with the lowest serum levels of tocopherols, but significant trends in these associations were limited to infections lasting </=120 days. Tocopherol, a class of chemical compounds of which many have Vitamin E activity describes a series of Organic compounds consisting of various methylated phenols Clearance of persistent HPV infection (lasting >120 days) was not significantly associated with circulating levels of tocopherols. Results from this investigation support an association of micronutrients with the rapid clearance of incident oncogenic HPV infection of the uterine cervix. 
A statistically significantly lower level of alpha-tocopherol was observed in the blood serum of HPV-positive patients with cervical intraepithelial neoplasia. The risk of dysplasia was four times higher for an alpha-tocopherol level < 7. 95 mumol/l. 
Higher folate status was inversely associated with becoming HPV test-positive. Women with higher folate status were significantly less likely to be repeatedly HPV test-positive and more likely to become test-negative. Studies have shown that lower levels of antioxidants coexisting with low levels of folic acid increases the risk of CIN development. Improving folate status in subjects at risk of getting infected or already infected with high-risk HPV may have a beneficial impact in the prevention of cervical cancer. 
However, another study showed no relationship between folate status and cervical dysplasia. 
Higher circulating levels of carotenoids were associated with a significant decrease in the clearance time of type-specific HPV infection, particularly during the early stages of infection (</=120 days). Carotenoids are organic Pigments that are naturally occurring in Chromoplasts of plants and some other photosynthetic Organisms Clearance of persistent HPV infection (lasting >120 days) was not significantly associated with circulating levels of carotenoids. 
The likelihood of clearing an oncogenic HPV infection is significantly higher with increasing levels of lycopenes. Lycopene is a bright red Carotenoid pigment and Phytochemical found in Tomatoes and other red fruits  A 56% reduction in HPV persistence risk was observed in women with the highest plasma [lycopene] concentrations compared with women with the lowest plasma lycopene concentrations. These data suggests that vegetable consumption and circulating lycopene may be protective against HPV persistence. 
Women who had either CIN or cervical cancer had markedly lower levels of CoQ10 in their blood and in their cervical cells than the women who were healthy. Coenzyme Q10 (also known as ubiquinone ubidecarenone coenzyme Q and abbreviated at times to CoQ10 CoQ Q10 or Q is a Benzoquinone, where Q
In a 1999 study, Docosahexaenoic acid inhibited growth of HPV16 immortalized cells. Docosahexaenoic acid (commonly known as DHA; 226(ω-3 all-cis -docosa-4710131619-hexa- enoic acid Trivial name cervonic 
Therapies for conditions caused by HPV are addressed in main articles covering the various HPV-related diseases.
The fact that prostitutes have much higher rates of cervical cancer than nuns was a key early observation leading researchers to speculate about a causal link between sexually transmitted HPVs and cervical cancer. Cervical cancer is Malignant Cancer of the Cervix uteri or cervical area Prostitution is the act of performing Sexual activity in exchange for Money. A Nun is a Woman who has taken special vows committing her to a religious life