Arjun Luthra

ISM-Period 6
Stanley, Margaret. "Immunobiology of HPV and HPV Vaccines." Gynecologic Oncology
(2008): n. pag. Elsevier Inc., Feb. 2008. Web. 30 May 2016.
<https://www.researchgate.net/profile/Margaret_Stanley2/publication/5377908_Immuno
biology_of_HPV_and_HPV_vaccines/links/54104ffa0cf2d8daaad37db6.pdf>.

Cervical cancer is the second most common cancer in women

HPV are true human carcinogens
In 1970, there was a belief that there was one type of HPV
Now, the scientific community has classified HPV into over 130 genotypes
HPV infects the mucosal epithelium in men and women
two most common low-risk viruses that cause warts on the anogenital mucosae
are HPV 6 and 1(Stanley)
HPV 16 and 18 are responsible for 70 percent of the incidence of cervical cancer
worldwide
The virus assembly and expression of viral protein develop within the upper
layers of the stratum spinosum and granulosum of squamous epithelia
HPV inhibits the differentiation of infected keratinocytes and encode proteins to
reactivate DNA synthesis in non-cycling cells for viral DNA replication
The virus remains invisible to the host for a long time
The virus also downregulates interferon responses, which has the property of
inhibiting viral replication
Although 80% to 90% of genital HPV infections resolve with time, about 10% to
20% of individuals do not become HPVDNA negative and the infection becomes
persistent(Stanley)
The 20 percent of individuals with persistent infection often get cervical
intraepithelial neoplasia, chromosomal instability and progressive development to
resist the bodys immune response
Founder of papilloma research, Shope conducted an experiment where he directly
injected the cottontail rabbit papilloma virus into the bloodstream and found that
papillomas did not arise
Stromal dendritic cells encounter the repeat structure of the virus like particles
and initiate an immune response cascade dependent on B cell memory
Evidence indicates that protection against high-grade HPV 16 and 18, and HPV 6
and 11, remains at greater than 98% over a 5 to 6.4-year period
The neutralizing antibodies developed through immunizations are often
heterogeneous meaning that they can be cross-reactive and can also serve for
nonspecific HPV types
Aluminum salts are a common adjuvant added to HPV vaccines

This resource was useful as it provided me with information about how the virus resists
or downregulates the human immune response.

Arjun Luthra
ISM-Period 6
"Concerns and Information About HPV Vaccines." WomensHealthSpecialists.org. Women's
Health Specialists, n.d. Web. 31 Mar. 2016.
<http://www.womenshealthspecialists.org/health-information/HPV-Vaccines>.

HPV is the most common sexual transmitted infection

Often both partners share the same type of HPV
HPV can be transmitted by any skin to skin contact
Condoms do not offer complete protection against HPV
HPV is not usually long lasting as research suggests that within 24 months the
infection is gone
Approximately 60% of men ages 18 to 70 carry HPV
The CDC estimates that over 80% of sexually active women will have acquired
genital HPV by age 50(Concerns and Information about HPV vaccines)
Factors that may hamper the bodys ability to fight HPV infection are smoking,
HIV and other diseases that weaken the immune system
Of the 100 types, about 25 types serve as players for infection of the anogenital
tract
HPV virus often lead to abnormal pap smears for women
Other factors that may hamper the immune system include previous Chlamydia
or herpes infection, poor nutrition, inability to get health care due to poverty, five
or more vaginal births and prolonged use of birth control pills (5 years or
longer)(Concerns and Information about HPV vaccine)
According to Womens Health Specialists, only about 20 percent of women do not
have adequate immune system to fight against HPV
The types of HPV that cause genital warts are usually not the cause or major
players that lead to cervical cancer
Although it is preventable, Cervical cancer is diagnosed in 12,900 women in the
United States each year and 4,400 women die of cervical cancer in the U.S. each
year
About 30 percent of cervical cancers cant be prevented by HPV vaccines
If a women is pregnant, it is advisable for them to not get the HPV vaccine
An HPV vaccine does not seem to be an adequate replacement for Pap test
screening
The vaccine has no value in treating existing HPV infection
Gardasil and Cervix are the two vaccines for HPV, Gardasil only serves to prevent
4 types of HPV

This resource was unique as it focused on the occurrence, prevalence and impact of the
HPV virus specifically in women.

Arjun Luthra
ISM-Period 6

"Summary of the WHO Position Paper on Vaccines against Human Papillomavirus

(HPV)." World Health Organization. World Health Organization, 2014. Web. 28 Feb.
2016.
<http://www.who.int/immunization/position_papers/pp_hpv_oct2014_summary.pdf>

HPV 16 and 18 are most common types of invasive cervical cancer, vaccines
HPV infection lead to vaginal, vulvar, penile, oropharyngeal and anal cancers
80% of cervical cancer cases occur in the less developed regions and mortality
rates vary as much as 18-fold between industrialized and developing countries
"Summary of the WHO Position Paper on Vaccines against Human
Papillomavirus (HPV)."
Genital warts, symptom of HPV, are usually flesh colored, firm growths or bumps
that appear on areas such around the vagina or anus, on the cervix, the penis,
scrotum, groin, or thigh
Cancer can develop in these specific areas
About 58 countries have introduced HPV vaccine as part of their immunization
program
Research is not completely definite to how HPV leads or correlates to cervical
cancer
The World Health Organization recognizes HPV as a priority for health care
The World Health Organization has considered in how to make HPV vaccines
increasingly economic feasible especially because of the occurrence of HPV in
under developing countries
A three dose is recommended for females above the age of 15 while a two dose of
HPV vaccine is advisable for females under the age of 15
If you are below the age of 15, it is advisable to have each dose about 12-15
months apart
If you are above the age of 15, it is advisable that the vaccine is given within 6
months apart
It is increasingly important to get vaccine especially if you have an adverse
condition that makes you immunocompromised or are immunocompromised
Research between the correlation of HPV 16 and 18 to cervical cancer has been
studied for at least eight years
Recombinant DNA technologies have made easier to develop HPV vaccines
The World Health Organization has initiated action by developing programs to
educate regarding the risk and the ways of protection against HPV
HPV vaccine is considered a priority for women and not as much for women

Arjun Luthra
ISM-Period 6
This article was definitely educational as it shows what concerns there are about HPV as
it considers the prevalence of HPV within certain age groups, certain demographic areas
and groups of different gender.
Mariani, Luciano, and Aldo Venuti. "HPV Vaccine: An Overview of Immune Response, Clinical
Protection, and New Approaches for the Future." Journal of Translational
Medicine (2010): n. pag. National Center for Biotechnology Information. BioMed
Central, 27 Oct. 2010. Web. 28 Feb. 2016.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988719/>.

Although most research find that the risk of HPV-infection remains as long as
women remain sexually active (at least 70-80% of risk during their lifetime), the
risk remains high even among the male population( Luciano and Venuti)
The viruss escape mechanisms include no viral-induced cytolysis or necrosis,
no inflammation, little release into the local milieu of proinflammatory
cytokines(Luciano and Venuti)
Often the intraepithelial dendritic cells are unable to detect viruses, which is
important to the innate immune response(Includes macrophages, DC, neutrophils)
Even with having antibodies for specific HPV types, reoccurrence of HPV
infection was found among women
Most effective vaccine was developed as a result of technology that allowed
recombinant DNA to generate virus-like particles that mimic the virus
Also they induce high levels of neutralizing antibodies, proteins which are created
by plasma cells that usually specific to a epitope on an antigen
Antigen dose in vaccine is higher than in natural infection, which allows for
activation of the innate and adaptive immune response
Other aspects of the immune response, in addition to humoral immunity using
antibody production, are used to fight against the foreign virus
IgG, an antibody found in extracellular fluid and the blood, reaches its maximum
height after the third dose of the immunization
current vaccines are able to elicit an immunological response against HPV-16 and
HPV-18, common oncogenic types found in cervical cancer
Long-term protection from the virus after immunization is questionable, but
studies indicate that time of protection is extending with the use of more efficient
vaccines
Vaccination for the L2 polypeptide, in addition to L1, will help fight the infection
because the antibodies specific to L2 epitopes will prevent virus from transferring
from extracellular matrix to cell surface

Arjun Luthra
ISM-Period 6
This source goes in depth to explain how HPV vaccines works, and what are the
advantages and drawbacks of the current vaccines determined by conclusive research.
"Genital HPV Infection - Fact Sheet." Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention, 18 Feb. 2016. Web. 28 Feb. 2016.
<http://www.cdc.gov/std/hpv/stdfact-hpv.htm>.

HPV causes warts or groups of bumps in the genital area and if the infection
progresses it may cause cancer
According to the CDC, children of the age of 11 to 12 should get vaccinated for
HPV
Young women can get HPV vaccine through age 26, and young men can get
vaccinated through age 21
HPV is usually asymptomatic and many people are unaware of the developing
infection
Research shows that About 79 million Americans are currently infected with
HPV. About 14 million people become newly infected each year. HPV is so
common that most sexually-active men and women will get at least one type of
HPV at some point in their lives(Genital HPV Infection-fact sheet)
Serves as the most common sexually transmitted infection and usually develops
due to oral, vaginal or anal sex
The burden of HPV infection also includes intraepithelial neoplasia grade 2 or 3
and adenocarcinoma in situ
Most common types are HPV 16 and 18, which account for 66 percent of cervical
cancer due to HPV
Administration of the immunization occurs in three doses of separate
times(specifically 2vHPV, 4vHPV, and 9vHPV)
2vHPV should not be used if the patient or individual has anaphylactic latex
allergy, while individuals with personal history of immediate hypersensitivity to
yeast should not take the 9vHPV
Data conclusively show that vaccines do not cause major health problems, and
symptoms after immunization range from low to moderate in site-related pain,
swelling and erythema
All vaccinated patients should practice abstinence or protective sexual behaviors
Patients that are immunocompromised are responsible for getting vaccination of
HPV
Unlike bacterial meningitis, vaccination for HPV is not required prior to entry
into college
Gardasil is the commonly used vaccine for HPV provided by clinical physicians
Each HPV vaccineGardasil and Cervarix are approved by the FDA
In regards to testing, anal pap tests are offered to check for anal cancer, there is
also Pap test for women

Arjun Luthra
ISM-Period 6
This resource by the CDC is beneficial as it provides in detail the statistical incidence
of HPV, what HPV is and what age group or special populations should get
immunizations for HPV.