Human papillomavirus infections detected in women aged older. Human papillomavirus hpv is a group of viruses that are extremely common worldwide. In spite of effective screening methods, cervical cancer continues to be a major public health problem. Attribution of 12 highrisk human papillomavirus genotypes. In 2018, more than 270,000 women died of cervix cancer globally with 85% of them being from developing countries. Longitudinal analysis of carcinogenic human papillomavirus. Results from a prototype realtime pcr assay that separately detected human papillomavirus genotype 16 hpv16, hpv18, and 12 other carcinogenic hpv genotypes in aggregate cobas 4800 hpv test and results from a pcr assay that detects 37 hpv genotypes individually linear array were compared using a convenience sample of cervical specimens n 531. The majority of these cancers are caused by the infection with carcinogenic strains of human papillomavirus hpv, which is also. Incidence and persistence of carcinogenic genital human papillomavirus infections in young women with or without chlamydia trachomatis coinfection. There are wide differences in cervical cancer incidence and mortality. Prevalence of human papillomavirus types associated with.
Currently, human papillomavirus hpv research focuses on hpv infection in adults and sexual transmission. Virtually all cases of cervical cancer are caused by persistent infections with a restricted set of human papillomaviruses hpv. The relationship of cervical cancer and sexual behavior was suspected for more than 100 years and was established by epidemiologic studies in the 1960s. The prevalence and risk of human papillomavirus infection in. Human papillomavirus infection and chlamydia coinfection hereinafter, chlamydia infection, an sti that often remains asymptomatic. Cervical cancer is the third most common cancer in women worldwide. The natural history of human papillomavirus infection. Although the great majority of infections resolve within. Carcinogenic human papillomavirus infection request pdf. Prevalence of human papillomavirus types associated with cervical lesions in sergipe state, northeastern brazil. These lesions, depending on the site affected, increase the risk of cancer of the cervix, vulva. Carcinogenic human papillomavirus infection nature.
Food and drug administration fda in 2006 for the prevention of hpv611related genital warts, and hpv1618related cervical cancers and precancers. The human papillomavirus hpv family comprises more than 170 different types that preferentially infect the mucosa of the genitals, upperrespiratory tract, or the skin. There are over 100 varieties of hpv, more than 40 of which are passed through sexual. Persistent infection with one of about 15 carcinogenic human papillomavirus hpv types is a necessary cause of cervical cancer. Hpv infection occurs mainly through sexual contact. Human papillomavirus infection and chlamydia co infection hereinafter, chlamydia infection, an sti that often remains asymptomatic. Frequency and risk factors for prevalent, incident, and persistent genital carcinogenic human papillomavirus infection in sexually active women. Carcinogenesis associated with human papillomavirus. There are more than 100 types of hpv, of which at least 14 are cancercausing also known as high risk type. New approaches in the evaluation for highrisk human. Prevalence and incidence of human papillomavirus hpv infection before and after pregnancy. For the most carcinogenic type hpv16, variant lineages representing further evolutionary divergence also differ in cancer risk. Screening for the cytologic manifestation of hpv papanicolaou test has been the successful mainstay of cervical cancer prevention for a half century. Attribution of 12 highrisk human papillomavirus genotypes to.
Carcinogenic human papillomavirus infection johns hopkins. Infection with carcinogenic types of human papillomavirus hpv is necessary for the development of cervical intraepithelial neoplasia cin. Carcinogenic risk of human papillomavirus hpv genotypes and. Indeed, together they account for 7080% of cervical cancers, 4050% of vulval and oropharyngeal cancers and 7080% of anal cancers. Based on the central role of persistent carcinogenic human papillomavirus hpv in cervical carcinogenesis, testing for carcinogenic hpv was recently introduced into cervical cancer screening. The discovery of hpv as a carcinogen led to the development of effective preventive vaccines and sensitive hpv dna and rna tests. Classification of weakly carcinogenic human papillomavirus types. Individuals with inherited immunodeficiencies, autoimmune disorders, organ or bone marrow transplantation, or infection with human immunodeficiency virus hiv are at increased risk of infection with both lowrisk and highrisk human papillomavirus hpv types. Although the great majority of infections resolve within 2 years, phylogenetically related, sexually. Hpv infection is associated with virtually all cervical cancers and a significant proportion of anogenital vulvar, vagina, penile, and anal and oropharyngeal cancers. Human papillomavirus hpv is a small doublestranded dna virus with tropism for epithelial cells. Human papillomaviruses 6, 11, and some human papillomavirus types of the genus beta including types 5 and 8 are possibly carcinogenic to human.
Aug 29, 2019 a populationbased prospective study of carcinogenic human papillomavirus variant lineages, viral persistence, and cervical neoplasia. Hpv genotyping occurs mainly when multiple infections are present, and for the less important carcinogenic types. Frequency and risk factors for prevalent, incident. Although most hpv infections clear up on their own and most precancerous lesions resolve. Human papillomavirus hpv infection is responsible for approximately 5% of all cancers and is associated with 30% of all pathogenrelated cancers. Genital human papillomavirus hpv infection is a common sexually transmitted disease that at the present time is not effectively controlled or treated. Oct 15, 2002 infection with carcinogenic types of human papillomavirus hpv is necessary for the development of cervical intraepithelial neoplasia cin.
A proposed clinical algorithm for using carcinogenic human papillomavirus hpv testing as the primary screening test and hpv genotyping to triage carcinogenic hpvpositive results and monitor viral persistence as a risk factor for cervical precancer and cancer. Evidence of synergy between smoking and several occupational causes of lung cancer arsenic, asbestos and radon, and between smoking and alcohol consumption for cancers of the oral cavity, pharynx, larynx and oesophagus and between smoking and human papillomavirus. Persistent infection with carcinogenic genotypes of the human papillomavirus hpv is the necessary etiologic factor for icc. There are wide differences in cervical cancer incidence and mortality by geographic. To this date, over 150 genotypes are known and are classified into two major groups, lowrisk and highrisk strains, depending on the ability of the virus to induce malignant transformation. Request pdf carcinogenic human papillomavirus infection infections with human papillomavirus hpv are common and transmitted by direct contact. Persistent infection with carcinogenic hpvs occurs in virtually all cases of cervical cancer.
Infections with human papillomavirus hpv are common and transmitted by direct contact. The viral genome has a common structure with 3 main areas. About 90% of hpv infections cause no symptoms and resolve spontaneously within two years. Dec 01, 2016 carcinogenic human papillomavirus infection. Chronic immunosuppression provides an environment for persistent hpv infection which carries a higher risk of malignant transformation. However, in some cases, an hpv infection persists and results in either warts or precancerous lesions. Every year nearly half a million new cases of cervix cancer are diagnosed worldwide, making this malignancy the fourth commonest cancer in women. During this time basic clinical investigations occurred which eventually led to the acceptance that hpv was the major cause of cervical and lower genital tract neoplasia. Cervical hpv types n 40 also represent the most common sexually transmitted agents, and most infections clear in 12 years.
Carcinogenicity of human papillomaviruses the lancet. Lyon, france iarc monographs on the evaluation of carcinogenic risks to humans. Human papillomavirus hpv types differ profoundly in cervical carcinogenicity. Human papillomavirus hpv has been identified as the cause of approximately 5% of all cancers worldwide. Prevalence and risk factors for carcinogenic human.
The epidemiology of human papillomavirus infection. Human papillomavirus hpv is the most common viral infection of the reproductive tract. The hostmicrobe interplay in human papillomavirusinduced. Carcinogenesis associated with human papillomavirus infection. Pdf incidence and persistence of carcinogenic genital. Human papillomavirus infection hpv infection is an infection caused by the human papillomavirus hpv. Persistent cervical infections by approximately 15 carcinogenic human papillomavirus hpv genotypes cause cervical cancer and its immediate precursor lesions 17, 22, 27. The prevalence and risk of human papillomavirus infection. For a more comprehensive description, the reader is referred to volume 90 of the iarc monographs iarc, 2007. Infection by oncogenic viruses can promote different stages of carcinogenesis.
Iarc publications website tobacco smoke and involuntary. Human papillomavirus infection is a major health problem and caused substantial benign and malignancy diseases among female and male worldwide. Following the completion of 3 worldwide clinical studies conducted in more than 20,500 women ages 16 to 26 years, a quadrivalent hpv6111618 l1 viruslike particle qhpv vaccine was approved by the u. The diversity of human papillomavirus infection among. Pooled analysis of the control arms of efficacy trials of hpv1618 as04adjuvanted vaccine. In the first prospective, populationbased study of hpv variants, we explored whether, on average, the. Together, vaccination programmes the ultimate longterm preventive strategy and screening using hpv tests could dramatically alter the landscape of hpvrelated. The diversity of human papillomavirus infection among human. Adding a test for human papillomavirus dna to cervicalcancer screening. Previous evaluations of hpvs have classified types 16 and 18 as carcinogenic to humans group 1, types 31 and 33 as probably carcinogenic to humans group 2a and some types other than 16, 18, 31 and 33 as possibly carcinogenic to humans group 2b. Since that time, new data have become available, these have been incorporated in the monograph, and taken into consideration in the present evaluation. Some health effects caused by hpv can be prevented by the hpv vaccines. Carcinogenic risk of human papillomavirus hpv genotypes.
A subset of genital hpvs, designated highrisk types, are preferentially. Genital hpv infection cdc fact sheet human papillomavirus hpv is the most common sexually transmitted infection in the united states. Human papillomavirus is a small, nonenveloped, doublestranded dna virus that is approximately 55 nm in diameter and a member of the papillomaviridae family. Hpv is the most common sexually transmitted infection sti. Hpv is mainly transmitted through sexual contact and most. Human papillomaviruses human papillomaviruses were considered by a previous iarc working group in 2005 iarc, 2007. Policy watch carcinogenicity of human papillomaviruses. The carcinogenicity of human papillomavirus types reflects. Among many types of hpv, around 15 are linked to cancer. Human papillomavirus hpv is a viral infection thats passed between people through skintoskin contact. Hpv infection is also associated with other skin and mucosal lesions such as warts and benign papillomas. Immunology and vaccinepreventable diseases pink book.
In february, 2005, 25 scientists from countries panel met at the international agency for research on cancer iarc. Apr 29, 2015 the human papillomavirus hpv family comprises more than 170 different types that preferentially infect the mucosa of the genitals, upperrespiratory tract, or the skin. Variants of the remaining 10 to 15 carcinogenic hpv types have not been well studied. The implication of chlamydia in the pathogenesis of cervical carcinoma is controversial, as its interference has not been demonstrated at a particular stage of the carcinogenic process. Over the course of the last 16 years, data from basic. Hpv emerging technologies in cervical cancer screening.
However, some hpv infections result in persistent lesions that in some cases undergo carcinogenic progression. Jul, 2019 human papillomavirus hpv infection is responsible for approximately 5% of all cancers and is associated with 30% of all pathogenrelated cancers. This is my account of early clinical experiences with human papillomavirus hpv between 1965 and 1990. The stages of cervical carcinogenesis are better understood than for most other major cancers, providing a successful cancer etiology and prevention model. The data are for 824 women aged 1549 years, for whom the results were reported pre. Characteristics of carcinogenic human papillomavirus. Transmission of carcinogenic human papillomavirus types. Incidence and persistence of carcinogenic genital human. Human papillomavirusesiarc working group on the evaluation of carcinogenic risks to humans 2005. Persistent infection with 1 of 1015 carcinogenic types of human papillomavirus hpv causes virtually all cases of cervical cancer. A populationbased prospective study of carcinogenic human papillomavirus variant lineages, viral persistence, and cervical neoplasia.
Pdf incidence and persistence of carcinogenic genital human. The first highrisk human papillomavirus hr hpv device indicated to be used in routine cervical cancer screening was fda approved in 2003. Human papillomaviruses 6, 11, and some human papillomavirus types of the genus beta including types 5 and 8 are possibly carcinogenic to human beings. Although the great majority of infections resolve within 2 years. Note that in this context, hpv testing always refers to the detection of carcinogenic hpv genotypes only. Although the great majority of infections resolve within 2 years, phylogenetically related, sexually transmitted hpv genotypes, notably hpv16, causeif not controlled immunologically or by screeningvirtually all cervical cancers worldwide, a large fraction of other anogenital cancers and an increasing. Human papillomavirus infection and cervical cancer. A populationbased prospective study of carcinogenic human. Lyon, france to reassess the carcinogenicity of human papillomaviruses. Agespecific prevalence rates of infection with human papillomavirus hpv as detected by the hybrid capture ii hcii assay a test for carcinogenic types of hpv and the polymerase chain reaction with probing for carcinogenic types of hpv pcronc. E early region, l late region and the genomic regulatory region.
Carcinogenicity of human papillomaviruses the lancet oncology. It is a matter of debate whether mothertochild transmission of hpv is an important infection route and whether children born to hpvpositive mothers are at a higher risk of. Although the great majority of infections resolve within 2 years, phylogenetically related, sexually transmitted hpv genotypes, notably hpv16, causeif not controlled immunologically or by screeningvirtually all cervical cancers worldwide, a large fraction of other anogenital cancers and an. New insights in the pathogenesis of hpv infection and the. Although the great majority of infections resolve within 2 years, phylogenetically related, sexually transmitted hpv genotypes, notably hpv16, cause if not controlled immunologically or by screening. Human papillomavirus 175 11 human papillomavirus hpv is the most common sexually transmitted infection in the united states.
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