Virology of human papillomavirus infections and the link to cancer
- Joel M Palefsky, MD
Joel M Palefsky, MD
- University of California San Francisco
- Immediate Past President, International Papillomavirus Society
- Immediate Past President, International Anal Neoplasia Society
- Ross D Cranston, MD
Ross D Cranston, MD
- Associate Professor
- Anal Dysplasia Clinic and Research Program
- Division of Infectious Diseases
- University of Pittsburgh
- Section Editors
- Bruce J Dezube, MD
Bruce J Dezube, MD
- Section Editor — Neoplasms in AIDS and Post-Transplantation
- Associate Professor of Medicine
- Harvard Medical School
- Don S Dizon, MD, FACP
Don S Dizon, MD, FACP
- Section Editor – Gynecologic Oncology
- Clinical Co-Director, Gynecologic Oncology
- Founder and Director, The Oncology Sexual Health Clinic
- Massachusetts General Hospital Cancer Center
- Associate Professor of Medicine
- Harvard Medical School
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. The biology of these viruses has been studied extensively and its link with malignancies is well established, specifically with cancers involving the anogenital (cervical, vaginal, vulvar, penile, anal) tract and those involving the head and neck. The virology of HPV and its association with malignancy will be reviewed here. The clinical manifestations, diagnosis, epidemiology, prevention, and treatment of HPV infection are discussed separately. (See "Epidemiology of human papillomavirus infections".)
Human papillomavirus (HPV) is a small deoxyribonucleic acid (DNA) virus of approximately 7900 base pairs. DNA sequencing techniques have facilitated HPV typing and characterization, with each type formally defined as distinct by having less than 90 percent DNA base-pair homology with any another HPV type . There are over 40 HPV types that infect the anogenital area. (See "The life cycle, natural history, and immunology of human papillomaviruses".)
HPV GENOTYPES AND RISK OF CANCER
There are numerous human papillomavirus (HPV) genotypes, and their association with cancer risk varies. This is reviewed below.
Cervical cancer — There is a broad separation of HPV genotypes based on their associated risk of cervical cancer:
●High-risk – This includes HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68
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- HPV GENOTYPES AND RISK OF CANCER
- Cervical cancer
- Head and neck cancer
- Anal cancer
- Penile cancer
- MOLECULAR PATHOGENESIS
- HPV proteins
- Role of p53 protein
- Role of retinoblastoma protein
- Other proteins
- HIV infection
- Progression from immortalization to malignancy
- RISK FACTORS FOR HPV INFECTION
- DETECTING HPV
- Indications for testing
- INFORMATION FOR PATIENTS