Human Papillomavirus and Cervical Cancer Infection
Discuss the below Mini Case Study:A 36-year-old female has a routine physical. She is single, doesn’t smoke and hasa few drinks of alcohol a week. She began menarche at age 11 and her first sexualintercourse was at age 14. She has had numerous sexual partners and does notregularly use barrier contraception. Physical examination is normal. The Papsmear comes back as atypical squamous cells of undetermined significance(ASCUS).a. What risk factors does she have for cervical cancer?b. Describe the pathogenesis of Human Papilloma Virus.c. Why should HPV testing be done and what are the tests to be ordered?d. What HPV subtypes are associated with cervical cancer?e. Explain the role of E6 and E7 HPV proteins in cervical cancer.f. Differentiate between Human Papilloma Virus and Herpes Simplex virus*** Be sure to substantiate your comments by stating the reasons and relatinganswers to evidence-based material. Include textbook and journal citations.Demonstrate organization, originality, and clarity of thought. Integrate yourreadings with examples from your personal experience and practice wherepossible
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Introduction:
Cervical cancer is one of the most common types of cancer among women worldwide. The Human Papillomavirus or HPV is a widespread sexually transmitted infection, with some types being associated with cervical cancer. In this mini-case study, we will discuss the risk factors for cervical cancer, the pathogenesis of HPV, the importance of HPV testing, and the HPV subtypes associated with cervical cancer.
a. What risk factors does she have for cervical cancer?
The patient has several risk factors for cervical cancer, including early onset of sexual activity, a history of multiple sexual partners, and not using barrier contraception regularly. These risk factors increase her chances of acquiring HPV infection, which can lead to the development of cervical cancer.
b. Describe the pathogenesis of Human Papillomavirus.
HPV is a DNA virus that infects the epithelial cells, and it is transmitted by skin-to-skin contact. The virus enters the host’s basal cells, replicates its DNA, and moves up the epithelium, leading to the lysis of the host epithelial cell. The HPV virus produces proteins such as E6 and E7 that inactivate the tumor suppressor genes, which can lead to uncontrolled cell growth and, eventually, cervical cancer.
c. Why should HPV testing be done and what are the tests to be ordered?
HPV testing is essential because it can detect the presence of HPV before any abnormalities are observed in the cervical epithelium. The tests to be ordered include the HPV DNA test, which identifies the HPV genotype, and the Pap smear or Cervical Cancer Screening, which examines the cervical cells for abnormal changes.
d. What HPV subtypes are associated with cervical cancer?
Several HPV subtypes are associated with cervical cancer, with HPV 16 and 18 being the most common. These subtypes are classified as high-risk types and are the primary focus of cervical cancer screening and prevention initiatives.
e. Explain the role of E6 and E7 HPV proteins in cervical cancer.
The E6 and E7 proteins are responsible for transforming the host epithelial cells. The E6 protein binds to the tumor suppressor protein p53, leading to its degradation and preventing the repair of the host cell’s DNA. The E7 protein inactivates the retinoblastoma protein (pRb), which regulates cell cycle progression. This inactivation leads to uncontrolled host cell proliferation, which can lead to cervical cancer.
f. Differentiate between Human Papilloma Virus and Herpes Simplex virus
HPV is a DNA virus that infects the epithelial cells of the skin or mucous membranes, and it is transmitted through skin-to-skin contact. In contrast, Herpes Simplex virus is an RNA virus that infects the neurons, and it is transmitted through direct contact with the secretions of mucosal membranes. While both viruses can cause sexually transmitted infections, they have different pathogeneses and clinical presentations. HPV is associated with genital warts and cervical cancer, while Herpes Simplex virus is associated with genital sores and blisters.
