The Causes, Symptoms, and Treatment of the Papillomaviruses in Humans - Term Paper Example

Institution : xxxxxxxxxxx Title : xxxxxxxxxxx Tutor : xxxxxxxxxxx Course : xxxxxxxxxxx @2013 Introduction Human papillomaviruses is one of the major sexually transmitted infections. It infects the mouth, throat and the genital areas in both males and females. Most people infected with this virus may not know that they have it. A person can carry the virus for years and pass it on to his or her sexual partners without realizing it. There exist at least forty types of the virus. All these viruses cause different health problems that are all passed on during sexual intercourse. It is very possible to contract more than one type of the papillomaviruses. The health complications resulting from the HPV infection are severe but they can be treated with the correct therapy. This essay critically analyses the causes, epidemiology, signs and symptoms, prevention and treatment of the papillomaviruses in humans. Causative agent The major causative agent for the human papillomaviruses comes from the viruses themselves. Different types of the viruses affect different parts of the human body. The high-risk viruses for example affect the cervix causing cervical cancer. The human papillomaviruses as the causative agents are structured, to fit their function. They replicate and are then transmitted to uninfected persons (Joan, 2012). Structure The structure of the causative agent of papillomaviruses, it is a viral capsid that consists of at least seventy two capsomeres. Every capsomere has two viral proteins. These proteins are known as major and minor capsid proteins. They are also known as L1 and L2 respectively. HPV uses a circle of double-strand DNA as its genome. The viruses have a genome of approximately 8000 base pairs of double stranded DNA in length. They all have at least nine potential reading frames. The proteins are preset in one of the two strands of the viral DNA. Therefore they can be read in the same direction. The genome can split into two major regions. The early region has the transforming proteins, the replication and the transcription regulatory proteins as well while the late region encopresis of the structural proteins of the virus. They are named this way since they describe the time they were expressed in the course of the infection. The early and late regions are divided by a stretch of non-transcription factors. The non-transcribed DNA is called the long control region. It consists of the transcriptional promoters and enhancers (Zheng, 2006). Replication Replication of the HPV is linked to the distinctive state of the cell. The virus infects the keratinocytes found in the basal layers of the stratified squamous epithelium. The early region genes also the L1 genes are expressed in the undifferentiated basal and suprabasal layers. The expression of the late region genes also L2 genes only takes place in the terminally differentiated cells of the squamous layer. It is in the squamous layer that the new virus particles are encapsulated and released to the environment as they die (Nasir, 2013). Transmission The HPV transmission happens in a simple way. It is transmitted through skin to skin contact with an infected person. Some types of the HPV are transmitted during vaginal and anal intercourse, which cause a lot of concern for the health and safety of the individuals. HPV is transmitted from an expectant mother to her child during normal delivery. However these cases are very minimal and rare. It has been scientifically proven that HPV is not only transferred sexually but can also occur simply by shaking someone’s hands with someone with genital warts. Additionally, HPV infections, especially genital warts, can be transmitted by seat surfaces, floors or toilets in most public setting (Nasir, 2013). Classification Papilloma viruses are very diverse group of viruses that cause several diseases including cancer of the cervix. The viruses have been classified according to the taxonomic levels: family, species, types, variants and genus. The papillomaviruses are in the family papillomaviradie. The family contains twenty nine genera. Human papillomaviruses were in the five genera: gamma, alpha, beta, mu and nu papillomaviruses. The others were isolated to birds and mammals. The human papillomaviruses genomes are static. Their sequence changes by mutation (Chelsea, 2013). Human papillomaviruses join each other to form a species that then cause diseases. The closely related HPV types: HPV-16and 31, HPV-2and 27, and HPV-6 and 11, cause the health problems in humans, like cancer. HPV types that are able to form a species with the HPV-2 are usually found in the skin warts. Those that form a species with the HPV-16 are high-risk. They are normally found in cervical cancer. The HPV subtypes are genomically 2-10% dissimilar from any papillomavirus types (Joan, 2010). When it comes to the variants of HPV types, studies have shown that there are very invisible differences it is impossible to distinguish them. The HPV types have been repeatedly isolated and the sequence of isolates is compared. Consequently, most of the HPV types are isolated in forms of 0 to 100 different genomic variants that showed a diversity of 1 to 2% (Chelsea, 2013). Epidemiology HPV infection is there in the whole world. It affects both men and women but a larger percentage of the victims are the women. Studies show that a larger percent of the infection depends on the period of the first sexual contact and the number of sexual partners. According to (Nasir.2013) he claims that among four sexual partners, one is infected with the disease. However studies have shown that even virgins can be infected. Those cases are very rare. Among 154 virgin women, two could be infected. Studies have also shown that HPV infection occurs not long after sexual activity with an infected person especially if it is a virgin. The infection epidemiological status is between eight to thirteen percent. This is equivalent to six hundred and forty million infected people in the world. Since the virus is very infectious, almost two thirds of all people get infected after sexual intercourse with related people after a period of three months. Seventy percent of genital papillomaviruses infection does not progress to disease. This is because they are subclinical: they can go away even without treatment. Researchers have estimated that the prevalence of pre-malignant HPV infections is between thirty to forty million people (Schottenfeld, 2006). Clinical symptoms Most people suffering from HPV do not develop symptoms. Most of the HPV infections go away for themselves. However in most cases they persist and can cause severe health problems. Some of the symptoms leading to these health issues are. Genital warts are the easiest to recognize signs of genital papilloma viruses. They appear as small groups of bumps around the genitals. They can be shaped as a cauliflower, can be small or large, and can be raised or flat. The warts appear within weeks or even months after sexual inter relations with an infected partner. If genital warts are left untreated, they may go away or remain unchanged. They might however increase in numbers or size worsening the situation. It is important to note that the HPV type that causes genital warts is different from the types that cause warts in other body parts (Yan, Cui, 1997). The HPV infections also cause cervical cancer. About a dozen of the HPV viruses can lead to cervical cancer. These viruses are also known as high risk types. Since the cervix is covered by a thin layer of tissue comprised of cells, it is most likely for the available HPV cells to penetrate through it (Lisa, 2009). The infected cells may be damaged causing the cancer to grow. Cervical cancer rarely exhibits any symptoms until it is totally advanced. However a woman should seek medical attention if she experiences abnormal bleeding from the vagina or suspect able change in the menstrual cycle and pain during sex or bleeding after or during sex. It is advisable for women to have frequent screening (Zenilman, 2012). Respiratory papilomatosis is also a condition caused by HPV. It is a recurrent condition where warts form around the larynx or other areas of the respiratory track. This may cause problems when breathing. Extreme cases of the problem may cause cancer of the respiratory system. Pregnant women suffering from HPV are most likely to have children with recurrent respiratory papilomatosis. Since the warts keep reoccurring frequently, there may be need for surgery repeatedly (Gearhart., 2012). Papillomaviruses are also exhibited in skin warts. These skin warts are noncancerous growths in the skin. These infection causes fast growth of cells around the outermost layer of the skin. There are different types of skin warts. The common warts are usually found around the hands and feet. They can also occur around the elbows. The plantar warts are found on the soles of feet. They cause pain when walking especially since they grow inwards. The periungual warts form under the fingernails or around the cuticles. These type are the most difficult to treat. Lastly are the flat warts. They are most commonly found on the forehead, and the arms. They are very frequent in children and teens (Lyon, 2007). Signs and symptoms of papillomaviruses are not that pronounced. Most people do not exhibit any symptoms. In 90% of HPV cases are cleared by the immune system within two years. Some types of these viruses can cause genital warts in both females and males. It is rare for the warts to form in the throat, but they can form in the throat. This causes problems in the respiratory system that affect a person’s breathing. Other HPV types cause normal cells in the body to become abnormal. They then cause cancer over time. The most common type of cancer is the cervical cancer although other types of less common cancers may occur (Lisa, 2009). Diagnosis and virus identification Diagnosing genital warts wrongly can result to morbidity. Wrong diagnosis of genital warts can result to inappropriate therapy, unnecessary treatment, psychosocial concerns and even mortality. Most of the papilloma viruses are less distinct and to be clinically recognized. One papilloma virus can be mistaken for another. When diagnosing HPV the physician should ask a couple of questions to the patient like the sexual history of the patient, other medical conditions, the symptoms the patient is experiencing among others. The doctor can diagnose the genital warts but just looking. The doctor is also able to identify some invisible variations in the tissue by applying vinegar to areas thought to have been infected (Davy, 2007). In the case of diagnosing and identifying cervical cancer, a magnifying instrument can be used to view the uterine cervix and the vagina. It is necessary to take small samples of tissues from the cervix and examine it through a microscope. A Pap smear test is also efficient in determining the possible presence of cervical HPV infection. A pap smear is a microscopic analysis of cells scraped from the uterine cervix for the detection of cervical cancer. A Pap smear test is the primary screening test for cervical cancer. However the Pap smear test is not specific test for HPV. A specific test is available to detect human papilloma in women but it is not recommended in all cases. The test can identify at least thirteen of the high-risk type of the papillomaviruses (Robert, 2007). Prevention of HPV Currently there are two major scientifically presented prevention methods for papilloma viruses; HPV vaccines and abstinence. However there are other ways of reducing the risk of infection. Abstinence is when an individual is not involving themselves in any sexual activity. This is the most absolute way of preventing HPV infection. If an individual is not sexually active they have very low chances for contracting the virus. Since some couples do not use condoms, it is advisable to be faithful in relationships (Monsonégo, 2007). An individual should limit their number of sexual partners to one partner. Being in a monogamous lifetime relationship will reduce the risk of contracting the disease. Consequently it is important to settle with a sexual partner who has had few sexual partners prior. Although even this way it is possible to contract the virus but it is possible to protect against the health effects of papilloma (Clare, 2008). For those who don’t have one sexual partner, it is advisable to use condoms. Although it is not clear the effectiveness of condoms at reducing the infection rate, Condoms lower the risk of developing HPV related diseases like genital warts and cervical cancer. However it is vital to consider the fact that HPV is not transmitted through the exchange of bodily fluids. It is transmitted through sexual skin-to-skin contact. This means even the other by wearing a condom it is still very possible to contract the virus (Joseph,2007). Human papillomaviruses vaccines are also recommended for boys and girls in the eleven to twelve years of age. These vaccines are safe and very effective and are able to protect males and females from the most common types of HPV leading to cancer and other health issues. However, the vaccines do not prevent an individual from all strains of HPV. The HPV vaccines are given in three doses in a period of six months. To get the maximum protection from the vaccines it is advisable to take the three doses. Boys and girls at the ages of 11 and 12 get the best protection provided by the HPV vaccines, since their immune reaction to the vaccine is better than in older women and men (Campo, 2006). Treatment of HPV There is no specific treatment for the virus in particular but there are treatments for the problems brought about by the HPV. In the case of genital warts, treatment can be painful and stressing. Treatment does not guarantee complete elimination. The warts can come back and one can still spread the infection. Warts that return after treatment cannot be treated using the same treatment method that was used before. Some people choose to stay with warts without treating them and wait for them to disappear by themselves (Merci, 2007). Treatment for genital warts include freezing, laser, medications or surgery. Doctors always recommend medications as the first choice. The doctor applies the medication around the area with warts or the patient can do it themselves. The type of treatment for genital warts depends on: the size and location of the warts, side effects of the treatment, the skills and the doctor’s opinion for each treatment. This is because the problems caused by the treatment may be severe and discouraging; an example is blockage of the urethra. Surgery may be done to remove the warts in cases where medications have failed and the patient still wants to have the warts removed. The other reason that can demand surgery is if the warts are wide spread around the infected area (Campo, 2006). Cancer is one of the most severe health hazards that come from the HPV viruses. It is best treatable when diagnosed early enough. The doctor will advise the patient on the best treatment considering factors as age, general health and stage of cancer. Some of the effective ways to treat cancer include surgery especially if the cancer is in its early stage. Radiotherapy is also effective and can be used as an alternative for surgery. If there is uncertainty on the elimination of cancer in the body after surgery, radiotherapy may be administered to the patient. Radiotherapy is most effective in treating larger tumors in the cervix. Chemotherapy is another effective method of treating cancer. It helps to shrink cancer especially if it has spread in large areas. It also stops and controls the spread of cancer and reduces the symptoms (Garcea, 2007). Recurrent respiratory papillomatosis is a rare condition; the warts that grow around the respiratory system can be removed through surgery and medications. Since the condition is recurrent, it may require treatment over and over (Campo, 2006). Future outlook It is obvious that the human papilloma viruses’ vaccines may not eliminate the related diseases like cervical cancer and genital warts for a couple of years to come. But that they can reduce the burden that infected people have to carry. There has however been the implementation of two commercial vaccines that are affordable even by the youths today. Additionally, with the clinical trials progressing and advancing, there is promising chance for changes in the field of developing the HPV vaccine (Nelson, 2007) Effective communication on behavior change, addressing the maladjusted individual and societal behaviors on reproductive health and sexual issues is very important. Most people should be enlightened on the effects of their irresponsible sexual behavior, they are involved in. these will be most effective in controlling the spread of the papillomaviruses (Davy, 2005) There have been proposals about new technological advancements in the hospitals. These will make the detection, management and treatment of cancer easier and effective. Therefore in some years to come it will be possible for men and women to get their real status when it comes to the papillomaviruses infection (Sharma, 2007). Conclusion The papillomaviruses come along with other serious health issues. Although treatable they cause a lot of distress in both men and women. It is almost impossible to tell when one has been infected with the disease. This is because the signs and symptoms are not very pronounced. It is possible for people to prevent getting infected with this disease. This can be done by abstaining from sex, having one sexual partner, using a condom during sexual intercourse and getting vaccinated especially at an early age.There is no specific treatment for the human papillomaviruses after infection. However there is treatment for the related medical issues like, genital and skin warts, and cervical cancer among others. Treatment can be given in terms of medications, or surgery. Chemotherapy and radiotherapy are alternative treatment methods for cancer. Since the rate of the infection keeps escalating as time goes by, there are different and promising solutions that can ensure that there are effective treatment methods for the infected. These include cheaper vaccines, better machinery for cancer screening and treatment. References Chelsea, G, 2013, Human Papillomavirus (HPV). New York: J. Wiley, Retrieved From < http://www.austincc.edu/microbio/2704w/hpv1.htm > Chambers, E, et al, 2013, Association of bovine papillomavirus with the equine sarcoid. Copyright Society for General Microbiology. Retrieved From < http://vir.sgmjournals.org/content/84/5/1055.full> Campo, M, 2006, Papillomavirus research : from natural history to vaccines and beyond. Wymondham, England: Caister Academic. Davy, C and Doorba,J,2005, Human papillomaviruses methods and protocols, Totowa, N.J: Humana Press. 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