Recent Advances in Human Papillomavirus Infection and Management [chapter]

Shailendra K. Saxena, Swatantra Kumar, Madhu Mati Goel, Apjit Kaur, Madan LB Bhatt
2018 Current Perspectives in Human Papillomavirus [Working Title]  
Human papillomavirus (HPV) accounts for approximately 4.5% of all cancers which differs at the level of economic development and geographical regions. The life cycle of the HPV is completely dependent on the epithelium differentiation without the involvement of cell death and systemic viremia. Carcinogenesis is the consequence of viral gene expression, dysregulated cell proliferation, and genomic instability. Keratinocytes are the target cell for HPV which act as the physical and immunological
more » ... and immunological barrier. In cervical carcinogenesis, the enhanced level of Th17 infiltration has been observed which increases with the disease progression and is coupled with CCL20 expression in the stromal mesenchymal compartment. IL-6 and M-CSF are known as "switch factors" which are imperative for pro-tumorigenic response in monocytes. Screening of cervical cancer includes three major procedures: cytology, nucleic acid test, and co-testing. For evaluating anal lesions, high-resolution anoscopy is performed which is similar to colposcopy. Prophylactic vaccination is the primary preventive measure to control the HrHPV infection and reduce the burden of HPV-related cancer. The precancerous stage of HPV infection includes excision, ablation, and immunotherapy. Radiotherapy is the acceptable primary treatment for the early stage of anogenital cancer, whereas for the advanced-stage metastatic cancer, palliative therapy is the only option. of ascus lesion, 74.8% of low-grade cervical lesions, and 88.9% of high-grade cervical lesions. HPV 16 has been detected in 19.3% of low-and 45.1% of highgrade cervical lesions [23] . Furthermore, anal HPV infection is the most frequent HPV infection of other anogenital areas. The global burden of anogenital cancers caused by HPV is very high where 88% of anal and <50% of cases attribute to the lower genital tract [24] . About 30,000 cases are reported in men with the 56.56% attributed to the anus and 43.33% to penile origin. In the case of women, 38,500 cases are reported with 46.75% cases attributed to the anus, 22% to the vulva, and 31.16% from the vaginal origin [1]. Furthermore, the predominance of anal HPV infection that has been observed in the men sex with men (MSM) is 58.8% or HIVinfected individuals. The oral HPV infection significantly differs by gender and with higher incidence in men [19] . The worldwide prevalence of HPV-associated head and neck cancer is 8.15%, that is, 37,200 cases, where 77.95% of cases belong to the oropharynx, 11.82% of cases correspond to the oral cavity, and 10.21% of cases correspond to the larynx [1].
doi:10.5772/intechopen.81970 fatcat:mshubztotbdqvnpnlvxbcvxlsu