Human papillomavirus natural history, complications and prognosis
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Most infections with HPV are subclinical, asymptomatic and resolves without any complications in immunocompetent individuals. Time to develop symptoms and signs is not well defined but it may take 3 weeks to 3 months for genital warts, several months to years for cellular abnormalities (metaplasia and dysplasia) and years for development of cancers. 90% of infections resolve within 2 years due to host immune response.Persistent HPV infection is associated with risk factors such as multiple sexual partners, alcohol consumption, immunosuppression, older age, and multiple types of HPV detected previously. Without treatment, persistent infection with low-risk types (low-grade intraepithelial lesions) may resolve spontaneously or persist and proliferate as warty lesions. However, high-risk HPV types (16,18,31,32) may lead to high-grade intraepithelial lesions which ultimately to carcinoma(cervical, anal, vaginal, vulvar, penile and oropharyngeal).Prognosis of HPV infection depends primarily on type of HPV causing infection.
Most infections with HPV are subclinical, asymptomatic and resolves without any complications in immunocompetent individuals. Time to develop symptoms and signs is not well defined but it may take 3 weeks to 3 months for genital warts, several months to years for cellular abnormalities (metaplasia and dysplasia) and years for development of cancers. 90% of infections resolve within 2 years due to host immune response.
Persistent HPV infection is associated with risk factors such as multiple sexual partners, alcohol consumption, immunosuppression, older age, and multiple types of HPV detected previously. Without treatment, persistent infection with low-risk types (low-grade intraepithelial lesions) may resolve spontaneously or persist and proliferate as warty lesions. However, high-risk HPV types (16,18,31,32) may lead to high-grade intraepithelial lesions which ultimately to carcinoma(cervical, anal, vaginal, vulvar, penile and oropharyngeal).Complications associated with the human papillomavirus infection include:genital warts, cervical cancer, vaginal cancer, vulvar cancer, anal cancer, penile cancer, head and neck cancer.
- Genital warts
- Cervical cancer
- Vaginal cancer
- Vulvar cancer
- Anal cancer
- Penile cancer
- Head and neck cancer
Good prognostic factors
- Low risk HPV type (1, 2, 4, 6, 11)
- Early diagnosis and treatment
- Regular follow-up
- Safe sex behavior
Bad prognostic factors
- High risk HPV type(16, 18, 31, 32)
- Multiple sexual partners
- Repeated infection in past years
- Delay in seeking treatment
- Lack of follow up and screening
- Metastatic carcinoma (cervical, anal, vaginal, oropharyngeal)
- Presence of other STDs (HIV, syphilis, chlamydia)
- Tobacco and alcohol usage
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