Human Papilloma Virus hyperplasia to dysplasia to invasive infections that affect skin and mucous

carcinoma. membranes.
A type of virus  To effectively replicate, HPV must
that can cause utilize the host cellular machinery. Incubation Period: 2 weeks to 8 months
abnormal tissue  During
growth (for the Mode of transmission
example, warts) process,  Direct contact, usually sexual, with
and other changes the viral an infected person.
to cells. protein  Non penetrative sexual activity.
Infection for a product  Transmission from a woman to a
long time with encoded newborn infant at the time of birth.
certain types of by E6
human binds to Period of communicability:
papillomavirus can the p53 tumor suppressor gene HPV is presumably communicable during
cause cervical product, which results in the the acute infection and during
cancer. Human papillomavirus may also play a premature degradation of the p53 persistent infection.
role in some other types of cancer, such as protein.
anal, vaginal, vulvar, penile, and oropharyngeal  The E7 protein binds to a tumor Clinical Manifestation:
cancers. Also called HPV. suppressor protein—the retinoblastoma
protein—and inhibits its function.
These protein products mediate much
Pathophysiology of the virus’ oncogenic potential and
 HPV infection occurs at the basal cell their production represents a key
layer of stratified squamous epithelial difference between the low- and high-
cells. risk strains of HPV.
 Infection stimulates cellular
proliferation in the epithelium and Causative Agent: The human  Anogenital Warts
infected cells display a broad spectrum papillomavirus, a member of the
of changes, ranging from benign family Papillomaviridae, is the etiologic
agent that causes Human Papillomavirus

typically applied directly to the lesion and
usually take many applications before they're
successful.
 Recurrent
Respiratory
Papillomatosis
 Cervical Dysplasia
 Cervical Cancer Precursors
 Cancer (cervical, anal, vaginal,
vulvar, penile, and oropharyngeal
cancer)
 Treatment:
Once an individual contracts HPV,
there is no treatment for the actual virus, but
those who have a good immune system will
usually fight off HPV on their own.
Medications to eliminate warts are  HPV4 vaccines (Gardasil, Merck) for
females and males 9 through 26 years
of age.
Surgical and other procedures
 Salicylic acid. Over-the-counter
treatments that contain salicylic acid If medications don't work, your doctor might
work by removing layers of a wart a suggest removing warts by one of these
little at a time. For use on common methods:
warts, salicylic acid can cause skin
irritation and isn't for use on your  Freezing with liquid nitrogen
face. (cryotherapy)
 Imiquimod (Aldara, Zyclara). This
prescription cream might enhance your
immune system's ability to fight HPV.
Common side effects include redness
and swelling at the application site.
 Podofilox (Condylox). Another topical
prescription, podofilox works by  Burning with an electrical current
destroying genital wart tissue. Podofilox (electrocautery)
may cause pain and itching where it's
 Surgical removal
applied.
 Laser surgery
 Trichloroacetic acid. This chemical
treatment burns off warts on the
Nursing Management:
palms, soles and genitals. It might cause
local irritation.
 Provide the patient with the physical
and psychological support the patient
needs only if he/she has insight and
understanding regarding the infection.
Trichomoniasis
A very common sexually transmitted
disease (STD). It is caused by infection
with a protozoan parasite called
Trichomonas vaginalis. Although symptoms
of the disease vary, most people who have
the parasite cannot tell they are infected.
Pathophysiology
 During infection with T vaginalis, jerky
motile trichomonads may be observed
on wet mount microscopy.  blood mononuclear cells.
 T vaginalis destroys epithelial cells by
direct cell contact and by release of
cytotoxic substances. It also binds to
host plasma proteins, thereby
preventing recognition by the
alternative complement pathway and by
host proteinases.
 During infection, the vaginal pH
increases, as does the number of
polymorphonuclear leukocytes (PMNs).
 PMNs, a type of white blood cell, are
the predominant host defense
mechanism. These cells respond to
chemotactic substances released by
trichomonads.
 There is also evidence that lymphocyte
priming occurs, as shown by the
presence of antigen-specific peripheral
Causative Agent: Trichomonas  vaginalis
Incubation Period:  4 to 20 days, with
average being 7 days.
Mode of transmission:
 Direct sexual contact
 Can be transmitted through contact
with wet objects, such as towels, wash
clothes.
Period of Communicability: The duration
of persistent infection. Infectivity is low
to moderate.
Clinical Manifestations:
 Many women and most men with Treatment:
trichomoniasis have no symptoms, at least not  Metronidazole 2 g orally, as a single
dose with food
at first. Trichomoniasis signs and symptoms
 tinidazole 2 g orally, as a single dose
for women include:
with food
 An often foul-smelling vaginal  metronidazole 400 mg orally, 12-hourly
discharge — which might be white, gray, for 5-7 days.
yellow or green
 Genital redness, burning and itching

 Pain with urination or sexual
intercourse Nursing Management:
 Antibiotic treatment
 Avoid vaginal, oral, and anal sex until
antibiotic treatment has eliminated the
parasite
 Treat all sexual partners to avoid re-
infection
 Avoid unprotected sex
 Prioritize sexual safety:
o Talk about protection methods
Trichomoniasis rarely causes symptoms in men.
with all partners
When men do have signs and symptoms, o Use condoms and other
however, they might include: protective measures
 Irritation inside the penis consistently and properly
 Burning with urination or after o Seek medical advice upon first
ejaculation signs of infection
 Discharge from the penis