Talk:Human papillomavirus

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Contents 1 Questionable Sentence 2 Suggestions 3 The HPV Test 4 General discussion 5 expand 6 taxonomy of HPV 7 NPOV; sources 8 "student"? 9 NPOV and quotes in controversy section 10 oncogenic HPV 11 Missing out on treatments. 12 treatments 13 What are these magical words? 14 Rearrangement 15 HPV 6-11 16 Prevention 17 Good 18 On another note 19 Some additions 20 Western disease? 21 External link 22 Incidence vs. Age Graph 23 Risk for Anal Cancer -- So WHY not adminstered to young men!!! 24 cited sources - reference list 25 75% figure?

[edit] Questionable Sentence

A recently approved HPV vaccine that blocks initial infection with several of the most common sexually transmitted HPV types may lead to further decreases in the incidence of HPV-induced cancer (Lowy and Schiller 2006). This sentence seems a bit misleading and may even be contradicted by a the CDC in a recent CNN article on HPV. [1] Please take a look and judge for yourselves but in order to be completely fact based this sentence perhaps should be removed.

[edit] Suggestions

The ["HPV-induced cancers" figure] and the text ("Sexually transmitted HPVs also cause [...] approximately 25% of cancers of the mouth and upper throat") seem to radically disagree. The figure doesn't show anywhere near 25% attributed to mouth and throat.

I'd like to see some specific statements about the impact of HPV on males, both heterosexual and homosexual. An FAQ I wish were answered, for example, are the risks to a male whose partner has been diagnosed with HPV.

In the interest of public service and reducing the spread of disease through easy access to information, it may be worth refocusing the initial paragraphs to address the key basics about risks (e.g. cancer), transmission (more specifics here would help, as "environmentally", "casual skin-to-skin contact", and "sexually" are all listed), and prevention.

Wikipedia becomes a more mainstream reference every day. I'm certainly not suggesting that the entire article be "dumbed down". But not everyone who comes to this page is a scientist, doctor, or even has an average IQ or better. Those who need more information will read further down. But many may not get past the top-most page. Just a thought. -- MKC 14:15, 8 February 2007 (UTC)

[edit] The HPV Test

I see information about prevention and about the vaccine, but I don't see any information about The HPV Test that can help detect whether or not a person has the virus. Some valuable information can be found at The HPV TEST and might be a valuable addition to this wikipedia page. --TrisDG 16:33, 5 December 2006 (UTC)TrisDG

[edit] General discussion

I know a number of women who have HPV, and think it really sucks, and feel like sex ed failed to warn them of the dangers. I think this article very significantly downplays some of the dangers.

First, I'm not sure if it's fair to imply HPV goes away within 1 year. It doesn't -- some forms will cause irregular pap smears and will contribute to cancer for the rest of your life.

Second, while HPV is endemic, the "bad" forms of HPV aren't yet (the kinds that cause cancer, warts, or other problems) -- lots of people have them, but nowhere near 80% (this figure should be supported more strongly -- it seemed weaker in the source), so it's not fair to imply that "HPV is an almost unavoidable, and invisible consequence of sexual activity." It's really not. With one partner over a lifetime (or a very small number), you probably won't get a bad type. With many partners, you'll almost certainly have to go in for pap smears every few months. It's not as bad as AIDS in symptoms, but it sucks. With future partners, you'll either need to be dishonest about it (not mention you got it, or lie about having it), or you'll have a much harder time getting laid. If you do get laid, you'll spread it more. It's a very bad thing.

One other note: there's research that implies a connection between HPV and reoccurent urinary tract infections. It might be good to confirm how good this research is, and put up something about it. I saw it on a pretty sketchy web site, but it linked to a real medical article (http://www.health-science-report.com/cgi-bin/alotek.cgi?topics=1&article=111). I don't have access to the original article, so I can't confirm if it is being misquoted.

---

The text on this page is identical to http://www.niaid.nih.gov/factsheets/stdhpv.htm

I'm guessing that's a US govmt source, so we can use it. COuld someone confirm?

(same applied to Genital wart, I cut some text and moved it there -- Tarquin 11:19 Feb 26, 2003 (UTC))

It doesn't matter at all, since works of the U.S. federal government are public domain. Of course, that source isn't really an encyclopedic entry. The page is completely different now, though it also seems to be lacking adequate detail, considering how widespread a disease it is.. —User:Mulad (talk) 16:30, May 6, 2005 (UTC)

From the American Cancer Society Website: http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_cervical_cancer_8.asp?rnav=cri

"...condoms do not protect against HPV..."

"...certain types of sexual behavior increase a woman's risk of getting HPV: sex at an early age, having many sexual partners, having sex with uncircumcised males..."

"...it is necessary to have had HPV for cervical cancer to develop..."

I know circumcision is the norm in the US, but it bothers me rather a lot that I'm effectively accused of putting women at risk of cancer by not mutilating myself. What's the science behind that? There's no actual explanation on that page. Chris 11:03, 27 August 2005 (UTC)

There is a statistically insignificant increase in HPV transmission from uncircumsized men to females and other men (and vise-versa in both cases). This doesnt mean that the same will hold true through more study. ITs rather doubtful should a firm and significant link be found that it would be related to the actual pysical functioning of the genitallia, but rahter realted to lifestyle. More firmly religious people are cicumsized per capita than religiously liberal and non-religious peoples; which makes it probable that they are havign more sex with more partners. In any case, a condom pretty much solves the problem aside from rare cases where HPV is spread even with the use of a condom in which case circumsision has nothing to do with it anyway. --LouieS 03:26, 29 August 2005 (UTC)

---

I have a good friend who had cervical cancer 2 years ago and it was not from HPV. She told me that there were, I think, 6 other women who had the cervical cancer she had and none were from an STI and that they were all being written up in medical journals. She was the youngest of the 6 or 7 and she is the only one who lived. So, for what it's worth, I take issue with the statement that 100% of cervical cancer is caused by HPV. I'm sorry I don't have any medical references for this, maybe someone with better access to medical journals could find something.

Also I'm confused that the beginning of the article states, "HPV infection is a necessary factor in the development of nearly all cases of cervical cancer," which would support my statement above; but then under "HPV-induced diseases:Cancer" it says, "...women with no history of the virus do not develop this type of cancer." Which is it - it causes NEARLY ALL cases or it's impossible to get cervical cancer without history of HPV? Or am I reading this incorrectly? I understand it's two different sources, but perhaps this article could choose one over the other or be more specific. 67.170.222.207 09:21, 10 February 2007 (UTC)

I brought this up as well, this improper use of the term all. Apparently my comment was deleted, but this really is an issue for me and others. 99% is the bare minimum percentage acheived before you should use the term all (medically it is 99%, scientifically it is 99.9%). The best estimates I have seen put the cancer/HPV link at 90%, well below the threshold for such rigid language.

[edit] expand

this needs more info.

• how is it transmitted? other sites say by "skin to skin contact". but you can't get it from holding hands. what do they mean exactly?

• does the virus stay in your body and contagious after the symptoms have cleared up? can you still give it to others? does it ever fully disappear? (i believe the virus stays in one's body and contagious forever).

• does it create symptoms in both men and women? (i believe symptoms in men are rare)

• a google search shows several different vaccine studies. can we get more details about them?

You CAN get HPV from holding hands and kissing, HPV is simply a virus that causes warts of any kind, not only genital warts; though genital warts can be spread even without sexual activity. The virus staying in your body depends upon they type, many types a killed through an immune respose within eight months (sourced from NIAID), HPV can be sprad to others without and symptoms present. Symptoms in women are more frequent but less often noticed. There is a vaccine in the works effective agains 16, 18, and 31 i believe which are the main HPV contributors to cancer. Though HPV is NOT the only way for cervical cancer to develop though it is the most common cause, I don't know where ACS gets their facts from, but those are bad ones. http://www.ashastd.org/hpvccrc/patientfaq.html --LouieS 18:38, 22 Jun 2005 (UTC)

[edit] taxonomy of HPV

The taxonomy of HPV has changed. E-M De Villiers et al publication in 2004 indicateds that Papillomavirus is the Family. alpha is the genus species 9 is one of the oncogenic species and within species 9 are the oncogenic types: including type 16. Within HPV type 16 are the variants of HPV 16 that make it slightly different the world round.

[edit] NPOV; sources

The article seems to the lack the former and needs the latter. Andre (talk) 19:55, 19 October 2005 (UTC)

I can work on it some, what in particular strikes you as needing work? Delldot 18:06, 6 November 2005 (UTC)

[edit] "student"?

"HPV is a student..."? (Complete with a link to "student" entry)

I assume this a typo for "virus"?

Yeah, that was vandalism. The person's been warned. Thanks for noticing! Delldot 18:06, 6 November 2005 (UTC)

[edit] NPOV and quotes in controversy section

I tried to NPOV the Controversy section of the article by representing the other side as well, though if you think I've gone too far in that direction you might tweak it some or add more info.

Also, I was concerned because there was a quotation in there that wasn't cited. There were three sets of quotes. Here's how it looked: "Because the vaccine protects against a sexually transmitted virus, many conservatives oppose making it mandatory, citing fears that it could send a subtle message condoning sexual activity before marriage...'I've talked to some who have said, "This is going to sabotage our abstinence message,' " said Gene Rudd, associate executive director of the Christian Medical and Dental Associations. So I removed the outer set of quotes. Does anyone know who we're qoting with the outside quotes? I was worried this text might be cut and pasted from somewhere. Thanks, delldot | talk 18:11, 18 November 2005 (UTC)

[edit] oncogenic HPV

The reference below disputes that HPV 16 & HPV 18 are the most common. I wonder whether this is due to geographical variation (like HIV-1, the primary strain in North America, vs. HIV-2, the primary strain in Africa).

Anyone have an idea about the geographic variance of HPV strains?

Andersson S, Mints M, Sallstrom J, Wilander E. The relative distribution of oncogenic types of human papillomavirus in benign, pre-malignant and malignant cervical biopsies. A study with human papillomavirus deoxyribonucleic acid sequence analysis. Cancer Detect Prev. 2005;29(1):37-41. Epub 2005 Jan 26. PMID 15734215

Nephron 00:16, 6 February 2006 (UTC)

[edit] Missing out on treatments.

[[It could be helpful if there was information regarding how the infection can be treated - what treatment can be offered to a victim. As it says there has been found no cure then we know that, but options of treatments are an important part. Correct me if I am wrong - I might not be seeing it. ]]

Since the treatments for common warts, genital warts, cervical pre-cancer and cervical cancer are very different, I think detailed discussion of treatment options belongs in those separate articles. Retroid 22:06, 10 June 2006 (UTC)

[edit] treatments

Treatments: medications, freeze warts, laser treatment, cutting and radiation (cancer).

[edit] What are these magical words?

...whose mission is to generate a cornified layer that seals the body and prevents dessecation. In this upper layer the late viral proteins L1 and L2 are expressed. They bind the viral DNA and autoassemble, giving rise to the complete virions, ready for a new infection, that are released as the dead keratinocytes descamate...

The first word dessecation? Is this passage really talking about dehydration? Secondly, descamate??? Is not a word that I can find at all, but is apparently a googlewhack.

Was this just vandalism, or a misspelling of a real word? I am not studying biology, so I really haven't a clue.

-Redwraith9

first time at site; these look like dessicate and desquamate. Sfahey 20:56, 18 August 2006 (UTC)

[edit] Rearrangement

This discussion page leads me to believe that most people who arrive at this article are primarily interested in HPV-related diseases. I therefore moved the general discussion of papillomavirus biology to the main article Papillomavirus. I also attempted to re-focus the intro and put the various HPV-related diseases in perspective. I think the Effects section could be organized a little better, but I wanted to give people a chance to object to the current changes first. I'm compiling a list of HPV-related articles on my Talk page - feel free to modify. Retroid 13:27, 28 May 2006 (UTC)

I certainly agree the articles (still) have too much overlap, and with (I expect) many more visitors here than to "papillomavirus" it's strange to refer to the latter in the lead paragraph as the "main" article. It seems to me that the best option for divvying up info between "P" and "HPV" should be 1) "HPV" having a brief "Biology of ..." section, with a header saying "See "P""; and 2) "P" having a brief "HPV and human disease" section, with a header saying "Main article: "HPV"". On a different note I am going to move those annoying top of the page comments down "below the box." Sfahey 21:34, 18 August 2006 (UTC)

[edit] HPV 6-11

Can a person contract the virus from merely touching the virgina with a hand, no prenetration?

Probably yes. Some epidemiological studies have found that adolescents begin to acquire genital HPV infections prior to engaging in penetrative sexual contact. It's therefore thought that mutual genital "petting" can result in transmission of genital HPV infections. Retroid 22:03, 10 June 2006 (UTC)

[edit] Prevention

There are problems in the passage about prevention: "Sexually-transmitted HPV infections may be distributed widely over genital skin and mucosal surfaces, and transmission can occur even when there are no visible symptoms. Thus, the only sure way to prevent genital HPV infection is to abstain from any contact with the genitals of another."

There is a logical flaw in this statement. Assuming all else is true the second sentence could be reworded as: "Thus, the only sure way to prevent sexually-transmitted HPV infections is to abstain from any contact with the genitals of another"

This may still be incorrect, eg. if another person could touch their infected genitals and then touch yours and infect you.

If the only way (other than childbirth) that HPV can only be spread is through "sexual" contact, then "Sexually-transmitted HPV" would be better worded as "All post-natal transmission of HPV is through sexual activity", or more acurately: "All post-natal transmission of HPV occurs through direct genital to genital contact."

I don't know what the situation is, but the current wording needs to be changed.

You could say, "The only sure way to avoid genital HPV infection would be lifelong sexual abstinence." That's technically accurate since it's thought that occasional infection of infants during birth is generally oral/respiratory (not genital). Anyway, even the reformulated sentence bugs me because it doesn't seem like especially useful advice for most folks. How about "People with greater numbers of sexual partners are at increased risk of developing HPV-related diseases."

The Prevention section could cover A) Pap smear and new HPV DNA tests, B) the new HPV vaccine, C) limiting # of sexual partners, D) condoms, E) topical microbicides.

Retroid 22:11, 13 June 2006 (UTC)

Oops, wasn't signed in when I implemented the above changes. 69.140.22.184 is me.

Retroid 18:15, 24 June 2006 (UTC)

[edit] Good

I probably shouldn't nominated since I once upon a time edited this article, but this is rapidly approaching good/featured article status. Maybe a pass through peer review? Anyway, congrats to Retroid, et al. jengod 08:03, 15 July 2006 (UTC)

Maybe after the introduction is sorted a bit more. It's huge. 72.48.26.130 07:35, 29 July 2006 (UTC)

Some material from Papillomavirus sneaked into the Intro section - in my opinion it resulted in some redundancy and a few bits of relatively arcane biology. I consolidated the redundancies and stripped out the arcane factoids. My theory is that the great majority of people arriving at this article are investigating A) Merck's "a virus causes cancer?!" vaccine ads, B) an abnormal pap smear, C) warts of some kind. So I'm with User 72.48.26.130 - the Intro should be terse and focus on HPV diseases. Retroid 23:29, 31 July 2006 (UTC)

See also Talk page for main article Papillomavirus. Retroid 14:30, 5 August 2006 (UTC)

[edit] On another note

The article would benefit from an actual cosmetic image of the HPV symptoms (warts etc) on a living human subject.

Image of Pap smear cells does the job nicely - good one, Euthman! Retroid 14:30, 4 August 2006 (UTC)

This is about the virus; pictures of genital warts belong in genital warts. — Omegatron 23:16, 4 August 2006 (UTC)

[edit] Some additions

I found the articles about Apoptosis and Necrosis linking to this page, I was checking for a place to insert a link about 'Apoptosis' in this article which may reveal informative on the subject, but I wasn't sure if it would apply to warts in general or common/plantar warts, or where I could insert it, a new text, in the current text or references. --TiCPU 18:52, 31 July 2006 (UTC)

One function of the papillomavirus oncogenes E6 and E7 is prevention of apoptosis. I added a link to Apoptosis in an appropriate spot in the main article Papillomavirus (and vice versa). Retroid 14:17, 4 August 2006 (UTC)

(New User here:) I wonder about the word "ASCUS" in the section labeled Prevention. This word isn't linked to anything. It's thrown around by my doc regularly, but yet I do not know what it means. When I look it up in the dictionary, it just talks about fungus. When I look in wiki it says the same thing. Can someone with some medical knowledge give a definition for this word and place it in this article. (Or write a little wiki page and link to there???) This user would be very appreciative.

[edit] Western disease?

Is this disease prevalent outside the West? I'm pretty sure it isn't.

Becuase only people in the West fuck? --Lincoln F. Stern 19:37, 21 February 2007 (UTC)

In my personal experience it's prevalent (as in an issue that is big enough to attract goverment and media attention) in Singapore. --PeterMarkSmith 03:40, 22 February 2007 (UTC)

HPV-associated cervical neoplasia is leading cause of dead from cancer in women in developing countries. in developed countries its second just behind breast cancer. thanks to early detection, pap smear etc. Xmort 14:24, 22 February 2007 (UTC)

[edit] External link

A well written article has been written that summarized treatment of HPV in "college-age" patients. This article is located at http://www.collegehealth-e.com/4/n02.htm any thoughts?

—The preceding unsigned comment was added by 71.127.172.67 (talk • contribs). 03:36, 9 October 2006

This user was adding www.collegehealth-e.com links to multiple medical articles. And has now engaged in dialogue - thank you. The articles are well written and, more importantly, well sourced. The problem is more of whether content should be added to wikipedia articles or external links. Ideally no external link should be made if it fails to add greater information than the finished article should have once it reaches featured-article status. In this case I think the collegehealth-e.com is generally more detailed. Secondly wikipedia is not here to act as a link to other sources - we don't have one-to-one links to the equivalent article at Encyclopaedia Britannica or Encarta - yet I appreciate that collegehealth-e.com is not trying to be an encyclopaedia on all topics. I am more uncertain the more collegehealth-e.com articles I look at, perhaps this is a useful resource? But if so, should it be a standard external link resource provided by Template:Disease infobox ?

Certainly populating multiple wikipedia articles without discussion strikes me as probably spamming... I'm going to raise the issue of the general appropriateness/usefulness of collegehealth-e.com links at the Clinical Medicine wikiproject – so please join discussion at Wikipedia talk:WikiProject Clinical medicine#www.collegehealth-e.com links. David Ruben ^Talk 03:01, 9 October 2006 (UTC)

[edit] Incidence vs. Age Graph

Shouldn't the incidence vs. age graph have some sort of metric on the y-axis? Ahhwhereami 01:26, 15 November 2006 (UTC)

[edit] Risk for Anal Cancer -- So WHY not adminstered to young men!!!

Why is the vaccine only approved for women?

I guess cervical cancer in heterosexual women of child-bearing age is more important than anal cancer in young gay/bisexual men.

Maybe they think vaccinating males will encourage them to have buttsex? --Lincoln F. Stern 19:39, 21 February 2007 (UTC)

They can't test men for the virus, thus they would have no way of knowing whether or not the vaccine worked. Pelargonium 09:15, 27 March 2007 (UTC)Pelargonium

[edit] cited sources - reference list

I noticed that recent edits cite a source (Richman) but do not include the full citation for the book or article in the reference list. I've requested this from the (new) editor HEYNURSIE on their talk page. Keesiewonder 11:04, 16 December 2006 (UTC)

[edit] 75% figure?

Baseman and Koutksy, 2005 does NOT have any reference to the quote that "with estimates suggesting that up to 75% of women will become infected with one or more of the sexually transmitted HPV types at some point during adulthood (Baseman and Koutsky, 2005)" Matter of fact, the number "75" is not in the text.

In the paper, it does say that >50% of women will contract one of the HPVs at some point. In the reference section of this Wikipedia article, someone states that "Note: the abstract of this paper states that 60% of initially HPV-negative women became infected over the course of five years of follow-up. 20% of the women in the study population were already infected at the onset of the study. This supports the conservative 75% figure given in the introduction section."

This may indeed be true for the Woodman study of English girls (ages 15-19), but may not be sufficient for generalization. At the very least, the 75% number needs a confirmatory reference, as Baseman and Koutsky's 2005 paper cannot be used as justification. 129.74.81.217 19:50, 9 February 2007 (UTC) jKay