Lecture 16: STI's B

Question 1

Human Papillomavirus Virus

Answer 1

Causes genital warts and cervical
cancer

Question 2

Globally, __________
cancer is the second
most frequent cancer
in Women.

Answer 2

Cervical

Question 3

HPV Transmission

Answer 3

-Majority of transmissions occur as a result of sexual
contact or close personal contact

-Condoms appear to reduce transmission, but do not
provide complete protection.

Question 4

What type of HPV causes: most cervical cancer cases?

Answer 4

16, 18

Question 5

What type of HPV causes most genital wart cases?

Answer 5

6,11

Question 6

Broadly describe the mechanism of HPV disease

Answer 6

1- Microabrasions in mucosa
2- Infects basal katatinocytes
3- Differentiate and move into distal mucosa
4- Viral assembly as cells move into mucosa
5- Infectious virus sheds
6- Chromosomal integration

Question 7

On the order of _______, HPV progresses to invasive carcinoma. It moves from low-grade to high-grade _____________ __________ ________ and then eventually, invasive carcinoma

Answer 7

Years
squamous intraepithelial lesions

Question 8

How do clinicians diagnose HPV?

Answer 8

Clinical signs, PAP, virus culture, PCR

Question 9

Why is serology not useful in diagnosing HPV?

Answer 9

High levels of seroprevalence

Question 10

How is HPV treated following a diagnosis?

Answer 10

Local therapy: imiquimod immune enhancer
Liguid nitrogen or surgical removal

Question 11

How do we prevent HPV?

Answer 11

Vaccine, which contains 6,11,16, and 18 which are accounted for 95% of cervical cancers

Question 12

What vaccine technology is used in HPV inocculation?

Answer 12

Recombinant technology where proteins for virus-like particles (VLPs) of the L1 protein

Non-infectious
Not live biological products

Question 13

What type of virus are HSV?

Answer 13

DNA viruses; HSV1 is more common

Question 14

What is the most common cause of genital ulcers?

Answer 14

Herpes virus

Question 15

When is herpes contagious?

Answer 15

Before the lesions appear, reccurrence is more common in HSV-2 in the genital area

Question 16

HSV-1 is commonly found…

Answer 16

Above the belt, humans only natural host

Question 17

HSV-2 is found…

Answer 17

Below the belt

Question 18

Talk about the pathophysiology of HSV

Answer 18

Lifelong infection, replicates in host nucleus, neurotropic, neuroinvasive replilcates in 8-16h

Question 19

What leads to HSV transmission?

Answer 19

Contact with mucous membrane, reactivation linked to stressors

Question 20

How is HSV treated?

Answer 20

Antiviral therapy- Acyclovir
Reduces risk of transmission to partners, not a cure

Question 21

What is more severe? A reccurent episode following intensive stress or the primary episode of an HSV infection ?

Answer 21

Primary

Question 22

HIV has tropism for _______ of the host ________ system

Answer 22

CD4 T cells, immune

Question 23

Where does HIV replicate?

Answer 23

In host CD4 T cells and macrophages

Question 24

How is most HIV transmitted?

Answer 24

Sex

Question 25

What chanes the chances of HIV transmission?

Answer 25

Amount of virus, amount of target cells in HIV-neg person, type of sex, presence of viral and bacterial co-infections

Question 26

Describe the stages of an HIV infection

Answer 26

In the acute phase, theres a rapid increase in HIV and killer cells, while helper T-cells decline. Antibodies begin to rise Over next decade... T-cells-decrease Antibodies- initially increase then rapidly decline approaching aids Killer cells- initial rise and decline HIV load- increases Once we reach AIDS, Increase in HIV, decrease in all other factors

Question 27

Where do we find CD4 T cells?

Answer 27

Blood and variosu anatomical sites HIV replicaes at various mucosal sites in the female and male genital tract

Question 28

When is RNA highest in a patient's semen?

Answer 28

In the initial phases, during seroconversion and in the acute infection phase over the first few weeks. Then there is a decline and the an increase as the client develops AIDS

Question 29

What happens with each STI episode or reactivation?

Answer 29

An increase in HIV RNA levels, this is tied to disease progression and risk of transmission

Question 30

Name some biological factors that increase a client's risk for HIV

Answer 30

Transmission: changing blood viral load, genital viral load, stage of infection Susceptibility: number of target cells, immune activation, tissue type, genetic factors

Question 31

Lab testing for HIV

Answer 31

HIV EIA tests for P24 antigen and gp120 antibody Positive test? Western blot (blood)

Question 32

What is the most common CURABLE STI in USA?

Answer 32

Trichomonas vaginalis

Question 33

Trichomonas Vaginitis

Answer 33

Protozaon parasite, 70% infections are asymptomatic Dx: Wet mount