Human papillomavirus

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Background

  • Oncogenic double-stranded DNA virus in the Papillomaviridae family

Clinical Manifestations

  • Most commonly associated with warts (including genital warts), cervical cancer, and penile cancer
Disease Common Genotypes Uncommon Genotypes
Plantar warts 1, 2, 27 4, 26, 28, 29, 41, 57, 63, 65, 77, 117, 125, 128, 129, 130, 131, 132, 133, 148, 149, 179, 184
Common warts 1, 2, 4, 27
Warts of meat, poultry, and fish handlers 2, 7 1, 3, 4, 10, 28
Flat and intermediate warts 3, 10 27, 28, 38, 41, 49, 75, 76, 126
Epidermodysplasia verruciformis 5, 8, 9, 12, 14, 15, 17 19, 20, 21, 22, 23, 24, 25, 36, 37, 38, 47, 49, 50, 75, 93
Condylomata acuminata 6, 11 16, 18, 26, 31, 33, 35, 40, 42, 43, 44, 45, 51, 52, 53, 54, 55, 56, 58, 59, 66, 68, 70, 153, 175, 178, 180, 200, 201, 202
Intraepithelial neoplasia
Intraepithelial neoplasia (unspecified) 26, 30, 34, 39, 40, 53, 57, 59, 61, 62, 67, 68, 69, 71, 81, 83
Intraepithelial neoplasia (low-grade) 6, 11 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, 54, 61, 70, 72, 74
Intraepithelial neoplasia (high-grade) 16, 18 6, 11, 31, 33, 34, 35, 39, 42, 44, 45, 51, 52, 56, 58, 66, 67
Cervical carcinoma 16, 18 26, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 67, 68, 73, 82
Recurrent respiratory papillomatosis 6, 11 16, 18, 31, 33, 35, 39
Focal epithelial hyperplasia of Heck 13, 32 18, 33, 45
Conjunctival papillomas and carcinomas 6, 11, 16

Prevention

Vaccination

Vaccine Genotypes Schedule
Girls and Women Boys and Men
9 to 15 years ≥15 years Immunocompromised 9 to 15 years ≥15 years Immunocompromised
Cervarix 16, 18 2 or 3 dose 3 dose 3 dose not indicated
Gardasil 6, 11, 16, 18 2 or 3 dose 3 dose 3 dose
Gardasil-9 6, 11, 16, 18, 31, 33, 45, 51, 58
  • Two-dose schedule
    • Only indicated for children aged at least 9 to less than 15 years
    • Given at 0 and 6 months
  • Three-dose schedule
    • Indicated for everyone, including children 9 years and older, men and women 15 years and older and immunocompromised people
    • Given at 0, 2, and 6 months