Unit 1: Sexuality -STI HPV (Human Papillomavirus)

Another name for HPV

Condylomata Acuminata...or genital warts

Assess for: Itching (Pruritis) Vag discharge Dyspareunia (Difficult or painful sexual intercourse) post-coital bleeding "Bumps" on the labia (or urethra or scotum on men)

HPV

Estimate 50% of sexually active women will contract...

HPV

HPV Complication: May impede a vaginal delivery and require a C-section

HPV

Histologic evaluation of a biopsy of

HPV

No curative therapy exists

HPV

Common Viral STI

HPV (Condylomata Acuminata)

This may be more common in pregnant women. -Lesions way enlarge during pregnancy -affect urination, defecation, mobility, and fetal descent.

HPV (Condylomata Acuminata)

HPV Complication: 2 types of HPV responsible for cervical cancers

HPV 16 is the most common high-risk type of HPV and usually doesn't result in any noticeable symptoms, even though it can bring about cervical changes. It causes 50 percent of cervical cancers worldwide. HPV 18 is another high-risk type of HPV.

Although viral screening is available, diagnosis is generally done based on...

History and physical examination

To rule out cervical cancer...(Test)

Papanicolaou (Pap) test

HPV Complication: Children may sustain epithelial tumors on the larynx.

Papillomas are benign epithelial tumors that are caused by infection with the human papilloma virus (HPV). They are the most common benign neoplasms affecting the larynx and upper respiratory tract. Malignant degeneration to squamous cell carcinoma can occur, but is very rare.

flat topped papules 1-4 cm in diameter

Cervical lesions

HPV is transmitted via

SEXual Contact

Highest rate of HPV in women is from what years of age?

20-24 yrs (HPV) (Note Chlamydia was 15-24 peaking between 18 - 20 yrs)

Gloves should be changed to avoid cross-contamination...

-because lesions may exist on the labia/vagina and anus

Clients need to assume a healthy lifestyle...

-rest, diet, and hydration to maximize immune function

If pregnant, cultures done weekly from...

35 weeks until delivery

HPV has how many serotypes that are STI's ???

40

Lesions

Brown to black and are painless but uncomfortable. May resolve spontaneously without treatment but warts or cancer may develop late

HPV requires multiple treatments

Cryotherapy, laser, electrocautery, cytoxic agents or surgical removal of lesions during pregnancy

Includes bathing with oatmeal solution, blow with cool hair dryer, keep the area clean and dry, cotton underwear/loose-fitting clothing

Lesion Care

Assess for lesions around ...

around posterior part of the vaginal introitus, around the buttocks, vulva, vagina, anus, and cervix (lesions are 2-3 mm in diameter, 10-15 mm in height) —lesions occur singly or in clusters (cauliflower-like mass)

HPV-DNA

in woman over 30 years

Education

• Teaching about transmission and the importance of prevention are critical since there is no cure • HPV vaccines are recommended for 11 and 12-year-old girls and boys—protects against some HPV - three doses over 6 months • Clients may be taught about barrier methods (male/female condoms) and the benefits of limiting numbers of sexual partners to prevent disease transmission • Avoid sexual contact until lesions healed

• trichloroacetic acid (TCA) and bichloroacetic acid (BCA)

◦ Applied to warts ◦ Use petroleum jelly to protect surrounding skin ◦ May be painful upon application Trichloroacetic acid (TCA) is a treatment for genital and anal warts caused by human papillomavirus (HPV). It is a powerful chemical that kills warts by destroying the proteins in the cells. After repeated application, it will cause the warts to shrink and eventually disappear.

podofilox liquid gel

◦ Apply to affected area BID x 3 days weekly x 3 to 4 weeks ◦ Not for use in pregnancy/breastfeeding

Imiquimod (Immune response modifiers).

◦ Not during pregnancy ◦ Immune response modifier Imiquimod is in a class of medications called immune response modifiers. It treats genital and anal warts by increasing the activity of the body's immune system. It is not known exactly how imiquimod cream works to treat actinic keratoses or superficial basal cell carcinoma.