An Analysis of the Role of HPV in Human Health, Disease and Public Health

Introduction

The human papillomavirus (HPV) is a diverse group of infectious viruses which afflict the mucosal cells and skin which normally serve as a demarcation between the external surroundings in human beings. They often manifest in a wide array of varieties but are generally divided into low-risk (LR) and high-risk (HR) carcinogenic versions. These pathogenic types were formally referred to as skin warts in ancient times and have been cited numerous times by the Roman physician Aulus Celsus. Nevertheless, its isolation first occurred in the first half of the 20th century when Richard Shope, a renowned American virologist, first isolated it (Rajkumar, 2016).  The transformation of papillomaviruses coincides with the evolution of mammals and reptiles which have traditionally been regarded as higher-order vertebrates.  This double-stranded DNA virus affects the epithelium by setting its cytopathic effect into motion and affecting its subject in a persistent fashion. Normally, it is transmitted through skin-to-skin contact; often sexually after which it proceeds to affect the anogenital area.  The virulence of specific versions of HPV usually varies, but most proceed to cause cancer by causing precancerous lesions on infected individuals. An evaluation of HPV in human health, disease and public health is thus critical in aiding the understanding of this disuse as a pathogen with a high likelihood of affecting a large demographic.

Microscopic, Cultivation and Non-Cultivation Methods for HPV

The traditional microscopic method for the diagnosis of HPV in a lab setting entails the use of cell culture and electron microscopy as early detection methods. Since it is not possible to cultivate the virus in cell cultures, diagnosis is done by means of an acetic acid test, biopsy, Pap smear or DNA test in an In Situ Hybridization setting (“Diagnosis of HPV Infections, HPV Testing in Patients,” 2018, p. 127). Acetic acid tests in non-cultivation often begin with a colonoscopy procedure by a trained clinician using a low-powered microscope. Acetic acid is then applied on the subject’s anogenital area as a precursor to obtaining biopsies for areas suspected to be infected with the virus.  The level of white lesions and mosaic patterns now serve as predictors for the presence of the virus in the culture. Moreover, the application of acetic acid allows the clinician to observe and asses the degree of infection. Experts recommend the use of colposcopy in extenuating circumstances such as when dealing with transplant patients who are evidently grappling with immunosuppression. Non-cultivation methods such as the use of colposcopy also allow experts to target abnormal tissues. Similarly, DNA techniques use direct probe hybridization to detect the presence of HPV virus in a controlled setting.

The Importance of Plasmids in Bacteria Genetics and in Genetic Engineering

Over the years, bacteria have been known for their prevalence and use of the double-stranded DNA in one of the most intricate depictions of complexity in the natural world. Their single circular chromosome contains plasmids which are circular DNA molecules. Bacteria select plasmids during conjugation from other bacterial cells with each of them having a unique replication sequence on the host bacterium. They can therefore multiply and copy themselves continuously in a bacterial cell to the extent of evolving and even becoming resistant to antibiotics. Plasmids protect bacteria and viruses from any extremes that may be encountered in their day-to-day survival. They are indispensible and use of the energy readily available in a cell made them a common hallmark of most virulent infections.

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Molecular biotechnology now dedicates most of its research to investigating plasmids as a way of understanding the delivery method used by vectors (Maver, Kocjan, Seme, & Poljak, 2015, p. 278). Engineering experiments now use DNA plasmids owing to their multiple cloning capabilities. Since it is easy to store DNA and move it at will whenever required in plasmids; from a test-tube environment to a more controlled cellular environment, scientists prefer using them in genetic engineering. Plasmids now become vectors during scientific experiments. The availability of selectable markers, the presence multiple cloning sites and an inherent origin of replication are the primary reasons why it is most preferred during genetic engineering.     

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Human/Microbe Relationship

Typically, healthcare practitioners usually endeavor to aid individuals infected with HPV to recover within the shortest time possible. Nevertheless, there are a myriad of immunological factors that come in to play and provide a window into the complex human/microbe relationship that exists with regard to the adaptive immune system. Attempts to manage the virus are normally hampered by a sophisticated evasion strategy honed over time to evade the immune response, resulting in malignant transformation. The result is a complete takeover of the immune system and the inception of chronic pro-inflammatory response that create a favorable environment for the development of tumors and the rapid progression of cancer (Kaste & Dolecek, 2014, p. 123). It is also critical to note that genetic variants in the host impact the viruses’ effects on the said individual and may affect infection outcomes. The virus harmonizes its infectious cycle with the intent of targeting its host’s cells and gaining entry to the epithelial cells. It then synchronizes with the epithelial differentiation program and continues to replicate undeterred after activating its viral cycle. HPV has worked its way around the innate immune system and impairs any response by the body including the transcription of cytokines and pro-inflammatory chemokines.

Virulence

E6 and E7 proteins are major virulence factors when dealing with HPV. Their presence often denotes the presence of high-risk papillomavirus. Any tumor suppressor present in the host is rendered inactive by the proteins which makes it increasingly difficult to regulate normal cell dividing rate. This results in a quick progression in the proliferation of cells that worsens the virus’ cancerous effect.

Prevention and Treatment Strategies

HPV is a now emerging as a disease burden threatening the provision of public health across the United States. It is currently estimated that the annual cost of successful HPV treatment is $210 million since it causes 5% of cancers (McKain, 2015). Since it is highly communicable, it can be prevented using vaccines such as Gardasil and Cervarix which are highly effective.  The use of condoms, abstinence and monogamy can also reduce infections considerably. Regular screenings are also critical as a preventative measure. Early diagnosis lowers cancer-related deaths. Consequently, the most common and convenient treatment method is the use of topical products such as podofilox (Condylox) which contains antimitotic properties critical when combating HPV. A licensed physician can also remove the warts in a hospital setting using topical podopphyllin resin which destroys the virus through protein coagulation.

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