papillomavirus
(pap‵ĭ-lō'mă-vī‵rŭs 
)
[papilloma + virus]
Any of a group of viruses that cause papillomas (warts) in humans and animals. They belong to the papovavirus family or group.
SEE: genital wart.
ABBR: HPV
A papillomavirus specific to humans and a common viral sexually transmitted disease (STD) in the U.S. A number of HPV types, esp. HPV 16, 18, 31, and 45, have been shown to contribute to squamous cell cancers of the anogenital region, including cancers of the anus, cervix, penis, and vulva, and cancers of the head and neck. Other HPV types (6 and 11) are responsible for genital warts. Worldwide, cervical cancer kills nearly 275,000 women every year.Vaccines that protect against cervical cancers include one with HPV 16 and 18 antigens (bivalent vaccine) and one HPV 6, 11, 16 and 18 antigens (quadrivalent vaccine).
HPV is the most common STD in the U.S.
Infection likely occurs via a disrupted epithelial barrier, such as a tear or abrasion that occurs during sexual intercourse or after minor skin injury such as a scrape.
Genital warts found particularly in the genitourinary area. They are most typically found on the anus, cervix, scrotum, groin, thigh, or penis.
HPV DNA confirms HPV infection. Two types of testing are completed: hybrid capture II and the polymerase chain reaction enzyme immunosorbent assay. Tissue biopsy may also be used to confirm HPV infection.
An HPV vaccine available in North America prevents infection by HPV types 6, 11, 16, and 18 and is most effective when given before the onset of sexual activity.
Imiquimod is used to treat warts of the genitals or anus. An alternative drug treatment is podophyllum. Cervical HPV lesions may be removed by loop electrosurgical excision procedure. Cryotherapy and laser surgery also may be used in treatment.
Encourage the patient to have a healthy lifestyle. Folate deficiency may increase the risk of cervical carcinogenesis, as does smoking and secondhand smoke. Assess the need for a nutrition or smoking cessation consultation. Make sure the patient understand s the use of all medications and also understand s surgical treatment choices.
In addition to explanations of all current treatments, teach patients strategies to prevent reinfection or infecting others. Provide additional instruction on transmission and identification of symptoms of other STIs. Because of the confidential and private nature of the health history and health teaching, interact with the patient in a private location where you are unlikely to be interrupted. While a list of partners for notification and treatment is not essential with HPV infection, it may be helpful so that the partners can be examined. Note that this procedure is apt to be embarrassing and stressful for the patient, who will require support and a nonjudgmental approach from the caregiver. Teach the patient safe sex behaviors.