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Chapter 19: Papilloma and Polyoma Viruses

INTRODUCTION

Historically, the papillomaviruses and polyomaviruses have been discussed together in microbiology textbooks, lumped under the category of papovaviruses. Papovaviruses are now split into two separate families: Papillomaviridae and Polyomaviridae. The unique characteristics that distinguish them from each other are shown in Table 19–1.

TABLE 19–1Characteristics of Papilloma and Polyoma Viruses
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TABLE 19–1 Characteristics of Papilloma and Polyoma Viruses
VIRUS SIZE HUMAN SUBTYPES TRANSMISSION DISEASE TREATMENT PREVENTION
Papillomavirus 55 nm HPV-1-4, 7, 10 Close skin-to-skin contact, occupational exposure, public shower/swimming pool

Skin warts

Common warts

Plantar warts

Flat cutaneous warts

Meat/fish handler warts

 Topical cytotoxins or surgical removal  
Papillomavirus 55 nm HPV-6, 11 Close contact, sexual contact

Oral, laryngeal papillomatosis

Genital warts (condylomata accuminata)

 Treatment of laryngeal lesions is complex, varied HPV vaccine
Papillomavirus 55 nm

HPV-16, 18

31, 33, 45, 52, and 58

 Sexual (anal, vaginal, oral) Cervical, oropharyngeal, other neoplasias May be removed by electrocautery HPV vaccine
Polyomavirus 45 nm BKV Respiratory, oral, contaminated food or water (?) Hemorrhagic cystitis in transplant recipients; postrenal transplantation nephropathy Cidofovir maybe used, but is not proven  
Polyomavirus 45 nm JCV Respiratory/oral contaminated food or water (?) Progressive multifocal leukoencephalopathy (PML) Reduce immune suppression  

BKV, BK virus; HPV, human papillomavirus; JCV, JC virus.

PAPILLOMAVIRUSES

Overview

Human papillomaviruses (HPVs) are the most common sexually transmitted infections in the United States. HPVs are naked capsid, icosahedral, double-stranded circular DNA viruses that replicate in the nucleus of the infected cell by using host RNA polymerase for transcription and host DNA polymerase for genome replication. More than 100 genotypes of HPVs have been identified in human specimens. The genotypes are antigenically different, and groups of genotypes are associated with specific lesions, and low-risk or high-risk genotypes for cancers. HPVs are transmitted through skin-to-skin contact and through vaginal, anal, or oral sex. HPVs have been identified in common hand warts, plantar warts, flat cutaneous warts of other skin areas (HPV 1-4, 7, 10); in juvenile laryngeal papillomas (HPV 6, 11); and in a variety of genital hyperplastic epithelial lesions, including cervical, vulvar, and penile warts and papillomas (HPV 6, 11, 16, 18). In addition, they are associated with premalignant cervical intraepithelial neoplasia (CIN) and malignant disease, cervical cancer (HPV 16, 18). Lesions comparable to those occurring in the cervix are now recognized in the anus, especially among men who have sex with men (MSM) and those who are infected by HIV. HPV 6 and 11 (low risk) are the most common genotypes associated with genital infections and cause benign condylomas, condylomata acuminata, HPV 16 and 18 are considered the high-risk genotypes because of their potential to cause malignant cancers such as cervical cancer in women and oropharyngeal cancer mainly in men. While a majority of HPV-associated infections are benign and cleared by the immune system over time, some progress to malignancies. HPV can be ...

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