The Study of HPV and Its Vaccines

Arjun Luthra
Mentor: Dr. Sanjiv Sur and Dr. Tanvi Patel
Department of Immunology and Allergy
UTMB Multispecialty Care Center
Teacher: Mrs. Kristi Click

Introduction

ISM HST Spring Semester 2016

Mentor: Dr. Sanjiv Sur and Dr. Tanvi Patel

Allergy/Immunology

UTMB Multispecialty Care Center

Dr. Patel is completing her first year of fellowship in the department of allergy and
immunology. Dr. Sur received his M.D. degree in Kanpur, India. He completed his
residency at University of Maryland.

What is Independent Study Mentorship

ISM is an advanced academic course that allows students to observe and follow a mentor,
an adult professional within their field of interest
Students are expected to research and develop a presentation on a specific topic within
their chosen field of study
Students are required to dedicate two hours of mentorship work and three hours of ISMrelated activities per week.
Students are required to report their findings in a weekly activity log and journal entry
Students are also required to develop a collegiate-level tangible final product to
supplement their final presentation

Weebly Site

arjunluthraism.weebly.com

The Study of HPV and Its Vaccine

This topic is pertinent and relevant to all age groups, especially adolescent individuals
and individuals going through college education.

Key Points of Presentation

Overview of Human Immunity: Adaptive and Innate Immunity

Discussion of Humoral vs Cell-Mediated Immune Response

Causes and Symptoms of HPV

The Diagnosis and Prevention of HPV

Information on the HPV Vaccine

Recommendations for HPV vaccinations

Purpose of the Immune System

Protect host from pathogens

Help host eliminate toxic and allergenic substances that enter through mucosal surfaces

How does the immune system differentiate between beneficial and harmful microbes?
Adaptive vs Innate Immunity

Innate: Consist of biochemical defense mechanisms that provide hard-wired response to

infection and are usually specific to broad groups of microbes
Phagocytic cells(macrophages), NK cells
Adaptive Immunity: Recognizes new foreign substances, develop specific immune
responses that reacts to specific antigens
Lymphocytes

Humoral Immunity and Cell-Mediated Response

Humoral Immune Response consists of lymphocytes secreting antibodies that prevent

infections by eliminating extracellular microbes
Cell-Mediated: T lymphocytes activate macrophages to kill phagocytosed microbes or
eliminate cell reservoirs of infection

The Human Papillomavirus

HPV is the most common sexually-transmitted infection.

Statistics for HPV

About 79 million Americans are currently infected with HPV. About 14 million people
become newly infected each year. (Center of Disease Control and Prevention
Persistent infection by oncogenic HPV types is a prerequisite for the development of
cervical cancer, which each year hits about 528000 women and causes 266000 deaths
worldwide(World Health Organization)

Human Papillomavirus and the Immune System

More than 100 types of human papillomaviruses are known

About 40 types of HPV affect the squamous epithelium of the skin and mucosal
epithelium of anogenital region
The Human Papilommavirus has several mechanisms of avoiding the immune system:
o No inflammation
o Infection is exclusively intraepithelial
o No blood-borne or viraemic phase
o Inhibiting interferon synthesis
o With these evasion techniques, the virus is able to duplicate quietly

Symptoms of HPV

HPV can be asymptomatic (patients may have infection without any presented symptoms
or health complications)
Genital warts, symptom of HPV, are usually flesh colored, firm growths or bumps that
appear on areas such around the vagina or anus, on the cervix, the penis, scrotum, groin,
or thigh

The Correlation between HPV and Cancer

Gene E6 inhibits the tumor suppressor p53 and allows for carcinogenesis
HPV 16 and 18 are responsible for 70 percent of the incidence of cervical cancer
worldwide
The 20 percent of individuals with persistent infection often get cervical intraepithelial
neoplasia, chromosomal instability and progressive development to resist the bodys
immune response
In addition to cervical cancer, HPV is associated with HPV infection lead to vaginal,
vulvar, penile, oropharyngeal and anal cancers

HPV Vaccine

The vaccine has no value in treating existing HPV infection, but functions in developing
immune memory
Most effective vaccine was developed as a result of technology that allowed recombinant
DNA to generate virus-like particles that mimic the virus

Antigen dose in vaccine is higher than in natural infection, which allows for activation of
the innate and adaptive immune response
IgG, an antibody found in extracellular fluid and the blood, reaches its maximum height
after the third dose of the immunization

Recommendations for HPV Vaccinations

According to the CDC, children of the age of 11 to 12 should get vaccinated for HPV
Young women can get HPV vaccine through age 26, and young men can get vaccinated
through age 21
Administration of the immunization occurs in three doses of separate times(specifically
2vHPV, 4vHPV, and 9vHPV)

Effectiveness of the Vaccine

The neutralizing antibodies developed through immunizations are often heterogeneous

meaning that they can be cross-reactive and can also serve for nonspecific HPV types
Long-term protection against HPV is questionable, but with more developing efficient
vaccines, the length of time of protection is being extended

Recommendations for HPV Vaccine

If you are below the age of 15, it is advisable to have each dose about 12-15 months apart
If you are above the age of 15, it is advisable that the vaccine is given within 6 months
apart

Those with hypersensitivity to yeast, should not receive the 9vHPV vaccine

Individuals with anaphylactic latex allergy should not have the 2vHPV vaccine

Women in their pregnancy should not receive the HPV vaccine

It is strongly advised that individuals with HIV or are immunocompromised should get
the HPV

Other Recommendations

All vaccinated patients should practice abstinence or protective sexual behaviors

Women are suggested to get a pap smear test to check for infection or development of
cancer

Side effects of HPV Vaccine

Data conclusively show that vaccines do not cause major health problems, and symptoms
after immunization range from low to moderate in site-related pain, swelling and
erythema

HPV and the Youth

Adolescents who are sexually active have the highest incidences of HPV infection rates
Over 50-80% of adolescents with infection develop it within 2-3 years of initiating
intercourse.
Unlike bacterial meningitis, HPV is not a required vaccine for entry into a college or
university

Survey

Purpose of the survey was to evaluate high school students understanding of HPV and its
vaccinations.
To gather data, I used a google form to survey the participants. I shared the link on
facebook and individually messaged individuals to ask whether they will be willing to
participate.
Survey Results

About 11 percent said that they know someone with HPV

About 40 percent have received vaccinations for HPV

95 percent of the participants selected that HPV can be transmitted through skin to skin
contact.
About 48 percent said that there are three recommended doses for HPV vaccine.

Survey Graph

Human Papillomavirus

Considered to be a sexually transmitted disease(passed through oral sex and intercourse)

Genital warts are strong indicator of infection of the virus

Lives on the bodys epithelial cells(surface of skin)

The viral types 16 and 18 are the most common types in invasive cervical cancer,
accounting for about 70% of all cervical cancers

There are about 100 types

Common among adolescents and young adults

Final Product

Purpose: to educate people about the field of allergy and immunology

Hypothetical case studies which will discuss the diagnosis and treatment of diseases
related to immune system (specifically HPV and meningococcal disease)

Final Product

Conclusion

Questions?
My extensive research and data strongly find that it is increasingly imperative that youth
or individuals take medical action and get their HPV vaccines
I liked this experienced because along with learning about HPV, I learned about the
necessary precautions individuals must take when dealing with food, drug and latex
allergies

Thank you

I would like to thank my mentors, Dr. Sur and Dr. Patel. I would also like to thank my
parents and my teacher Mrs. Kristi Click for giving me this opportunity. I also appreciate
all the evaluators and audience members today for taking time to view my presentation.

Works Cited

Abbas, Abul K., Andrew H. Lichtman, and Shiv Pillai. Cellular and Molecular
Immunology. Philadelphia: Saunders/Elsevier, 2012. Print.
"Genital HPV Infection - Fact Sheet." Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention, 18 Feb. 2016. Web. 28 Feb. 2016.
<http://www.cdc.gov/std/hpv/stdfact-hpv.htm>.
"HPV Warts." Diseases Pictures. N.p., n.d. Web. 29 Feb. 2016.
<http://diseasespictures.com/hpv-warts/>.
Mariani, Luciano, and Aldo Venuti. "HPV Vaccine: An Overview of Immune Response,
Clinical Protection, and New Approaches for the Future." Journal of Translational
Medicine (2010): n. pag. National Center for Biotechnology Information. BioMed
Central, 27 Oct. 2010. Web. 28 Feb. 2016.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988719/>.

"01 Elements of the Immune System - Biology 1bg313 with Sandra Kleinau at Uppsala
Universitet - StudyBlue." StudyBlue. N.p., n.d. Web. 29 Feb. 2016.
<https://www.studyblue.com/notes/note/n/01-elements-of-the-immunesystem/deck/13502341>.
"Prevention and Control of Meningococcal Disease: Recommendations of the Advisory
Committee on Immunization Practices (ACIP)." Centers for Disease Control and
Prevention. Centers for Disease Control and Prevention, 22 Mar. 2013. Web. 28 Feb.
2016. <http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm>.
"Summary of the WHO Position Paper on Vaccines against Human Papillomavirus
(HPV)." World Health Organization. World Health Organization, 2014. Web. 28 Feb.
2016.