Human Papilloma Virus (HPV)

A. DefinitionHuman papilloma virus (HPV) is a pathogen DNA yangmenyebabkan incidence of various benign tumors (warts) and several lesipramaligma and malignant. To date more than 100 known subtipeHPV, with 33 of them are known to infect the genital tract. HPVdapat infection causes cervical cancer, penis and anus. Transmission of HPV genitalhampir solely through sexual intercourse, although autoinokulasi danpenularan through fomite can also occur. Infection can be transmitted during childbirth kepadaneonatus. The biggest risk factor for the onset of HPV adalahjumlah sex partners. Smoking, use of oral contraceptives (OC), and kehamilantampaknya increase susceptibility to HPV infection.B. EtiologyHuman Papillomavirus (HPV) was identified as the cause kondilomaakuminata. Wart condyloma is located in the genital area (urethra, rectum genitaldan). Condyloma is a sexually transmitted disease and berpengaruhburuk for both partners. The incubation period can occur up to several bulantanpa signs and symptoms of the disease. Usually during kehamilandan more when there is excessive discharge from the vagina. Meskipunsedikit, cauliflower collection can grow and as a result adalahakumulasi materials in various parts of purulent, foul odor usually gray, pale yellow or red muda.Kondiloma akuminata is shaped bumps or warts bungakol a small tapered flowers grow up to form a group that continues to evolve sexually transmitted. Kondilomaakuminata found in various parts of the penis or sexual melaluihubungan usually obtained through the rectum around the anal canal, the woman found padapermukaan mucosa of the vulva, cervix, or around the anus in the perineum.
 Condylomata often seems fragile or easily distracted, can terssebar multisentris multifocal and varied both in number and ukurannya.Lesinya can be very widespread so as to master the normal appearance of the genitalia dananatomi. The most common body area is the frenulum, corona, the glans in the male and the posterior introitus in women.C. Clinical ManifestationsCondyloma akuminata disaerah which often appears moist, usually padapenis, vulva, vaginal walls and walls of the cervix and can spread sampaidaerah perianal, foul smelling, warts / warts provides an illustration of a pink, flat, flower picture kolPada men can attack the penis, urethral and rectal area. Dapatdormant infection or can not be detected, because some lesions hidden didalamfolikel hair or in a circle in the penis that does not disirkumsisi.Pada akuminata condiloma woman attacked the moist areas of labiaminora and vagina. Most of the lesions occur without symptoms. In sebagiankasus bleeding usually occur after coitus, itching or vaginal warts dischargeUkuran typically 1-2 mm each, but when assembled sampaiberdiameter 10, 2 cm and stemmed. And usually there is a very small sampaitidak attention. Sometimes it appears more than one area. In the case of yangjarang, bleeding and urinary tract obstruction if the virus reaches the channel uretra.Memiliki active sexual life history with multiple partners.D. PathophysiologyHPV is a group of DNA double-strand viruses. About 30 types infect HPVdapat anogenital tract. These viruses cause local infection papilomatous danmuncul as condyloma lesions. Melaluiaktivitas sexually transmitted HPV infection.
 HPV-related genital tract are divided into groups of low risk and high risk genotypes didasarkana over their big masing.Sebagian genital condylomata infected by HPV type-6 or HPV-11.Sementara types 16, 18, 31, 33, 45, 51 , 52, 56, 68, 89 is a risk tinggi.Papiloma epiteliotropik and viruses are dependent dariadanya reflikasinya berdeferensisasi squamous epithelium. Padalapisan viral DNA can be found under the epithelium, but the structure of viral proteins was not found. Layer affected basalsel marked with clear boundaries in the dermis. Menjadihiperplasia layer (acanthosis), pars papilare the dermis elongated. Gambaranhiperkeratosis not always exist, unless the warts have been found at the time yanglama or treatment is not successful, where the stratum corneum hanyamengandung two layers of cells parakeratosis. Koibeytes radiated - scatter out of the outermost layer of the wart genialia. Squamous cell is a broad zone of restricted matureperinuclear of peripheral cytoplasm. The point can diperluasdan hyperchromasi, two or more nuclei / nuclei can be seen. Research ultrastrukturalmenunjukkan presence of virus particles in a section sel.Koilositosis nuclei appear to indicate again a specific cytopathic effect of HPV.E. PathogenesisPapillomavirus invade squamous epithelium (the sensitive area of ​​infection) on the mucosa kulitdanvirus inoculation in basal cell
cell differentiation into selkeratinosit
sensitivity of transformed cellsallows the virus evolves so that the infection became productive secaravegetatif
danhiperplasia morphological changes due to acceleration of proliferation and inhibition of cell differentiation
sifatkelainan that there remains benign and is characterized by a clear boundary with jaringannormal. Others have become dysplastic and is characterized by atipi cell nucleus, mitosistak controlled and chromosomal changes. Some of them continued menjadikarsinoma and is characterized by cell invasion into surrounding tissues or metastasejauh to other organs.

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