Recent Advances in Human Papillomavirus Infection and Management

Abstract

Human papillomavirus (HPV) accounts for approximately 4.5% of all cancers which differs at the level of economic development and geographical regions. The life cycle of the HPV is completely dependent on the epithelium differentiation without the involvement of cell death and systemic viremia. Carcinogenesis is the consequence of viral gene expression, dysregulated cell proliferation, and genomic instability. Keratinocytes are the target cell for HPV which act as the physical and immunological barrier. In cervical carcinogenesis, the enhanced level of Th17 infiltration has been observed which increases with the disease progression and is coupled with CCL20 expression in the stromal mesenchymal compartment. IL-6 and M-CSF are known as "switch factors" which are imperative for pro-tumorigenic response in monocytes. Screening of cervical cancer includes three major procedures: cytology, nucleic acid test, and co-testing. For evaluating anal lesions, high-resolution anoscopy is performed which is similar to colposcopy. Prophylactic vaccination is the primary preventive measure to control the HrHPV infection and reduce the burden of HPV-related cancer. The precancerous stage of HPV infection includes excision, ablation, and immunotherapy. Radiotherapy is the acceptable primary treatment for the early stage of anogenital cancer, whereas for the advanced-stage metastatic cancer, palliative therapy is the only option.

Factors Influencing Recentralization of Local Government Functions in Uganda

“…Finally, the review found out that the fear of local autonomy, which compelled the central Government to recentralise KCCA in 2006 to weaken the opposition and threaten its power centre, while on the positive note has since then led to the provision of more resources to the capital city, leading to its growth and development overtime (Aili, 2010 andNabaho, 2013). This move to recentralise local Government recentralised functions has since weakened the decentralisation policy implementation, which has been seen as a viable system of local governance and as one of most strategic reforms implemented in Uganda since independence in 1962 (Saxena, et al, 2010). In my view, continuous recentralisation of local government functions without prior arrangement with local governments to a large extent has caused a down-turn in terms of reduced service delivery with regard to the quality and quantity at the local level.…”

Buschke-Löwenstein tumour (BLT)/giant condyloma acuminatum (GCA): An immunopathogenesis insight

“…5 The highest prevalence and risk of HPV genital infection were found in adolescents, although no significant reduction was found with age progression in Asia and Africa. 6 In Indonesia, based on data from 12 teaching hospitals during the period 2007-2011, CA ranked as one of the top 3 for STI. 7 Nevertheless, case findings for BLT/GCA are relatively rare due to the predisposing factor for the disease in which it happened in individuals in an immunocompromised state.…”