CPM Fall 2019 - 18

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pairs. Five antigens are early and two are late. The early antigens
are E1 governing viral plasmid replication, E2 viral transcription
modulator and viral plasmid replication, E4 filamentous cytoplasmic
networks with shared cellular distribution as keratin intermediate
filaments, E5 regulation cell growth, E6 oncogene interaction
with p53 via mutation, and E7 cancer promotion apoptosis of
wild p53 cells and immortalization of mutated p53 interacting
with retinoblastoma tumor suppressor gene. The late antigens are
L1, a major antigenic protein against which the vaccine is aimed,
and L2, a weaker antigen of the late proteins. Protection is not
dependent on a cellular immune response making this acceptable
for those with HIV and other infections.
Side effects of the vaccine include rash, local swelling, headache,
nausea, vomiting, fatigue, dizziness, and generalized weakness.
Observation for 15 minutes after the dosage is recommended as
syncope may occur, more commonly in males.

717-857-7400 | HomelandatHome.org
Hospice volunteers are always welcome.

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Again, prevention is much better than treating diseases that
could be prevented. Although most individuals will spontaneously
clear the infection and not progress to disease, there is no current
way of predicting who will progress. Think of your role as that of
a beachcomber who is on the shore tossing back starfish washed
ashore by the tide. Someone told him he was wasting time as it
didn't matter because of the vast number of starfish. As he went
on tossing starfish back into the ocean, he told his critic that it
certainly mattered to the starfish in his hand. People should be
treated with the same respect as those starfish.
REFERENCES
Graham, SV. Human Papilloma Virus: Gene Expression, Regulation and Prospects
for Novel Diagnostic Methods and Antiviral Therapies. Future Microbiology 2010;
6 (10): 1493-1506.
Cox, JT and Palefsky, JM. Human Papilloma Virus Vaccination. Up to Date as of
January 2, 2019.
Palefsky, JM and Cranston, RD. Virology of Human Papilloma Virus Infections
and the Link to Cancer. Up to Date as of January 7, 2019.
National Institute of Cancer Prevention and Research. Cancer Statistics.
Committee Opinion Number 704. Human Papilloma Virus Vaccination. American College of Obstetricians and Gynecologists, June 2017.
Bonnez, W and Reichman, RC. Chapter 144 Papilloma Viruses, Principles and
Practice of Infectious Diseases 7th Edition, Edd Mandell, GL, Bennett, JE and
Doun, R.
Sankaranarayanan et al. HPV Screening in Rural India Versus VIA NEJM 2009;
360: 1385-94.

18 Fall 2019 Central PA Medicine


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CPM Fall 2019

Table of Contents for the Digital Edition of CPM Fall 2019

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https://www.nxtbook.com/hoffmann/CPAMed/CPMSummer2021
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring2021
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter2021
https://www.nxtbook.com/hoffmann/CPAMed/CPMFall2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMSummer2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMFall19
https://www.nxtbook.com/hoffmann/CPAMed/CPMSummer19
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring19
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter19
https://www.nxtbook.com/hoffmann/CPAMed/CPMFall18
https://www.nxtbook.com/hoffmann/CPAMed/Summer2018
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring18
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter18
https://www.nxtbook.com/hoffmann/CPAMed/Fall2017
https://www.nxtbook.com/hoffmann/CPAMed/CentralPAMedicine_Summer17
https://www.nxtbook.com/hoffmann/CPAMed/CentralPAMedicine_Spring17
https://www.nxtbook.com/hoffmann/CPAMed/CentralPAMedicine_Feb2017
https://www.nxtbookmedia.com