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id="toc-Cancer-sublist" class="vector-toc-list"> <li id="toc-Case_statistics" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Case_statistics"> <div class="vector-toc-text"> 2.2.1 Case statistics </div> </a> <ul id="toc-Case_statistics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Cancer_development" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Cancer_development"> <div class="vector-toc-text"> 2.2.2 Cancer development </div> </a> <ul id="toc-Cancer_development-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Squamous_cell_carcinoma_of_the_skin" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Squamous_cell_carcinoma_of_the_skin"> <div class="vector-toc-text"> 2.2.3 Squamous cell carcinoma of the skin </div> </a> <ul id="toc-Squamous_cell_carcinoma_of_the_skin-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Cervical_cancer" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Cervical_cancer"> <div class="vector-toc-text"> 2.2.4 Cervical cancer </div> </a> <ul id="toc-Cervical_cancer-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Anal_cancer" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Anal_cancer"> <div class="vector-toc-text"> 2.2.5 Anal cancer </div> </a> <ul id="toc-Anal_cancer-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Penile_cancer" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Penile_cancer"> <div class="vector-toc-text"> 2.2.6 Penile cancer </div> </a> <ul id="toc-Penile_cancer-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Head_and_neck_cancers" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Head_and_neck_cancers"> <div class="vector-toc-text"> 2.2.7 Head and neck cancers </div> </a> <ul id="toc-Head_and_neck_cancers-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Lung_cancer" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Lung_cancer"> <div class="vector-toc-text"> 2.2.8 Lung cancer </div> </a> <ul id="toc-Lung_cancer-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Skin_cancer" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Skin_cancer"> <div class="vector-toc-text"> 2.2.9 Skin cancer </div> </a> <ul id="toc-Skin_cancer-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Cause" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Cause"> <div class="vector-toc-text"> 3 Cause </div> </a> <button aria-controls="toc-Cause-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Cause subsection </button> <ul id="toc-Cause-sublist" class="vector-toc-list"> <li id="toc-Transmission" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Transmission"> <div class="vector-toc-text"> 3.1 Transmission </div> </a> <ul id="toc-Transmission-sublist" class="vector-toc-list"> <li id="toc-Perinatal" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Perinatal"> <div class="vector-toc-text"> 3.1.1 Perinatal </div> </a> <ul id="toc-Perinatal-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Genital_infections" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Genital_infections"> <div class="vector-toc-text"> 3.1.2 Genital infections </div> </a> <ul id="toc-Genital_infections-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hands" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Hands"> <div class="vector-toc-text"> 3.1.3 Hands </div> </a> <ul id="toc-Hands-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Shared_objects" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Shared_objects"> <div class="vector-toc-text"> 3.1.4 Shared objects </div> </a> <ul id="toc-Shared_objects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Blood" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Blood"> <div class="vector-toc-text"> 3.1.5 Blood </div> </a> <ul id="toc-Blood-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> 3.1.6 Surgery </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Virology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Virology"> <div class="vector-toc-text"> 3.2 Virology </div> </a> <ul id="toc-Virology-sublist" class="vector-toc-list"> <li id="toc-Evolution" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Evolution"> <div class="vector-toc-text"> 3.2.1 Evolution </div> </a> <ul id="toc-Evolution-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-E6/E7_proteins" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#E6/E7_proteins"> <div class="vector-toc-text"> 3.2.2 E6/E7 proteins </div> </a> <ul id="toc-E6/E7_proteins-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Latency_period" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Latency_period"> <div class="vector-toc-text"> 3.2.3 Latency period </div> </a> <ul id="toc-Latency_period-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Clearance" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Clearance"> <div class="vector-toc-text"> 3.2.4 Clearance </div> </a> <ul id="toc-Clearance-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 4 Diagnosis </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Diagnosis subsection </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Cervical_testing" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cervical_testing"> <div class="vector-toc-text"> 4.1 Cervical testing </div> </a> <ul id="toc-Cervical_testing-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mouth_testing" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Mouth_testing"> <div class="vector-toc-text"> 4.2 Mouth testing </div> </a> <ul id="toc-Mouth_testing-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Testing_men" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Testing_men"> <div class="vector-toc-text"> 4.3 Testing men </div> </a> <ul id="toc-Testing_men-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_testing" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_testing"> <div class="vector-toc-text"> 4.4 Other testing </div> </a> <ul id="toc-Other_testing-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> 5 Prevention </div> </a> <button aria-controls="toc-Prevention-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Prevention subsection </button> <ul id="toc-Prevention-sublist" class="vector-toc-list"> <li id="toc-Vaccines" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Vaccines"> <div class="vector-toc-text"> 5.1 Vaccines </div> </a> <ul id="toc-Vaccines-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Condoms" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Condoms"> <div class="vector-toc-text"> 5.2 Condoms </div> </a> <ul id="toc-Condoms-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Disinfection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Disinfection"> <div class="vector-toc-text"> 5.3 Disinfection </div> </a> <ul id="toc-Disinfection-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> 6 Management </div> </a> <ul id="toc-Management-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> 7 Epidemiology </div> </a> <button aria-controls="toc-Epidemiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Epidemiology subsection </button> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> <li id="toc-United_States" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#United_States"> <div class="vector-toc-text"> 7.1 United States </div> </a> <ul id="toc-United_States-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Ireland" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ireland"> <div class="vector-toc-text"> 7.2 Ireland </div> </a> <ul id="toc-Ireland-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Sri_Lanka" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Sri_Lanka"> <div class="vector-toc-text"> 7.3 Sri Lanka </div> </a> <ul id="toc-Sri_Lanka-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Inner_Mongolia" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Inner_Mongolia"> <div class="vector-toc-text"> 7.4 Inner Mongolia </div> </a> <ul id="toc-Inner_Mongolia-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> 8 History </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> 9 Research </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> 10 See also </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 11 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 12 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Human papillomavirus infection</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 70 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-70" aria-hidden="true" > 70 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Menslikepapilloomvirus-infeksie" title="Menslikepapilloomvirus-infeksie – Afrikaans" lang="af" hreflang="af" data-title="Menslikepapilloomvirus-infeksie" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target">Afrikaans</a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%81%D9%8A%D8%B1%D9%88%D8%B3_%D8%A7%D9%84%D9%88%D8%B1%D9%85_%D8%A7%D9%84%D8%AD%D9%84%D9%8A%D9%85%D9%8A_%D8%A7%D9%84%D8%A8%D8%B4%D8%B1%D9%8A" title="فيروس الورم الحليمي البشري – Arabic" lang="ar" hreflang="ar" data-title="فيروس الورم الحليمي البشري" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Virus_del_papiloma_humanu" title="Virus del papiloma humanu – Asturian" lang="ast" hreflang="ast" data-title="Virus del papiloma humanu" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target">Asturianu</a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/%C4%B0nsan_papilloma_virusu" title="İnsan papilloma virusu – Azerbaijani" lang="az" hreflang="az" data-title="İnsan papilloma virusu" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target">Azərbaycanca</a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%A7%DB%8C%D9%86%D8%B3%D8%A7%D9%86_%D9%BE%D8%A7%D9%BE%DB%8C%D9%84%D9%88%D9%85%D8%A7%D9%88%DB%8C%D8%B1%D9%88%D8%B3_%D8%B9%D9%81%D9%88%D9%86%D8%AA%DB%8C" title="اینسان پاپیلوماویروس عفونتی – South Azerbaijani" lang="azb" hreflang="azb" data-title="اینسان پاپیلوماویروس عفونتی" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target">تۆرکجه</a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%B9%E0%A6%BF%E0%A6%89%E0%A6%AE%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%A8_%E0%A6%AA%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%AA%E0%A6%BF%E0%A6%B2%E0%A7%8B%E0%A6%AE%E0%A6%BE%E0%A6%AD%E0%A6%BE%E0%A6%87%E0%A6%B0%E0%A6%BE%E0%A6%B8_%E0%A6%B8%E0%A6%82%E0%A6%95%E0%A7%8D%E0%A6%B0%E0%A6%AE%E0%A6%A3" title="হিউম্যান প্যাপিলোমাভাইরাস সংক্রমণ – Bangla" lang="bn" hreflang="bn" data-title="হিউম্যান প্যাপিলোমাভাইরাস সংক্রমণ" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target">বাংলা</a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%A7%D0%BE%D0%B2%D0%B5%D1%88%D0%BA%D0%B8_%D0%BF%D0%B0%D0%BF%D0%B8%D0%BB%D0%BE%D0%BC%D0%B5%D0%BD_%D0%B2%D0%B8%D1%80%D1%83%D1%81" title="Човешки папиломен вирус – Bulgarian" lang="bg" hreflang="bg" data-title="Човешки папиломен вирус" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target">Български</a></li><li class="interlanguage-link interwiki-bo mw-list-item"><a href="https://bo.wikipedia.org/wiki/%E0%BD%98%E0%BD%B2%E0%BD%A0%E0%BD%B2%E0%BC%8B%E0%BD%A2%E0%BD%B2%E0%BD%82%E0%BD%A6%E0%BC%8B%E0%BD%A2%E0%BE%A3%E0%BC%8B%E0%BD%A3%E0%BE%B7%E0%BD%93%E0%BC%8B%E0%BD%A0%E0%BD%96%E0%BD%B4%E0%BD%A2%E0%BC%8B%E0%BD%93%E0%BD%91%E0%BC%8B%E0%BD%91%E0%BD%B4%E0%BD%82%E0%BC%8B" title="མིའི་རིགས་རྣ་ལྷན་འབུར་ནད་དུག་ – Tibetan" lang="bo" hreflang="bo" data-title="མིའི་རིགས་རྣ་ལྷན་འབུར་ནད་དུག་" data-language-autonym="བོད་ཡིག" data-language-local-name="Tibetan" class="interlanguage-link-target">བོད་ཡིག</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Virus_del_papil%C2%B7loma_hum%C3%A0" title="Virus del papil·loma humà – Catalan" lang="ca" hreflang="ca" data-title="Virus del papil·loma humà" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Lidsk%C3%BD_papilomavirus" title="Lidský papilomavirus – Czech" lang="cs" hreflang="cs" data-title="Lidský papilomavirus" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/HPV" title="HPV – Danish" lang="da" hreflang="da" data-title="HPV" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Humane_Papillomviren" title="Humane Papillomviren – German" lang="de" hreflang="de" data-title="Humane Papillomviren" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Inimese_papilloomiviirus" title="Inimese papilloomiviirus – Estonian" lang="et" hreflang="et" data-title="Inimese papilloomiviirus" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target">Eesti</a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/HPV" title="HPV – Greek" lang="el" hreflang="el" data-title="HPV" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target">Ελληνικά</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Virus_del_papiloma_humano" title="Virus del papiloma humano – Spanish" lang="es" hreflang="es" data-title="Virus del papiloma humano" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Homa_papilomaviruso" title="Homa papilomaviruso – Esperanto" lang="eo" hreflang="eo" data-title="Homa papilomaviruso" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Giza_papilomaren_birus" title="Giza papilomaren birus – Basque" lang="eu" hreflang="eu" data-title="Giza papilomaren birus" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target">Euskara</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%88%DB%8C%D8%B1%D9%88%D8%B3_%D9%BE%D8%A7%D9%BE%DB%8C%D9%84%D9%88%D9%85_%D8%A7%D9%86%D8%B3%D8%A7%D9%86%DB%8C" title="ویروس پاپیلوم انسانی – Persian" lang="fa" hreflang="fa" data-title="ویروس پاپیلوم انسانی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Papillomavirus_humain" title="Papillomavirus humain – French" lang="fr" hreflang="fr" data-title="Papillomavirus humain" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Papal%C3%B3maiv%C3%ADreas_daonna" title="Papalómaivíreas daonna – Irish" lang="ga" hreflang="ga" data-title="Papalómaivíreas daonna" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target">Gaeilge</a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Virus_do_papiloma_humano" title="Virus do papiloma humano – Galician" lang="gl" hreflang="gl" data-title="Virus do papiloma humano" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target">Galego</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%9D%B8%EC%9C%A0%EB%91%90%EC%A2%85_%EB%B0%94%EC%9D%B4%EB%9F%AC%EC%8A%A4" title="인유두종 바이러스 – Korean" lang="ko" hreflang="ko" data-title="인유두종 바이러스" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Human_papillomavirus_infection" title="Human papillomavirus infection – Hausa" lang="ha" hreflang="ha" data-title="Human papillomavirus infection" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target">Hausa</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%84%D5%A1%D6%80%D5%A4%D5%B8%D6%82_%D5%BA%D5%A1%D5%BA%D5%AB%D5%AC%D5%B8%D5%B4%D5%A1%D5%BE%D5%AB%D6%80%D5%B8%D6%82%D5%BD" title="Մարդու պապիլոմավիրուս – Armenian" lang="hy" hreflang="hy" data-title="Մարդու պապիլոմավիրուս" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%AE%E0%A4%BE%E0%A4%A8%E0%A4%B5_%E0%A4%85%E0%A4%82%E0%A4%95%E0%A5%81%E0%A4%B0%E0%A4%BE%E0%A4%B0%E0%A5%8D%E0%A4%AC%E0%A5%81%E0%A4%A6_%E0%A4%B5%E0%A4%BF%E0%A4%B7%E0%A4%BE%E0%A4%A3%E0%A5%81" title="मानव अंकुरार्बुद विषाणु – Hindi" lang="hi" hreflang="hi" data-title="मानव अंकुरार्बुद विषाणु" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target">हिन्दी</a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Humani_papiloma_virus" title="Humani papiloma virus – Croatian" lang="hr" hreflang="hr" data-title="Humani papiloma virus" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target">Hrvatski</a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Homala_papilo-viruso" title="Homala papilo-viruso – Ido" lang="io" hreflang="io" data-title="Homala papilo-viruso" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target">Ido</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Infeksi_papilomavirus_manusia" title="Infeksi papilomavirus manusia – Indonesian" lang="id" hreflang="id" data-title="Infeksi papilomavirus manusia" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Human_papillomavirus" title="Human papillomavirus – Interlingua" lang="ia" hreflang="ia" data-title="Human papillomavirus" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target">Interlingua</a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Virus_del_papilloma_umano" title="Virus del papilloma umano – Italian" lang="it" hreflang="it" data-title="Virus del papilloma umano" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A0%D7%92%D7%99%D7%A3_%D7%94%D7%A4%D7%A4%D7%99%D7%9C%D7%95%D7%9E%D7%94_%D7%94%D7%90%D7%A0%D7%95%D7%A9%D7%99" title="נגיף הפפילומה האנושי – Hebrew" lang="he" hreflang="he" data-title="נגיף הפפילומה האנושי" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%9F%D0%B0%D0%BF%D0%B8%D0%BB%D0%BB%D0%BE%D0%BC%D0%B0" title="Папиллома – Kazakh" lang="kk" hreflang="kk" data-title="Папиллома" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target">Қазақша</a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Maambukizi_ya_virusi_vya_papilloma_vya_binadamu" title="Maambukizi ya virusi vya papilloma vya binadamu – Swahili" lang="sw" hreflang="sw" data-title="Maambukizi ya virusi vya papilloma vya binadamu" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target">Kiswahili</a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Cilv%C4%93ka_papilomas_v%C4%ABrusa_infekcija" title="Cilvēka papilomas vīrusa infekcija – Latvian" lang="lv" hreflang="lv" data-title="Cilvēka papilomas vīrusa infekcija" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target">Latviešu</a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/%C5%BDmogaus_papilomos_virusas" title="Žmogaus papilomos virusas – Lithuanian" lang="lt" hreflang="lt" data-title="Žmogaus papilomos virusas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target">Lietuvių</a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Hum%C3%A1n_papillomav%C3%ADrus" title="Humán papillomavírus – Hungarian" lang="hu" hreflang="hu" data-title="Humán papillomavírus" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target">Magyar</a></li><li class="interlanguage-link interwiki-mad mw-list-item"><a href="https://mad.wikipedia.org/wiki/Infeksi_papilomavirus_manossa" title="Infeksi papilomavirus manossa – Madurese" lang="mad" hreflang="mad" data-title="Infeksi papilomavirus manossa" data-language-autonym="Madhurâ" data-language-local-name="Madurese" class="interlanguage-link-target">Madhurâ</a></li><li class="interlanguage-link interwiki-mk badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://mk.wikipedia.org/wiki/%D0%A7%D0%BE%D0%B2%D0%B5%D1%87%D0%BA%D0%B8_%D0%BF%D0%B0%D0%BF%D0%B8%D0%BB%D0%BE%D0%BC%D0%B5%D0%BD_%D0%B2%D0%B8%D1%80%D1%83%D1%81" title="Човечки папиломен вирус – Macedonian" lang="mk" hreflang="mk" data-title="Човечки папиломен вирус" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target">Македонски</a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%B9%E0%B5%8D%E0%B4%AF%E0%B5%82%E0%B4%AE%E0%B5%BB_%E0%B4%AA%E0%B4%BE%E0%B4%AA%E0%B5%8D%E0%B4%AA%E0%B4%BF%E0%B4%B2%E0%B5%8B%E0%B4%AE_%E0%B4%B5%E0%B5%88%E0%B4%B1%E0%B4%B8%E0%B5%8D" title="ഹ്യൂമൻ പാപ്പിലോമ വൈറസ് – Malayalam" lang="ml" hreflang="ml" data-title="ഹ്യൂമൻ പാപ്പിലോമ വൈറസ്" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target">മലയാളം</a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%AE%E0%A4%BE%E0%A4%A8%E0%A4%B5%E0%A5%80_%E0%A4%AA%E0%A5%85%E0%A4%AA%E0%A4%BF%E0%A4%B2%E0%A5%8B%E0%A4%AE%E0%A4%BE_%E0%A4%B5%E0%A4%BF%E0%A4%B7%E0%A4%BE%E0%A4%A3%E0%A5%82" title="मानवी पॅपिलोमा विषाणू – Marathi" lang="mr" hreflang="mr" data-title="मानवी पॅपिलोमा विषाणू" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target">मराठी</a></li><li class="interlanguage-link interwiki-xmf mw-list-item"><a href="https://xmf.wikipedia.org/wiki/%E1%83%90%E1%83%93%E1%83%90%E1%83%9B%E1%83%98%E1%83%94%E1%83%A0%E1%83%98%E1%83%A8_%E1%83%9E%E1%83%90%E1%83%9E%E1%83%98%E1%83%9A%E1%83%9D%E1%83%9B%E1%83%90_%E1%83%95%E1%83%98%E1%83%A0%E1%83%A3%E1%83%A1%E1%83%98" title="ადამიერიშ პაპილომა ვირუსი – Mingrelian" lang="xmf" hreflang="xmf" data-title="ადამიერიშ პაპილომა ვირუსი" data-language-autonym="მარგალური" data-language-local-name="Mingrelian" class="interlanguage-link-target">მარგალური</a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Jangkitan_papilomavirus_manusia" title="Jangkitan papilomavirus manusia – Malay" lang="ms" hreflang="ms" data-title="Jangkitan papilomavirus manusia" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target">Bahasa Melayu</a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%90%E1%80%8F%E1%80%BE%E1%80%AC%E1%80%80%E1%80%BC%E1%80%BD%E1%80%80%E1%80%BA%E1%80%94%E1%80%AD%E1%80%AF%E1%80%B7%E1%80%9B%E1%80%B1%E1%80%AC%E1%80%82%E1%80%AB" title="တဏှာကြွက်နို့ရောဂါ – Burmese" lang="my" hreflang="my" data-title="တဏှာကြွက်နို့ရောဂါ" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target">မြန်မာဘာသာ</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Humaan_papillomavirus" title="Humaan papillomavirus – Dutch" lang="nl" hreflang="nl" data-title="Humaan papillomavirus" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%83%92%E3%83%88%E3%83%91%E3%83%94%E3%83%AD%E3%83%BC%E3%83%9E%E3%82%A6%E3%82%A4%E3%83%AB%E3%82%B9" title="ヒトパピローマウイルス – Japanese" lang="ja" hreflang="ja" data-title="ヒトパピローマウイルス" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Papillomavirus_hos_mennesker" title="Papillomavirus hos mennesker – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Papillomavirus hos mennesker" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%AA%E0%AC%BE%E0%AC%AA%E0%AC%BF%E0%AC%B2%E0%AD%8B%E0%AC%AE%E0%AC%BE%E0%AC%AD%E0%AD%81%E0%AC%A4%E0%AC%BE%E0%AC%A3%E0%AD%81_%E0%AC%B8%E0%AC%82%E0%AC%95%E0%AD%8D%E0%AC%B0%E0%AC%AE%E0%AC%A3" title="ପାପିଲୋମାଭୁତାଣୁ ସଂକ୍ରମଣ – Odia" lang="or" hreflang="or" data-title="ପାପିଲୋମାଭୁତାଣୁ ସଂକ୍ରମଣ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Wirus_brodawczaka_ludzkiego" title="Wirus brodawczaka ludzkiego – Polish" lang="pl" hreflang="pl" data-title="Wirus brodawczaka ludzkiego" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/V%C3%ADrus_do_papiloma_humano" title="Vírus do papiloma humano – Portuguese" lang="pt" hreflang="pt" data-title="Vírus do papiloma humano" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Papilomavirusul_uman" title="Papilomavirusul uman – Romanian" lang="ro" hreflang="ro" data-title="Papilomavirusul uman" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target">Română</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9F%D0%B0%D0%BF%D0%B8%D0%BB%D0%BB%D0%BE%D0%BC%D0%B0%D0%B2%D0%B8%D1%80%D1%83%D1%81%D1%8B_%D1%87%D0%B5%D0%BB%D0%BE%D0%B2%D0%B5%D0%BA%D0%B0" title="Папилломавирусы человека – Russian" lang="ru" hreflang="ru" data-title="Папилломавирусы человека" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%B8%E0%B7%8F%E0%B6%B1%E0%B7%80_%E0%B6%B4%E0%B7%90%E0%B6%B4%E0%B7%92%E0%B6%BD%E0%B7%9D%E0%B6%B8%E0%B7%8F_%E0%B7%80%E0%B7%9B%E0%B6%BB%E0%B7%83%E0%B6%BA" title="මානව පැපිලෝමා වෛරසය – Sinhala" lang="si" hreflang="si" data-title="මානව පැපිලෝමා වෛරසය" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target">සිංහල</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Human_papillomavirus" title="Human papillomavirus – Simple English" lang="en-simple" hreflang="en-simple" data-title="Human papillomavirus" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/%C4%BDudsk%C3%BD_papilomav%C3%ADrus" title="Ľudský papilomavírus – Slovak" lang="sk" hreflang="sk" data-title="Ľudský papilomavírus" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target">Slovenčina</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Humani_papilomski_virus" title="Humani papilomski virus – Slovenian" lang="sl" hreflang="sl" data-title="Humani papilomski virus" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Humani_papiloma_virus" title="Humani papiloma virus – Serbian" lang="sr" hreflang="sr" data-title="Humani papiloma virus" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target">Српски / srpski</a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Humani_papiloma_virus" title="Humani papiloma virus – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Humani papiloma virus" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target">Srpskohrvatski / српскохрватски</a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Papilloomavirukset" title="Papilloomavirukset – Finnish" lang="fi" hreflang="fi" data-title="Papilloomavirukset" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Humant_papillomvirus" title="Humant papillomvirus – Swedish" lang="sv" hreflang="sv" data-title="Humant papillomvirus" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Human_papillomavirus" title="Human papillomavirus – Tagalog" lang="tl" hreflang="tl" data-title="Human papillomavirus" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target">Tagalog</a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a 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class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle">(Redirected from <a href="/w/index.php?title=HPV_infection&redirect=no" class="mw-redirect" title="HPV infection">HPV infection</a>)</div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Human disease</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"HPV" redirects here. For other uses, see <a href="/wiki/HPV_(disambiguation)" class="mw-disambig" title="HPV (disambiguation)">HPV (disambiguation)</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Human papillomavirus infection</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Human papillomavirus</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><a href="/wiki/File:2r5k.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e5/2r5k.jpg/220px-2r5k.jpg" decoding="async" width="220" height="175" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e5/2r5k.jpg/330px-2r5k.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e5/2r5k.jpg/440px-2r5k.jpg 2x" data-file-width="1000" data-file-height="797" /></a></td></tr><tr><td colspan="2" class="infobox-full-data">The major capsid protein L1 of HPV 11</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Infectious_disease_(medical_specialty)" class="mw-redirect" title="Infectious disease (medical specialty)">Infectious disease</a>, <a href="/wiki/Gynecology" class="mw-redirect" title="Gynecology">gynecology</a>, <a href="/wiki/Oncology" title="Oncology">oncology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">None, <a href="/wiki/Warts" class="mw-redirect" title="Warts">warts</a><a href="#cite_note-who-cervicalc-1">[1]</a><a href="#cite_note-Lj2014-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data">Cancer of the <a href="/wiki/Cervical_cancer" title="Cervical cancer">cervix</a>, <a href="/wiki/Vulva_cancer" class="mw-redirect" title="Vulva cancer">vulva</a>, <a href="/wiki/Vaginal_cancer" title="Vaginal cancer">vagina</a>, <a href="/wiki/Penis_cancer" class="mw-redirect" title="Penis cancer">penis</a>, <a href="/wiki/Anal_cancer" title="Anal cancer">anus</a>, <a href="/wiki/Oropharyngeal_cancer" title="Oropharyngeal cancer">mouth, tonsils, or throat</a><a href="#cite_note-who-cervicalc-1">[1]</a><a href="#cite_note-Lj2014-2">[2]</a> <a href="#cite_note-StatPearls_2020-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Human papillomavirus spread by direct contact<a href="#cite_note-CDC2015What-4">[4]</a><a href="#cite_note-Mil2015-5">[5]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data">Sexual contact</td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data"><a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccines</a>, <a href="/wiki/Condom" title="Condom">condoms</a><a href="#cite_note-CDC2015What-4">[4]</a><a href="#cite_note-6">[6]</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">Most people are infected at some point in time<a href="#cite_note-CDC2015What-4">[4]</a></td></tr></tbody></table> Human papillomavirus infection (HPV infection) is caused by a <a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a> from the <a href="/wiki/Papillomaviridae" title="Papillomaviridae">Papillomaviridae</a> family.<a href="#cite_note-Mil2015-5">[5]</a> Many HPV infections cause no symptoms and 90% resolve spontaneously within two years.<a href="#cite_note-who-cervicalc-1">[1]</a> In some cases, an HPV infection persists and results in either <a href="/wiki/Wart" title="Wart">warts</a> or <a href="/wiki/Precancerous_lesions" class="mw-redirect" title="Precancerous lesions">precancerous lesions</a>.<a href="#cite_note-Lj2014-2">[2]</a> These lesions, depending on the site affected, increase the risk of cancer of the <a href="/wiki/Cervical_cancer" title="Cervical cancer">cervix</a>, <a href="/wiki/Vulva_cancer" class="mw-redirect" title="Vulva cancer">vulva</a>, <a href="/wiki/Vaginal_cancer" title="Vaginal cancer">vagina</a>, <a href="/wiki/Penis_cancer" class="mw-redirect" title="Penis cancer">penis</a>, <a href="/wiki/Anal_cancer" title="Anal cancer">anus</a>, <a href="/wiki/Oropharyngeal_cancer" title="Oropharyngeal cancer">mouth, tonsils, or throat</a>.<a href="#cite_note-who-cervicalc-1">[1]</a><a href="#cite_note-Lj2014-2">[2]</a><a href="#cite_note-StatPearls_2020-3">[3]</a> Nearly all <a href="/wiki/Cervical_cancer" title="Cervical cancer">cervical cancer</a> is due to HPV, and two strains – HPV16 and HPV18 – account for 70% of all cases.<a href="#cite_note-who-cervicalc-1">[1]</a><a href="#cite_note-CDC2015Can-7">[7]</a> HPV16 is responsible for almost 90% of <a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">HPV-positive oropharyngeal cancers</a>.<a href="#cite_note-StatPearls_2020-3">[3]</a> Between 60% and 90% of the other cancers listed above are also linked to HPV.<a href="#cite_note-CDC2015Can-7">[7]</a> HPV6 and HPV11 are common causes of <a href="/wiki/Genital_wart" title="Genital wart">genital warts</a> and <a href="/wiki/Laryngeal_papillomatosis" title="Laryngeal papillomatosis">laryngeal papillomatosis</a>.<a href="#cite_note-who-cervicalc-1">[1]</a> An HPV infection is caused by the human papillomavirus, a DNA virus from the papillomavirus family.<a href="#cite_note-Bzhalava2013-8">[8]</a> Over 200 types have been described.<a href="#cite_note-hpv-nci-9">[9]</a> An individual can become infected with more than one type of HPV,<a href="#cite_note-CDC2015QA-10">[10]</a> and the disease is only known to affect humans.<a href="#cite_note-Mil2015-5">[5]</a><a href="#cite_note-11">[11]</a> More than 40 types may be <a href="/wiki/Sexually_transmitted_infection" title="Sexually transmitted infection">spread through sexual contact</a> and infect the <a href="/wiki/Human_anus" title="Human anus">anus</a> and <a href="/wiki/Genitals" class="mw-redirect" title="Genitals">genitals</a>.<a href="#cite_note-CDC2015What-4">[4]</a> Risk factors for persistent infection by sexually transmitted types include early age of first <a href="/wiki/Sexual_intercourse" title="Sexual intercourse">sexual intercourse</a>, multiple sexual partners, smoking, and <a href="/wiki/Immunosuppression" title="Immunosuppression">poor immune function</a>.<a href="#cite_note-who-cervicalc-1">[1]</a> These types are typically spread by sustained direct skin-to-skin contact, with <a href="/wiki/Vaginal_sex" class="mw-redirect" title="Vaginal sex">vaginal</a> and <a href="/wiki/Anal_sex" title="Anal sex">anal sex</a> being the most common methods.<a href="#cite_note-CDC2015What-4">[4]</a> HPV infection can also <a href="/wiki/Vertically_transmitted_infection" title="Vertically transmitted infection">spread from a mother to baby during pregnancy</a>.<a href="#cite_note-CDC2015QA-10">[10]</a> There is no evidence that HPV can spread via common items like toilet seats,<a href="#cite_note-12">[12]</a> but the types that cause warts may spread via surfaces such as floors.<a href="#cite_note-13">[13]</a> HPV is not killed by common hand sanitizers and disinfectants, increasing the possibility of the virus being transferred via non-living infectious agents called <a href="/wiki/Fomite" title="Fomite">fomites</a>.<a href="#cite_note-14">[14]</a> <a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccines</a> can prevent the most common types of infection.<a href="#cite_note-CDC2015What-4">[4]</a> To be most effective, inoculation should occur before the onset of sexual activity, and are therefore recommended between the ages of 9–13 years.<a href="#cite_note-who-cervicalc-1">[1]</a> <a href="/wiki/Cervical_cancer_screening" class="mw-redirect" title="Cervical cancer screening">Cervical cancer screening</a>, such as the <a href="/wiki/Papanicolaou_test" class="mw-redirect" title="Papanicolaou test">Papanicolaou test</a> ("pap smear"), or examination of the cervix after applying <a href="/wiki/Acetic_acid" title="Acetic acid">acetic acid</a>, can detect both early cancer and abnormal cells that may develop into cancer.<a href="#cite_note-who-cervicalc-1">[1]</a> Screening allows for early treatment which results in better outcomes.<a href="#cite_note-who-cervicalc-1">[1]</a> Screening has reduced both the number of cases and the number of deaths from cervical cancer.<a href="#cite_note-Saw2015-15">[15]</a> Genital warts can be removed by <a href="/wiki/Cryotherapy" title="Cryotherapy">freezing</a>.<a href="#cite_note-Mil2015-5">[5]</a> Nearly every sexually active individual is infected by HPV at some point in their lives.<a href="#cite_note-CDC2015What-4">[4]</a> HPV is the most common <a href="/wiki/Sexually_transmitted_infection" title="Sexually transmitted infection">sexually transmitted infection (STI)</a>, globally.<a href="#cite_note-Mil2015-5">[5]</a> High-risk HPVs cause about 5% of all cancers worldwide and about 37,300 cases of cancer in the United States each year.<a href="#cite_note-hpv-nci-9">[9]</a> Cervical cancer is among the most common cancers worldwide, causing an estimated 604,000 new cases and 342,000 deaths in 2020.<a href="#cite_note-who-cervicalc-1">[1]</a> About 90% of these new cases and deaths of cervical cancer occurred in <a href="/wiki/Developing_country" title="Developing country">low- and middle-income countries</a>.<a href="#cite_note-who-cervicalc-1">[1]</a> Roughly 1% of sexually active adults have genital warts.<a href="#cite_note-CDC2015QA-10">[10]</a> Cases of skin warts have been described since the time of <a href="/wiki/Ancient_Greece" title="Ancient Greece">ancient Greece</a>, but it was not until 1907 that they were determined to be caused by a virus.<a href="#cite_note-CRC_Press-16">[16]</a> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="HPV_types">HPV types</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=1" title="Edit section: HPV types">edit</a>]</div> HPV is a group of more than 200 related viruses, which are designated by a number for each virus type.<a href="#cite_note-hpv-nci-9">[9]</a> Some HPV types, such as HPV5, may establish infections that persist for the lifetime of the individual without ever manifesting any clinical symptoms. HPV types 1 and 2 can cause common warts in some infected individuals.<a href="#cite_note-17">[17]</a> HPV types 6 and 11 can cause genital warts and <a href="/wiki/Laryngeal_papillomatosis" title="Laryngeal papillomatosis">laryngeal papillomatosis</a>.<a href="#cite_note-who-cervicalc-1">[1]</a> Many HPV types are <a href="/wiki/Carcinogen" title="Carcinogen">carcinogenic</a>.<a href="#cite_note-:5-18">[18]</a> About twelve HPV types (including types 16, 18, 31, and 45) are called "high-risk" types because persistent infection has been linked to cancer of the <a href="/wiki/Oropharynx" class="mw-redirect" title="Oropharynx">oropharynx</a>,<a href="#cite_note-StatPearls_2020-3">[3]</a> <a href="/wiki/Laryngeal_cancer" title="Laryngeal cancer">larynx</a>,<a href="#cite_note-StatPearls_2020-3">[3]</a> <a href="/wiki/Vulvar_cancer" title="Vulvar cancer">vulva</a>, <a href="/wiki/Vaginal_cancer" title="Vaginal cancer">vagina</a>, <a href="/wiki/Cervical_cancer" title="Cervical cancer">cervix</a>, <a href="/wiki/Penile_cancer" title="Penile cancer">penis</a>, and <a href="/wiki/Anal_cancer" title="Anal cancer">anus</a>.<a href="#cite_note-hpv-nci-9">[9]</a><a href="#cite_note-Pahud2015-19">[19]</a><a href="#cite_note-20">[20]</a> These cancers all involve sexually transmitted infection of HPV to the <a href="/wiki/Epithelium#Stratified_epithelium" title="Epithelium">stratified epithelial tissue</a>.<a href="#cite_note-who-cervicalc-1">[1]</a><a href="#cite_note-Lj2014-2">[2]</a> HPV type 16 is the strain most likely to cause cancer and is present in about 47% of all cervical cancers,<a href="#cite_note-Baseman-21">[21]</a><a href="#cite_note-22">[22]</a> and in many vaginal and vulvar cancers,<a href="#cite_note-23">[23]</a> penile cancers, anal cancers, and cancers of the head and neck. The table below lists common symptoms of HPV infection and the associated types of HPV. <table class="wikitable" style="margin:1em;"> <tbody><tr> <th>Disease </th> <th>HPV type </th></tr> <tr> <td>Common <a href="/wiki/Wart" title="Wart">warts</a> </td> <td>2, 7, 22 </td></tr> <tr> <td><a href="/wiki/Plantar_wart" title="Plantar wart">Plantar warts</a> </td> <td>1, 2, 4, 63 </td></tr> <tr> <td><a href="/wiki/Verruca_plana" class="mw-redirect" title="Verruca plana">Flat warts</a> </td> <td>3, 10, 28 </td></tr> <tr> <td><a href="/wiki/Anogenital_warts" class="mw-redirect" title="Anogenital warts">Anogenital warts</a> </td> <td>6, 11, 42, 44 and others<a href="#cite_note-Kumar19-24">[24]</a> </td></tr> <tr> <td><a href="/wiki/Anal_dysplasia" title="Anal dysplasia">Anal dysplasia</a> (lesions) </td> <td>16, 18, 31, 53, 58<a href="#cite_note-25">[25]</a> </td></tr> <tr> <td>Genital <a href="/wiki/Cancer" title="Cancer">cancers</a> </td> <td> <ul><li>Highest risk:<a href="#cite_note-Kumar19-24">[24]</a> 16, 18, 31, 45</li> <li>Other high-risk:<a href="#cite_note-hpv-nci-9">[9]</a><a href="#cite_note-Kumar19-24">[24]</a> 33, 35, 39, 51, 52, 56, 58, 59, 66, 68</li> <li>Probably high-risk:<a href="#cite_note-Etiology_of_human_cancer-26">[26]</a> 26, 53, 73, 82</li></ul> </td></tr> <tr> <td><a href="/wiki/Epidermodysplasia_verruciformis" title="Epidermodysplasia verruciformis">Epidermodysplasia verruciformis</a> </td> <td>more than 15 types </td></tr> <tr> <td><a href="/wiki/Epithelial_hyperplasia" class="mw-redirect" title="Epithelial hyperplasia">Focal epithelial hyperplasia</a> (mouth) </td> <td>13, 32 </td></tr> <tr> <td>Mouth <a href="/wiki/Papillomas" class="mw-redirect" title="Papillomas">papillomas</a> </td> <td>6, 7, 11, 16, 32 </td></tr> <tr> <td><a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">Oropharyngeal cancer</a> </td> <td>16<a href="#cite_note-StatPearls_2020-3">[3]</a> </td></tr> <tr> <td><a href="/wiki/Verrucous_cyst" title="Verrucous cyst">Verrucous cyst</a> </td> <td>60 </td></tr> <tr> <td><a href="/wiki/Laryngeal_papillomatosis" title="Laryngeal papillomatosis">Laryngeal papillomatosis</a> </td> <td>6, 11 </td></tr></tbody></table> Available <a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccines</a> protect against either two, four, or nine types of HPV.<a href="#cite_note-WHO2022-27">[27]</a> There are six prophylactic HPV vaccines licensed for use: the bivalent vaccines <a href="/wiki/Cervarix" title="Cervarix">Cervarix</a>, Cecolin, and Walrinvax; the quadrivalent vaccines Cervavax and <a href="/wiki/Gardasil" title="Gardasil">Gardasil</a>; and the nonavalent vaccine <a href="/wiki/Gardasil_9" class="mw-redirect" title="Gardasil 9">Gardasil 9</a>.<a href="#cite_note-WHO2022-27">[27]</a> All HPV vaccines protect against at least HPV types 16 and 18, which cause the greatest risk of cervical cancer. The quadrivalent vaccines also protect against HPV types 6 and 11. The nonavalent vaccine Gardasil 9 provides protection against those four types (6, 11, 16, and 18), along with five other high-risk HPV types responsible for 20% of cervical cancers (types 31, 33, 45, 52, and 58).<a href="#cite_note-WHO2022-27">[27]</a> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=2" title="Edit section: Signs and symptoms">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="Warts">Warts</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=3" title="Edit section: Warts">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Papilloma.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/03/Papilloma.jpg/220px-Papilloma.jpg" decoding="async" width="220" height="110" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/03/Papilloma.jpg/330px-Papilloma.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/03/Papilloma.jpg/440px-Papilloma.jpg 2x" data-file-width="1395" data-file-height="695" /></a><figcaption>Papilloma</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Sample_HPV-6_Histology_Report_for_Throat_Warts_(Papiloma).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/31/Sample_HPV-6_Histology_Report_for_Throat_Warts_%28Papiloma%29.jpg/220px-Sample_HPV-6_Histology_Report_for_Throat_Warts_%28Papiloma%29.jpg" decoding="async" width="220" height="142" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/31/Sample_HPV-6_Histology_Report_for_Throat_Warts_%28Papiloma%29.jpg/330px-Sample_HPV-6_Histology_Report_for_Throat_Warts_%28Papiloma%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/31/Sample_HPV-6_Histology_Report_for_Throat_Warts_%28Papiloma%29.jpg/440px-Sample_HPV-6_Histology_Report_for_Throat_Warts_%28Papiloma%29.jpg 2x" data-file-width="2196" data-file-height="1415" /></a><figcaption>A sample DNA test report for HPV genotype from a laboratory</figcaption></figure> Skin infection ("<a href="/wiki/Cutaneous" class="mw-redirect" title="Cutaneous">cutaneous</a>" infection) with HPV is very widespread.<a href="#cite_note-28">[28]</a> Skin infections with HPV can cause noncancerous skin growths called <a href="/wiki/Wart" title="Wart">warts</a> (verrucae). Warts are caused by a rapid growth of cells on the outer layer of the skin.<a href="#cite_note-29">[29]</a> While cases of warts have been described since the time of ancient Greece, their viral cause was not known until 1907.<a href="#cite_note-CRC_Press-16">[16]</a> Skin warts are most common in childhood and typically appear and regress spontaneously over the course of weeks to months. Recurring skin warts are common.<a href="#cite_note-30">[30]</a> All HPVs are believed to be capable of establishing long-term "latent" infections in small numbers of <a href="/wiki/Stem_cell" title="Stem cell">stem cells</a> present in the skin. Although these latent infections may never be fully eradicated, immunological control is thought to block the appearance of symptoms such as warts. Immunological control is HPV type-specific, meaning an individual may become resistant to one HPV type while remaining susceptible to other types.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Types of warts include: <ul><li><a href="/wiki/Wart" title="Wart">Common warts</a> are usually found on the hands and feet, but can also occur in other areas, such as the elbows or knees. Common warts have a characteristic <a href="/wiki/Cauliflower" title="Cauliflower">cauliflower</a>-like surface and are typically slightly raised above the surrounding skin. Cutaneous HPV types can cause genital warts but are not associated with the development of cancer.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>]</li> <li><a href="/wiki/Plantar_wart" title="Plantar wart">Plantar warts</a> are found on the soles of the feet; they grow inward, generally causing pain when walking.</li> <li>Subungual or <a href="/wiki/Periungual_wart" title="Periungual wart">periungual warts</a> form under the <a href="/wiki/Fingernail" class="mw-redirect" title="Fingernail">fingernail</a> (subungual), around the fingernail, or on the <a href="/wiki/Cuticle" title="Cuticle">cuticle</a> (periungual). They are more difficult to treat than warts in other locations.<a href="#cite_note-31">[31]</a></li> <li><a href="/wiki/Flat_wart" title="Flat wart">Flat warts</a> are most commonly found on the arms, face, or forehead. Like common warts, flat warts occur most frequently in children and teens. In people with normal immune function, flat warts are not associated with the development of cancer.<a href="#cite_note-32">[32]</a></li></ul> Common, flat, and plantar warts are much less likely to spread from person to person. <div class="mw-heading mw-heading4"><h4 id="Genital_warts">Genital warts</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=4" title="Edit section: Genital warts">edit</a>]</div> HPV infection of the skin in the genital area is the most common sexually transmitted infection worldwide.<a href="#cite_note-WCR2014-33">[33]</a> Such infections are associated with <a href="/wiki/Genital_wart" title="Genital wart">genital or anal warts</a> (medically known as condylomata acuminata or venereal warts), and these warts are the most easily recognized sign of genital HPV infection.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] The strains of HPV that can cause genital warts are usually different from those that cause warts on other parts of the body, such as the hands or feet, or even the inner thighs. A wide variety of HPV types can cause genital warts, but types 6 and 11 together account for about 90% of all cases.<a href="#cite_note-34">[34]</a><a href="#cite_note-EMed-35">[35]</a> However, in total more than 40 types of HPV are transmitted through sexual contact and can infect the skin of the anus and genitals.<a href="#cite_note-CDC2015What-4">[4]</a> Such infections may cause genital warts, although they may also remain asymptomatic.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] The great majority of genital HPV infections never cause any overt symptoms and are cleared by the immune system in a matter of months. Moreover, people may transmit the virus to others even if they do not display overt symptoms of infection. Most people acquire genital HPV infections at some point in their lives, and about 10% of women are currently infected.<a href="#cite_note-WCR2014-33">[33]</a> A large increase in the incidence of genital HPV infection occurs at the age when individuals begin to engage in sexual activity. As with cutaneous HPVs, immunity to genital HPV is believed to be specific to a specific strain of HPV.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading4"><h4 id="Laryngeal_papillomatosis">Laryngeal papillomatosis</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=5" title="Edit section: Laryngeal papillomatosis">edit</a>]</div> In addition to genital warts, infection by HPV types 6 and 11 can cause a rare condition known as recurrent <a href="/wiki/Laryngeal_papillomatosis" title="Laryngeal papillomatosis">laryngeal papillomatosis</a>, in which warts form on the <a href="/wiki/Larynx" title="Larynx">larynx</a><a href="#cite_note-36">[36]</a> or other areas of the respiratory tract.<a href="#cite_note-Sinal_2005-37">[37]</a><a href="#cite_note-38">[38]</a> These warts can recur frequently, may interfere with breathing, and in extremely rare cases can progress to cancer. For these reasons, repeated surgery to remove the warts may be advisable.<a href="#cite_note-Sinal_2005-37">[37]</a><a href="#cite_note-39">[39]</a> <div class="mw-heading mw-heading3"><h3 id="Cancer">Cancer</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=6" title="Edit section: Cancer">edit</a>]</div> <div class="mw-heading mw-heading4"><h4 id="Case_statistics">Case statistics</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=7" title="Edit section: Case statistics">edit</a>]</div> Cervical cancer is among the most common cancers worldwide, causing an estimated 604,000 new cases and 342,000 deaths in 2020.<a href="#cite_note-who-cervicalc-1">[1]</a> About 90% of these new cases and deaths of cervical cancer occurred in <a href="/wiki/Developing_country" title="Developing country">low- and middle-income countries</a>, where screening tests and treatment of early cervical cell changes are not readily available.<a href="#cite_note-who-cervicalc-1">[1]</a> In the United States, about 37,300 cases of cancer due to HPV occur each year.<a href="#cite_note-hpv-nci-9">[9]</a> <table class="wikitable" style="margin:1em;"> <caption>The number of HPV-associated cancers in the period of 2008–2012 in the U.S.<a href="#cite_note-CDC2016Epi-40">[40]</a> </caption> <tbody><tr> <th>Cancer area </th> <th>Average annual number of cases </th> <th>HPV attributable (estimated) </th> <th>HPV 16/18 attributable (estimated) </th></tr> <tr> <td>Cervix </td> <td align="right">11,771 </td> <td align="right">10,700 </td> <td align="right">7,800 </td></tr> <tr> <td>Oropharynx (men) </td> <td align="right">12,638 </td> <td align="right">9,100 </td> <td align="right">8,000 </td></tr> <tr> <td>Oropharynx (women) </td> <td align="right">3,100 </td> <td align="right">2,000 </td> <td align="right">1,600 </td></tr> <tr> <td>Vulva </td> <td align="right">3,554 </td> <td align="right">2,400 </td> <td align="right">1,700 </td></tr> <tr> <td>Anus (women) </td> <td align="right">3,260 </td> <td align="right">3,000 </td> <td align="right">2,600 </td></tr> <tr> <td>Anus (men) </td> <td align="right">1,750 </td> <td align="right">1,600 </td> <td align="right">1,400 </td></tr> <tr> <td>Penis </td> <td align="right">1,168 </td> <td align="right">700 </td> <td align="right">600 </td></tr> <tr> <td>Vagina </td> <td align="right">802 </td> <td align="right">600 </td> <td align="right">400 </td></tr> <tr> <td><a href="/wiki/Rectum" title="Rectum">Rectum</a> (women) </td> <td align="right">513 </td> <td align="right">500 </td> <td align="right">400 </td></tr> <tr> <td>Rectum (men) </td> <td align="right">237 </td> <td align="right">200 </td> <td align="right">200 </td></tr> <tr> <td>Total </td> <td align="right">38,793 </td> <td align="right">30,700 </td> <td align="right">24,600 </td></tr></tbody></table> <div class="mw-heading mw-heading4"><h4 id="Cancer_development">Cancer development</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=8" title="Edit section: Cancer development">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:HPV-16_genome_organization.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e7/HPV-16_genome_organization.png/220px-HPV-16_genome_organization.png" decoding="async" width="220" height="228" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e7/HPV-16_genome_organization.png/330px-HPV-16_genome_organization.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e7/HPV-16_genome_organization.png/440px-HPV-16_genome_organization.png 2x" data-file-width="1393" data-file-height="1441" /></a><figcaption>Genome organization of human papillomavirus type 16, one of the subtypes known to cause cervical cancer (E1-E7 early genes, L1-L2 late genes: capsid)</figcaption></figure> In some infected individuals, their immune systems may fail to control HPV. Lingering infection with high-risk HPV types, such as types 16, 18, 31, and 45, can favor the development of cancer.<a href="#cite_note-41">[41]</a> Co-factors such as cigarette smoke can also enhance the risk of such HPV-related cancers.<a href="#cite_note-42">[42]</a><a href="#cite_note-43">[43]</a> HPV is believed to cause cancer by integrating its genome into <a href="/wiki/Nuclear_DNA" title="Nuclear DNA">nuclear DNA</a>. Some of the early genes expressed by HPV, such as E6 and E7, act as <a href="/wiki/Oncogene" title="Oncogene">oncogenes</a> that promote tumor growth and <a href="/wiki/Malignant_transformation" title="Malignant transformation">malignant transformation</a>.<a href="#cite_note-CRC_Press-16">[16]</a> HPV genome integration can also cause <a href="/wiki/Carcinogenesis" title="Carcinogenesis">carcinogenesis</a> by promoting genomic instability associated with alterations in DNA copy number.<a href="#cite_note-44">[44]</a> E6 produces a protein (also called E6) that simultaneously binds to two host cell proteins called <a href="/wiki/P53" title="P53">p53</a> and E6-Associated Protein (<a href="/wiki/UBE3A" title="UBE3A">E6-AP</a>). E6AP is an E3 <a href="/wiki/Ubiquitin_ligase" title="Ubiquitin ligase">Ubiquitin ligase</a>, an enzyme whose purpose is to tag proteins with a <a href="/wiki/Post-translational_modification" title="Post-translational modification">post-translational modification</a> called Ubiquitin. By binding both proteins, E6 induces E6AP to attach a chain of <a href="/wiki/Ubiquitin" title="Ubiquitin">ubiquitin</a> molecules to p53, thereby flagging p53 for <a href="/wiki/Proteasome" title="Proteasome">proteosomal</a> degradation.<a href="#cite_note-45">[45]</a><a href="#cite_note-46">[46]</a> Normally, p53 acts to prevent cell growth and promotes <a href="/wiki/Apoptosis" title="Apoptosis">cell death</a> in the presence of DNA damage. p53 also upregulates the p21 protein, which blocks the formation of the <a href="/wiki/Cyclin_D/Cdk4" title="Cyclin D/Cdk4">cyclin D/Cdk4</a> complex, thereby preventing the phosphorylation of <a href="/wiki/Retinoblastoma_protein" title="Retinoblastoma protein">retinoblastoma protein</a> (RB), and in turn, halting cell cycle progression by preventing the activation of <a href="/wiki/E2F" title="E2F">E2F</a>. In short, p53 is a tumor-suppressor protein that arrests the cell cycle and prevents cell growth and survival when DNA damage occurs.<a href="#cite_note-47">[47]</a> Thus, the degradation of p53, induced by E6, promotes unregulated cell division, cell growth and cell survival, all characteristics of cancer.<a href="#cite_note-48">[48]</a> It is important to note, that while the interaction between E6, E6AP and p53 was the first to be characterized, there are multiple other proteins in the host cell which interact with E6 and assist the induction of cancer.<a href="#cite_note-49">[49]</a> <div class="mw-heading mw-heading4"><h4 id="Squamous_cell_carcinoma_of_the_skin">Squamous cell carcinoma of the skin</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=9" title="Edit section: Squamous cell carcinoma of the skin">edit</a>]</div> Studies have also shown a link between a wide range of HPV types and <a href="/wiki/Squamous_cell_carcinoma_of_the_skin" class="mw-redirect" title="Squamous cell carcinoma of the skin">squamous cell carcinoma of the skin</a>. In such cases, in vitro studies suggest that the E6 protein of the HPV virus may inhibit <a href="/wiki/Apoptosis" title="Apoptosis">apoptosis</a> induced by <a href="/wiki/Ultraviolet_light" class="mw-redirect" title="Ultraviolet light">ultraviolet light</a>.<a href="#cite_note-BMJ_Karagas-50">[50]</a> <div class="mw-heading mw-heading4"><h4 id="Cervical_cancer">Cervical cancer</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=10" title="Edit section: Cervical cancer">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:HPV_causing_cervical_cancer.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/43/HPV_causing_cervical_cancer.jpg/220px-HPV_causing_cervical_cancer.jpg" decoding="async" width="220" height="124" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/43/HPV_causing_cervical_cancer.jpg/330px-HPV_causing_cervical_cancer.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/43/HPV_causing_cervical_cancer.jpg/440px-HPV_causing_cervical_cancer.jpg 2x" data-file-width="1920" data-file-height="1080" /></a><figcaption>Artist's impression of cervical cancer caused by HPV.</figcaption></figure> Nearly all cases of <a href="/wiki/Cervical_cancer" title="Cervical cancer">cervical cancer</a> are associated with HPV infection, with two types, HPV16 and HPV18, present in 70% of cases.<a href="#cite_note-who-cervicalc-1">[1]</a><a href="#cite_note-CDC2015Can-7">[7]</a><a href="#cite_note-Baseman-21">[21]</a><a href="#cite_note-51">[51]</a><a href="#cite_note-Ault_2006-52">[52]</a><a href="#cite_note-53">[53]</a> In 2012, twelve HPV types were considered carcinogenic for cervical cancer by the <a href="/wiki/International_Agency_for_Research_on_Cancer" title="International Agency for Research on Cancer">International Agency for Research on Cancer</a>: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59.<a href="#cite_note-:51-54">[54]</a> One study found that 74% of squamous cell carcinomas and 78% of adenocarcinomas tested positive for HPV types 16 or 18.<a href="#cite_note-pmid17131323-55">[55]</a> Persistent HPV infection increases the risk for developing cervical carcinoma. Individuals who have an increased incidence of these types of infection are women with HIV/AIDS, who are at a 22-fold increased risk of cervical cancer.<a href="#cite_note-pmid23199960-56">[56]</a><a href="#cite_note-pmid23259425-57">[57]</a> The carcinogenic HPV types in cervical cancer belong to the <a href="/wiki/Alphapapillomavirus" title="Alphapapillomavirus">alphapapillomavirus</a> genus and can be grouped further into HPV <a href="/wiki/Clade" title="Clade">clades</a>.<a href="#cite_note-58">[58]</a> The two major carcinogenic HPV clades, alphapapillomavirus-9 (A9) and alphapapillomavirus-7 (A7), contain <a href="/wiki/Papillomaviridae" title="Papillomaviridae">HPV16</a> and <a href="/wiki/Papillomaviridae" title="Papillomaviridae">HPV18</a>, respectively.<a href="#cite_note-59">[59]</a> These two HPV clades were shown to have different effects on tumour molecular characteristics and patient prognosis, with clade A7 being associated with more aggressive pathways and an inferior prognosis.<a href="#cite_note-60">[60]</a> In 2020, about 604,000 new cases and 342,000 deaths from cervical cancer occurred worldwide. Around 90% of these occurred in the <a href="/wiki/Developing_world" class="mw-redirect" title="Developing world">developing world</a>.<a href="#cite_note-who-cervicalc-1">[1]</a> Most HPV infections of the cervix are cleared rapidly by the immune system and do not progress to cervical cancer (see below the <a href="#Clearance">Clearance subsection in Virology</a>). Because the process of transforming normal cervical cells into cancerous ones is slow, cancer occurs in people having been infected with HPV for a long time, usually over a decade or more (persistent infection).<a href="#cite_note-Sinal_2005-37">[37]</a><a href="#cite_note-61">[61]</a> Furthermore, both the HPV infection and cervical cancer drive metabolic modifications that may be correlated with the aberrant regulation of enzymes related to metabolic pathways.<a href="#cite_note-62">[62]</a> Non-European (NE) HPV16 variants are significantly more carcinogenic than European (E) HPV16 variants.<a href="#cite_note-63">[63]</a> <div class="mw-heading mw-heading4"><h4 id="Anal_cancer">Anal cancer</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=11" title="Edit section: Anal cancer">edit</a>]</div> The risk for anal cancer is 17 to 31 times higher among HIV-positive individuals who were coinfected with high-risk HPV, and 80 times higher for particularly HIV-positive men who have sex with men.<a href="#cite_note-:8-64">[64]</a> <a href="/wiki/Anal_Pap_smear" title="Anal Pap smear">Anal Pap smear</a> screening for anal cancer might benefit some subpopulations of men or women engaging in anal sex.<a href="#cite_note-65">[65]</a> No consensus exists, though, that such screening is beneficial, or who should get an anal Pap smear.<a href="#cite_note-66">[66]</a><a href="#cite_note-67">[67]</a> <div class="mw-heading mw-heading4"><h4 id="Penile_cancer">Penile cancer</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=12" title="Edit section: Penile cancer">edit</a>]</div> HPV is associated with approximately 50% of <a href="/wiki/Penile_cancer" title="Penile cancer">penile cancers</a>. In the United States, penile cancer accounts for about 0.5% of all cancer cases in men. HPV16 is the most commonly associated type detected. The risk of penile cancer increases 2- to 3-fold for individuals who are infected with HIV as well as HPV.<a href="#cite_note-:8-64">[64]</a> <div class="mw-heading mw-heading4"><h4 id="Head_and_neck_cancers">Head and neck cancers</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=13" title="Edit section: Head and neck cancers">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/HPV-mediated_oropharyngeal_cancer" class="mw-redirect" title="HPV-mediated oropharyngeal cancer">HPV-mediated oropharyngeal cancer</a></div> Oral infection with high-risk carcinogenic HPV types (most commonly HPV 16)<a href="#cite_note-CDC2016Epi-40">[40]</a> is associated with an increasing number of <a href="/wiki/Head_and_neck_cancer" title="Head and neck cancer">head and neck cancers</a>.<a href="#cite_note-:4-68">[68]</a><a href="#cite_note-Ault_2006-52">[52]</a><a href="#cite_note-D'Souza_2007-69">[69]</a><a href="#cite_note-ridge-70">[70]</a> This association is independent of <a href="/wiki/Tobacco" title="Tobacco">tobacco</a> and <a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">alcohol</a> use.<a href="#cite_note-ridge-70">[70]</a><a href="#cite_note-71">[71]</a><a href="#cite_note-72">[72]</a> The local percentage varies widely, from 70% in the United States<a href="#cite_note-73">[73]</a> to 4% in Brazil.<a href="#cite_note-74">[74]</a> Engaging in anal or oral sex with an HPV-infected partner may increase the risk of developing these types of cancers.<a href="#cite_note-D'Souza_2007-69">[69]</a> In the United States, the number of newly diagnosed, HPV-associated head and neck cancers has surpassed that of cervical cancer cases.<a href="#cite_note-:4-68">[68]</a> The rate of such cancers has increased from an estimated 0.8 cases per 100,000 people in 1988<a href="#cite_note-pmid21969503-75">[75]</a> to 4.5 per 100,000 in 2012,<a href="#cite_note-CDC2016Epi-40">[40]</a> and, as of 2021, the rate has continued to increase.<a href="#cite_note-76">[76]</a> Researchers explain these recent data by an increase in oral sex. This type of cancer is more common in men than in women.<a href="#cite_note-pmid17891052-77">[77]</a> The mutational profile of HPV-positive and HPV-negative head and neck cancer has been reported, further demonstrating that they are fundamentally distinct diseases.<a href="#cite_note-78">[78]</a> <div class="mw-heading mw-heading4"><h4 id="Lung_cancer">Lung cancer</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=14" title="Edit section: Lung cancer">edit</a>]</div> Some evidence links HPV to benign and malignant tumors of the upper respiratory tract. The International Agency for Research on Cancer has found that people with lung cancer were significantly more likely to have several high-risk forms of HPV antibodies compared to those who did not have lung cancer.<a href="#cite_note-79">[79]</a> Researchers looking for HPV among 1,633 lung cancer patients and 2,729 people without the lung disease found that people with lung cancer had more types of HPV than noncancer patients did, and among lung cancer patients, the chances of having eight types of serious HPV were significantly increased.<a href="#cite_note-80">[80]</a> In addition, expression of HPV structural proteins by immunohistochemistry and in vitro studies suggest HPV presence in bronchial cancer and its precursor lesions.<a href="#cite_note-81">[81]</a> Another study detected HPV in the <a href="/wiki/Exhaled_breath_condensate" title="Exhaled breath condensate">exhaled breath condensate</a> (EBC), bronchial brushing and neoplastic lung tissue of cases, and found a presence of an HPV infection in 16.4% of the subjects affected by nonsmall cell lung cancer, but in none of the controls.<a href="#cite_note-82">[82]</a> The reported average frequencies of HPV in lung cancers were 17% and 15% in Europe and the Americas, respectively, and the mean number of HPV in Asian lung cancer samples was 35.7%, with a considerable heterogeneity between certain countries and regions.<a href="#cite_note-83">[83]</a> <div class="mw-heading mw-heading4"><h4 id="Skin_cancer">Skin cancer</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=15" title="Edit section: Skin cancer">edit</a>]</div> In very rare cases, HPV may cause <a href="/wiki/Epidermodysplasia_verruciformis" title="Epidermodysplasia verruciformis">epidermodysplasia verruciformis</a> (EV) in individuals with a <a href="/wiki/Immunodeficiency" title="Immunodeficiency">weakened immune system</a>. The virus, unchecked by the immune system, causes the overproduction of <a href="/wiki/Keratin" title="Keratin">keratin</a> by <a href="/wiki/Keratinocyte" title="Keratinocyte">skin cells</a>, resulting in lesions resembling warts or <a href="/wiki/Cutaneous_horn" title="Cutaneous horn">cutaneous horns</a> which can ultimately transform into <a href="/wiki/Skin_cancer" title="Skin cancer">skin cancer</a>, but the development is not well understood.<a href="#cite_note-84">[84]</a><a href="#cite_note-:6-85">[85]</a> The specific types of HPV that are associated with EV are HPV5, HPV8, and HPV14.<a href="#cite_note-:6-85">[85]</a> <div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=16" title="Edit section: Cause">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="Transmission">Transmission</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=17" title="Edit section: Transmission">edit</a>]</div> Sexually transmitted HPV is divided into two categories: low-risk and high-risk. Low-risk HPVs cause warts on or around the genitals. Type 6 and 11 cause 90% of all genital warts and recurrent respiratory papillomatosis that causes benign tumors in the air passages. High-risk HPVs cause cancer and consist of about twelve identified types.<a href="#cite_note-hpv-nci-9">[9]</a> Types 16 and 18 are responsible for causing most of HPV-caused cancers. These high-risk HPVs cause 5% of the cancers in the world. In the United States, high-risk HPVs cause 3% of all cancer cases in women and 2% in men.<a href="#cite_note-86">[86]</a> Risk factors for persistent genital HPV infections, which increases the risk for developing cancer, include early age of first sexual intercourse, multiple partners, smoking, and immunosuppression.<a href="#cite_note-who-cervicalc-1">[1]</a> Genital HPV is spread by sustained direct skin-to-skin contact, with vaginal, anal, and oral sex being the most common methods.<a href="#cite_note-CDC2015What-4">[4]</a><a href="#cite_note-Pahud2015-19">[19]</a> Occasionally, it can spread from <a href="/wiki/Non-penetrative_sex#Manual_sex" title="Non-penetrative sex">manual sex</a> or <a href="/wiki/Vertically_transmitted_infection" title="Vertically transmitted infection">from a mother to her baby during pregnancy</a>.<a href="#cite_note-AH_Al._2019-87">[87]</a><a href="#cite_note-88">[88]</a> HPV is difficult to remove via standard hospital disinfection techniques, and may be transmitted in a healthcare setting on re-usable gynecological equipment, such as vaginal ultrasound transducers. The period of communicability is still unknown, but probably at least as long as visible HPV lesions persist. HPV may still be transmitted even after lesions are treated and no longer visible or present.<a href="#cite_note-:0-89">[89]</a> <div class="mw-heading mw-heading4"><h4 id="Perinatal">Perinatal</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=18" title="Edit section: Perinatal">edit</a>]</div> Although genital HPV types can be transmitted from mother to child during birth, the appearance of genital HPV-related diseases in newborns is rare. However, the lack of appearance does not rule out asymptomatic latent infection, as the virus has proven to be capable of hiding for decades. <a href="/wiki/Perinatal" class="mw-redirect" title="Perinatal">Perinatal</a> transmission of HPV types 6 and 11 can result in the development of juvenile-onset recurrent <a href="/wiki/Respiratory_papillomatosis" class="mw-redirect" title="Respiratory papillomatosis">respiratory papillomatosis</a> (JORRP). JORRP is very rare, with rates of about 2 cases per 100,000 children in the United States.<a href="#cite_note-Sinal_2005-37">[37]</a> Although JORRP rates are substantially higher if a woman presents with genital warts at the time of giving birth, the risk of JORRP in such cases is still less than 1%.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading4"><h4 id="Genital_infections">Genital infections</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=19" title="Edit section: Genital infections">edit</a>]</div> Genital HPV infections are transmitted primarily by contact with the genitals, anus, or mouth of an infected sexual partner.<a href="#cite_note-cite_pmid|16950018-90">[90]</a> Of the 120 known human papilloma viruses, 51 species and three subtypes infect the genital mucosa.<a href="#cite_note-91">[91]</a> Fifteen are classified as high-risk types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82), three as probable high-risk (26, 53, and 66), and twelve as low-risk (6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and 89).<a href="#cite_note-:5-18">[18]</a> Condoms do not completely protect from the virus because the areas around the genitals including the inner thigh area are not covered, thus exposing these areas to the infected person's skin.<a href="#cite_note-Egendorf2007-92">[92]</a> <div class="mw-heading mw-heading4"><h4 id="Hands">Hands</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=20" title="Edit section: Hands">edit</a>]</div> Studies have shown HPV transmission between hands and genitals of the same person and sexual partners. Hernandez tested the genitals and dominant hand of each person in 25 heterosexual couples every other month for an average of seven months. She found two couples where the man's genitals infected the woman's hand with high-risk HPV, two where her hand infected his genitals, one where her genitals infected his hand, two each where he infected his own hand, and she infected her own hand.<a href="#cite_note-Hernandez_Transmission-93">[93]</a><a href="#cite_note-Hernandez_Transmission-93">[93]</a> Hands were not the main source of transmission in these 25 couples, but they were significant.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Partridge reports men's fingertips became positive for high risk HPV at more than half the rate (26% per two years) as their genitals (48%).<a href="#cite_note-Giuliano_Optimal-94">[94]</a> Winer reports 14% of fingertip samples from sexually active women were positive.<a href="#cite_note-Winer_Detection-95">[95]</a> Non-sexual hand contact seems to have little or no role in HPV transmission. Winer found all fourteen fingertip samples from virgin women negative at the start of her fingertip study.<a href="#cite_note-Winer_Detection-95">[95]</a> In a separate report on genital HPV infection, 1% of virgin women (1 of 76) with no sexual contact tested positive for HPV, while 10% of virgin women reporting non-penetrative sexual contact were positive (7 of 72).<a href="#cite_note-Winer_Genital-96">[96]</a> <div class="mw-heading mw-heading4"><h4 id="Shared_objects">Shared objects</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=21" title="Edit section: Shared objects">edit</a>]</div> Sharing of possibly contaminated objects, for example, razors,<a href="#cite_note-:0-89">[89]</a> may transmit HPV.<a href="#cite_note-pmid8849195-97">[97]</a><a href="#cite_note-98">[98]</a><a href="#cite_note-99">[99]</a> Although possible, transmission by routes other than sexual intercourse is less common for female genital HPV infection.<a href="#cite_note-cite_pmid|16950018-90">[90]</a> Fingers-genital contact is a possible way of transmission but unlikely to be a significant source.<a href="#cite_note-Winer_Detection-95">[95]</a><a href="#cite_note-Sonnex-100">[100]</a> <div class="mw-heading mw-heading4"><h4 id="Blood">Blood</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=22" title="Edit section: Blood">edit</a>]</div> Though it has traditionally been assumed that HPV is not transmissible via blood – as it is thought to only infect cutaneous and mucosal tissues – recent studies have called this notion into question. Historically, HPV DNA has been detected in the blood of cervical cancer patients.<a href="#cite_note-KruegerStuart2010-101">[101]</a> In 2005, a group reported that, in frozen blood samples of 57 sexually naive pediatric patients who had <a href="/wiki/Vertical_transmission" title="Vertical transmission">vertical</a> or <a href="/wiki/Transfusion_transmitted_infection" title="Transfusion transmitted infection">transfusion-acquired</a> HIV infection, 8 (14.0%) of these samples also tested positive for HPV-16.<a href="#cite_note-pmid-102">[102]</a> This seems to indicate that it may be possible for HPV to be transmitted via <a href="/wiki/Blood_transfusion" title="Blood transfusion">blood transfusion</a>. However, as non-sexual transmission of HPV by other means is not uncommon, this could not be definitively proven. In 2009, a group tested <a href="/wiki/Australian_Red_Cross" title="Australian Red Cross">Australian Red Cross</a> blood samples from 180 healthy male donors for HPV, and subsequently found DNA of one or more strains of the virus in 15 (8.3%) of the samples.<a href="#cite_note-pmid19697401-103">[103]</a> However, it is important to note that detecting the presence of HPV DNA in blood is not the same as detecting the virus itself in blood, and whether or not the virus itself can or does reside in blood in infected individuals is still unknown. As such, it remains to be determined whether HPV can or cannot be transmitted via blood.<a href="#cite_note-KruegerStuart2010-101">[101]</a> This is of concern, as blood donations are not currently screened for HPV, and at least some organizations such as the <a href="/wiki/American_Red_Cross" title="American Red Cross">American Red Cross</a> and other Red Cross societies do not presently appear to disallow HPV-positive individuals from donating blood.<a href="#cite_note-RedCross_2012-104">[104]</a> <div class="mw-heading mw-heading4"><h4 id="Surgery">Surgery</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=23" title="Edit section: Surgery">edit</a>]</div> Hospital transmission of HPV, especially to surgical staff, has been documented. Surgeons, including urologists and/or anyone in the room, is subject to HPV infection by inhalation of noxious viral particles during <a href="/wiki/Electrocautery" class="mw-redirect" title="Electrocautery">electrocautery</a> or <a href="/wiki/Laser_ablation" title="Laser ablation">laser ablation</a> of a condyloma (wart).<a href="#cite_note-PMC147-105">[105]</a> There has been a case report of a laser surgeon who developed extensive laryngeal papillomatosis after providing laser ablation to patients with anogenital condylomata.<a href="#cite_note-PMC147-105">[105]</a> <div class="mw-heading mw-heading3"><h3 id="Virology">Virology</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=24" title="Edit section: Virology">edit</a>]</div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:5keq.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2e/5keq.png/220px-5keq.png" decoding="async" width="220" height="176" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2e/5keq.png/330px-5keq.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2e/5keq.png/440px-5keq.png 2x" data-file-width="500" data-file-height="400" /></a><figcaption><a href="/wiki/Cryo-electron_microscopy" class="mw-redirect" title="Cryo-electron microscopy">Cryo-electron microscopy</a> structure of the HPV type 16 <a href="/wiki/Viral_capsid" class="mw-redirect" title="Viral capsid">viral capsid</a> protein. Rendered from <a href="/wiki/Protein_Data_Bank" title="Protein Data Bank">PDB</a>: <a rel="nofollow" class="external text" href="https://www.rcsb.org/structure/5KEQ">5KEQ</a><a href="#cite_note-guan_2017-106">[106]</a></figcaption></figure> HPV infection is limited to the <a href="/wiki/Stratum_basale" title="Stratum basale">basal cells</a> of <a href="/wiki/Epithelium#Stratified_epithelium" title="Epithelium">stratified epithelium</a>, the only tissue in which they replicate.<a href="#cite_note-mechanism-107">[107]</a> The virus cannot bind to live tissue; instead, it infects <a href="/wiki/Epithelial" class="mw-redirect" title="Epithelial">epithelial</a> tissues through micro-abrasions or other epithelial trauma that exposes segments of the <a href="/wiki/Basement_membrane" title="Basement membrane">basement membrane</a>.<a href="#cite_note-mechanism-107">[107]</a> The infectious process is slow, taking 12–24 hours for initiation of transcription. It is believed that involved antibodies play a major neutralizing role while the <a href="/wiki/Virion" class="mw-redirect" title="Virion">virions</a> still reside on the basement membrane and cell surfaces.<a href="#cite_note-mechanism-107">[107]</a> HPV lesions are thought to arise from the proliferation of infected basal <a href="/wiki/Keratinocytes" class="mw-redirect" title="Keratinocytes">keratinocytes</a>. Infection typically occurs when basal cells in the host are exposed to the infectious virus through a disturbed epithelial barrier as would occur during sexual intercourse or after minor skin abrasions. HPV infections have not been shown to be <a href="/wiki/Cytolytic" class="mw-redirect" title="Cytolytic">cytolytic</a>; rather, viral particles are released as a result of degeneration of <a href="/wiki/Desquamation" title="Desquamation">desquamating</a> cells. HPV can survive for many months and at low temperatures without a host; therefore, an individual with plantar warts can spread the virus by walking barefoot.<a href="#cite_note-EMed-35">[35]</a> HPV is a small double-stranded circular DNA virus with a genome of approximately 8000 base pairs.<a href="#cite_note-Pahud2015-19">[19]</a><a href="#cite_note-Scheurer_2005-108">[108]</a> The HPV life cycle strictly follows the differentiation program of the host keratinocyte. It is thought that the HPV <a href="/wiki/Virion" class="mw-redirect" title="Virion">virion</a> infects <a href="/wiki/Epithelial" class="mw-redirect" title="Epithelial">epithelial</a> tissues through micro-abrasions, whereby the virion associates with putative receptors such as alpha <a href="/wiki/Integrin" title="Integrin">integrins</a>, <a href="/wiki/Laminin" title="Laminin">laminins</a>, and <a href="/wiki/Annexin_A2" title="Annexin A2">annexin A2</a><a href="#cite_note-109">[109]</a> leading to entry of the virions into <a href="/wiki/Basal_lamina" title="Basal lamina">basal</a> epithelial cells through <a href="/wiki/Clathrin" title="Clathrin">clathrin</a>-<a href="/wiki/Receptor-mediated_endocytosis" title="Receptor-mediated endocytosis">mediated endocytosis</a> and/or <a href="/wiki/Caveolin" title="Caveolin">caveolin</a>-mediated endocytosis depending on the type of HPV.<a href="#cite_note-110">[110]</a> At this point, the viral <a href="/wiki/Genome" title="Genome">genome</a> is transported to the nucleus by unknown mechanisms and establishes itself at a copy number of 10-200 viral genomes per cell. A sophisticated <a href="/wiki/Transcription_(genetics)" class="mw-redirect" title="Transcription (genetics)">transcriptional cascade</a> then occurs as the host keratinocyte begins to divide and become increasingly differentiated in the upper layers of the epithelium.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading4"><h4 id="Evolution">Evolution</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=25" title="Edit section: Evolution">edit</a>]</div> The phylogeny of the various strains of HPV generally reflects the migration patterns of Homo sapiens and suggests that HPV may have diversified along with the human population. Studies suggest that HPV evolved along five major branches that reflect the ethnicity of human hosts, and diversified along with the human population.<a href="#cite_note-111">[111]</a> Researchers initially identified two major variants of HPV16, European (HPV16-E), and Non-European (HPV16-NE).<a href="#cite_note-112">[112]</a> More recent analyses based on thousands of HPV16 genomes show that indeed two major clades exist, that are further subdivided into four lineages (designated A-D) and even further subdivided into 16 sublineages (A1–4, B1–4, C1–4 and D1–4).<a href="#cite_note-:10-113">[113]</a><a href="#cite_note-:11-114">[114]</a> The A1-A3 sublineages constitute the European variant, A4 the Asian variant, B1-B4 the African type I variant, C1–C4 the African type II variant, D1 the North American variant, D2 the Asian American type I variant, D3 the Asian American type II variant.<a href="#cite_note-:10-113">[113]</a> The various lineages and sublineages have different oncogenic capacity, where overall, the non-European lineages are considered to increase the risk for cancer.<a href="#cite_note-115">[115]</a> Although HPV16 is a DNA virus, there are signs of recombination among the different lineages.<a href="#cite_note-:11-114">[114]</a><a href="#cite_note-116">[116]</a> Based on an analysis of more than 3600 genomes, between 0.3 and 1.2% of them could be recombinant.<a href="#cite_note-:11-114">[114]</a> Thus, ideally, genotyping (for cancer-risk assessment) of HPV16 should not be based only on certain genes, but on all genes from the entire genome.<a href="#cite_note-:11-114">[114]</a> A bioinformatics tool named HPV16-Genotyper performs i) HPV16 lineage genotyping, ii) it detects potential recombination events, iii) it identifies, within the submitted sequences, mutations/SNPs that have been reported (in literature) to increase the risk for cancer.<a href="#cite_note-:11-114">[114]</a> <div class="mw-heading mw-heading4"><h4 id="E6/E7_proteins">E6/E7 proteins</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=26" title="Edit section: E6/E7 proteins">edit</a>]</div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:4giz.E6.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/4giz.E6.png/220px-4giz.E6.png" decoding="async" width="220" height="152" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/4giz.E6.png/330px-4giz.E6.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fb/4giz.E6.png/440px-4giz.E6.png 2x" data-file-width="890" data-file-height="616" /></a><figcaption> Structure of the HPV type 16 oncoprotein E6 (purple), as obtained by <a href="/wiki/X-ray_crystallography" title="X-ray crystallography">X-ray crystallography</a>, shown bound to the LxxLL <a href="/wiki/Peptide" title="Peptide">peptide</a> motif of the human protein <a href="/wiki/UBE3A" title="UBE3A">UBE3A</a> (cyan). Rendered from <a href="/wiki/Protein_Data_Bank" title="Protein Data Bank">PDB</a>: <a rel="nofollow" class="external text" href="https://www.rcsb.org/structure/4GIZ">4GIZ</a>.<a href="#cite_note-zanier_2013-117">[117]</a></figcaption></figure> The two primary oncoproteins of high risk HPV types are E6 and E7. The "E" designation indicates that these two proteins are <a href="/wiki/Early_protein" title="Early protein">early proteins</a> (expressed early in the HPV life cycle), while the "L" designation indicates that they are <a href="/wiki/Late_protein" title="Late protein">late proteins</a> (late expression).<a href="#cite_note-Ault_2006-52">[52]</a> The HPV genome is composed of six early (E1, E2, E4, E5, E6, and E7) <a href="/wiki/Open_reading_frame" title="Open reading frame">open reading frames</a> (ORF), two late (L1 and L2) ORFs, and a non-coding long control region (LCR).<a href="#cite_note-Ganguly-118">[118]</a> After the host cell is infected viral early promoter is activated and a polycistronic primary RNA containing all six early ORFs is transcribed. This polycistronic RNA then undergoes active RNA splicing to generate multiple isoforms of <a href="/wiki/MRNA" class="mw-redirect" title="MRNA">mRNAs</a>.<a href="#cite_note-Zheng-119">[119]</a> One of the spliced isoform RNAs, E6*I, serves as an E7 mRNA to translate E7 protein.<a href="#cite_note-Tang-120">[120]</a> However, viral early transcription subjects to viral E2 regulation and high E2 levels repress the transcription. HPV genomes integrate into host genome by disruption of E2 ORF, preventing E2 repression on E6 and E7. Thus, viral genome integration into host DNA genome increases E6 and E7 expression to promote cellular proliferation and the chance of malignancy. The degree to which E6 and E7 are expressed is correlated with the type of cervical lesion that can ultimately develop.<a href="#cite_note-Scheurer_2005-108">[108]</a> <dl><dt>Role in cancer</dt></dl> Sometimes papillomavirus genomes are found integrated into the host genome, and this is especially noticeable with oncogenic HPVs.<a href="#cite_note-121">[121]</a> The E6/E7 proteins inactivate two tumor suppressor proteins, <a href="/wiki/P53" title="P53">p53</a> (inactivated by E6) and <a href="/wiki/PRb" class="mw-redirect" title="PRb">pRb</a> (inactivated by E7).<a href="#cite_note-anil-122">[122]</a> The viral <a href="/wiki/Oncogene" title="Oncogene">oncogenes</a> E6 and E7<a href="#cite_note-123">[123]</a> are thought to modify the cell cycle so as to retain the differentiating host keratinocyte in a state that is favourable to the amplification of viral genome replication and consequent late gene expression. E6 in association with host E6-associated protein, which has ubiquitin ligase activity, acts to ubiquitinate p53, leading to its proteosomal degradation. E7 (in oncogenic HPVs) acts as the primary transforming protein. E7 competes for <a href="/wiki/Retinoblastoma_protein" title="Retinoblastoma protein">retinoblastoma protein</a> (pRb) binding, freeing the transcription factor <a href="/wiki/E2F" title="E2F">E2F</a> to transactivate its targets, thus pushing the cell cycle forward. All HPV can induce transient proliferation, but only strains 16 and 18 can immortalize cell lines in vitro. It has also been shown that HPV 16 and 18 cannot immortalize primary <a href="/wiki/Rat" title="Rat">rat</a> cells alone; there needs to be activation of the <a href="/wiki/Ras_(protein)" class="mw-redirect" title="Ras (protein)">ras</a> oncogene. In the upper layers of the host epithelium, the late genes L1 and L2 are transcribed/translated and serve as structural proteins that encapsidate the amplified viral genomes. Once the genome is encapsidated, the capsid appears to undergo a redox-dependent assembly/maturation event, which is tied to a natural redox gradient that spans both suprabasal and cornified epithelial tissue layers. This assembly/maturation event stabilizes virions, and increases their specific infectivity.<a href="#cite_note-124">[124]</a> Virions can then be sloughed off in the dead <a href="/wiki/Squamous_epithelium" class="mw-redirect" title="Squamous epithelium">squames</a> of the host epithelium and the viral lifecycle continues.<a href="#cite_note-125">[125]</a> A 2010 study has found that E6 and E7 are involved in <a href="/wiki/Beta-catenin" class="mw-redirect" title="Beta-catenin">beta-catenin</a> nuclear accumulation and activation of <a href="/wiki/Wnt_signaling_pathway" title="Wnt signaling pathway">Wnt signaling</a> in HPV-induced cancers.<a href="#cite_note-126">[126]</a> <div class="mw-heading mw-heading4"><h4 id="Latency_period">Latency period</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=27" title="Edit section: Latency period">edit</a>]</div> Once an HPV virion invades a cell, an active infection occurs, and the virus can be transmitted. Several months to years may elapse before squamous intraepithelial lesions (SIL) develop and can be clinically detected. The time from active infection to clinically detectable disease may make it difficult for epidemiologists to establish which partner was the source of infection.<a href="#cite_note-PMC147-105">[105]</a> <div class="mw-heading mw-heading4"><h4 id="Clearance">Clearance</h4>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=28" title="Edit section: Clearance">edit</a>]</div> Most HPV infections are cleared up by most people without medical action or consequences. The table provides data for high-risk types (i.e. the types found in cancers).[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <table class="wikitable"> <caption>Clearance rates of high risk types of HPV<a href="#cite_note-Giuliano_Age-127">[127]</a> </caption> <tbody><tr> <th style="width:250px;">Months after initial positive test </th> <th style="width:150px;">8 months </th> <th style="width:150px;">12 months </th> <th style="width:150px;">18 months </th></tr> <tr> <td>% of men tested negative </td> <td>70% </td> <td>80% </td> <td>100% </td></tr></tbody></table> Clearing an infection does not always create immunity if there is a new or continuing source of infection. Hernandez' 2005-6 study of 25 couples reports "A number of instances indicated apparent reinfection [from partner] after viral clearance."<a href="#cite_note-Hernandez_Transmission-93">[93]</a> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=29" title="Edit section: Diagnosis">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:HPV_tree_1.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c8/HPV_tree_1.png/220px-HPV_tree_1.png" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c8/HPV_tree_1.png/330px-HPV_tree_1.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c8/HPV_tree_1.png/440px-HPV_tree_1.png 2x" data-file-width="720" data-file-height="540" /></a><figcaption>Notable HPV<a href="#cite_note-128">[128]</a> types and associated diseases</figcaption></figure> Over 200 types of HPV have been identified, and they are designated by numbers.<a href="#cite_note-hpv-nci-9">[9]</a><a href="#cite_note-Bzhalava2013-8">[8]</a><a href="#cite_note-anil-122">[122]</a> They may be divided into "low-risk" and "high-risk" types. Low-risk types cause warts and high-risk types can cause lesions or cancer.<a href="#cite_note-pmid12873163-129">[129]</a><a href="#cite_note-130">[130]</a> <div class="mw-heading mw-heading3"><h3 id="Cervical_testing">Cervical testing</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=30" title="Edit section: Cervical testing">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Cervical_screening" title="Cervical screening">Cervical screening</a></div> Guidelines from the <a href="/wiki/American_Cancer_Society" title="American Cancer Society">American Cancer Society</a> recommend different screening strategies for cervical cancer based on a woman's age, screening history, risk factors and choice of tests.<a href="#cite_note-131">[131]</a> Because of the link between HPV and cervical cancer, the ACS currently recommends early detection of cervical cancer in average-risk asymptomatic adults primarily with cervical cytology by Pap smear, regardless of HPV vaccination status. Women aged 30–65 should preferably be tested every 5 years with both the HPV test and the Pap test. In other age groups, a Pap test alone can suffice unless they have been diagnosed with <a href="/wiki/Atypical_squamous_cells_of_undetermined_significance" class="mw-redirect" title="Atypical squamous cells of undetermined significance">atypical squamous cells of undetermined significance</a> (ASC-US).<a href="#cite_note-132">[132]</a> Co-testing with a Pap test and HPV test is recommended because it decreases the rate of false-negatives. According to the National Cancer Institute, "The most common test detects DNA from several high-risk HPV types, but it cannot identify the types that are present. Another test is specific for DNA from HPV types 16 and 18, the two types that cause most HPV-associated cancers. A third test can detect DNA from several high-risk HPV types and can indicate whether HPV-16 or HPV-18 is present. A fourth test detects RNA from the most common high-risk HPV types. These tests can detect HPV infections before cell abnormalities are evident.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] "Theoretically, the HPV DNA and RNA tests could be used to identify HPV infections in cells taken from any part of the body. However, the tests are approved by the FDA for only two indications: for follow-up testing of women who seem to have abnormal Pap test results and for cervical cancer screening in combination with a <a href="/wiki/Pap_test" title="Pap test">Pap test</a> among women over age 30."<a href="#cite_note-133">[133]</a> <div class="mw-heading mw-heading3"><h3 id="Mouth_testing">Mouth testing</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=31" title="Edit section: Mouth testing">edit</a>]</div> Guidelines for oropharyngeal cancer screening by the Preventive Services Task Force and <a href="/wiki/American_Dental_Association" title="American Dental Association">American Dental Association</a> in the U.S. suggest conventional visual examination, but because some parts of the oropharynx are hard to see, this cancer is often only detected in later stages.<a href="#cite_note-:8-64">[64]</a> The diagnosis of oropharyngeal cancer occurs by biopsy of exfoliated cells or tissues. The <a href="/wiki/National_Comprehensive_Cancer_Network" title="National Comprehensive Cancer Network">National Comprehensive Cancer Network</a> and <a href="/wiki/College_of_American_Pathologists" title="College of American Pathologists">College of American Pathologists</a> recommend testing for HPV in oropharyngeal cancer.<a href="#cite_note-:8-64">[64]</a> However, while testing is recommended, there is no specific type of test used to detect HPV from oral tumors that is currently recommended by the FDA in the United States. Because HPV type 16 is the most common type found in oropharyngeal cancer, p16 <a href="/wiki/Immunohistochemistry_test" title="Immunohistochemistry test">immunohistochemistry</a> is one test option used to determine if HPV is present,<a href="#cite_note-pmid31093365-134">[134]</a> which can help determine course of treatment since tumors that are negative for p16 have better outcomes. Another option that has emerged as a reliable option is HPV DNA <a href="/wiki/In_situ_hybridization" title="In situ hybridization">in situ hybridization</a> (ISH) which allows for visualization of the HPV.<a href="#cite_note-:8-64">[64]</a> <div class="mw-heading mw-heading3"><h3 id="Testing_men">Testing men</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=32" title="Edit section: Testing men">edit</a>]</div> There is not a wide range of tests available even though HPV is common; most studies of HPV used tools and custom analysis not available to the general public.<a href="#cite_note-Dunne-135">[135]</a>[<a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers">needs update</a>] Clinicians often depend on the vaccine among young people and high clearance rates (see <a href="#Clearance">Clearance subsection in Virology</a>) to create a low risk of disease and mortality, and treat the cancers when they appear. Others believe that reducing HPV infection in more men and women, even when it has no symptoms, is important (herd immunity) to prevent more cancers rather than just treating them.<a href="#cite_note-Burchell_Modeling-136">[136]</a><a href="#cite_note-Kim-137">[137]</a>[<a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers">needs update</a>] Where tests are used, negative test results show safety from transmission, and positive test results show where shielding (condoms, gloves) is needed to prevent transmission until the infection clears.<a href="#cite_note-138">[138]</a> Studies have tested for and found HPV in men, including high-risk types (i.e. the types found in cancers), on fingers, mouth, saliva, anus, urethra, urine, semen, blood, scrotum and penis.<a href="#cite_note-Dunne-135">[135]</a> The aforementioned Qiagen/Digene kit was successfully used <a href="/wiki/Off-label_use" title="Off-label use">off-label</a> to test the penis, scrotum and anus<a href="#cite_note-Nicolau-139">[139]</a> of men in long-term relationships with women who were positive for high-risk HPV. Of these men, 60% were found to carry the virus, primarily on the penis.<a href="#cite_note-Nicolau-139">[139]</a>[<a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers">needs update</a>] Similar studies have been conducted on women using cytobrushes - an endocervical brush for sampling the cervix in females - and custom analysis.<a href="#cite_note-Aguilar-140">[140]</a><a href="#cite_note-Weaver-141">[141]</a>[<a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers">needs update</a>] In one study researchers sampled subjects' urethra, scrotum and penis.<a href="#cite_note-Aguilar-140">[140]</a><a href="#cite_note-Weaver-141">[141]</a>[<a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers">needs update</a>] Samples taken from the urethra added less than 1% to the HPV rate. Studies like this led Giuliano to recommend sampling the glans, shaft and crease between them, along with the scrotum, since sampling the urethra or anus added very little to the diagnosis.<a href="#cite_note-Giuliano_Optimal-94">[94]</a> Dunne recommends the glans, shaft, their crease, and the foreskin.<a href="#cite_note-Dunne-135">[135]</a> In one study the subjects were asked not to wash their genitals for 12 hours before sampling, including the urethra as well as the scrotum and the penis.<a href="#cite_note-Aguilar-140">[140]</a> Other studies are silent on washing – a particular gap in studies of the hands.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] One small study used wet cytobrushes, rather than wet the skin.<a href="#cite_note-Weaver-141">[141]</a> It found a higher proportion of men to be HPV-positive when the skin was rubbed with a 600 grit emery paper before being swabbed with the brush, rather than swabbed with no preparation. It's unclear whether the emery paper collected the virions or simply loosened them for the swab to collect.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Studies have found self-collection (with emery paper and Dacron swabs) as effective as collection done by a clinician, and sometimes more so, since patients were more willing than a clinician to scrape vigorously.<a href="#cite_note-Hernandez_Comparison-142">[142]</a>[<a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers">needs update</a>]<a href="#cite_note-Ogilvie-143">[143]</a> Women had similar success in self-sampling using tampons, swabs, cytobrushes and lavage.<a href="#cite_note-Petignat-144">[144]</a>[<a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers">needs update</a>] Several studies used cytobrushes to sample fingertips and under fingernails, without wetting the area or the brush.<a href="#cite_note-Winer_Detection-95">[95]</a><a href="#cite_note-Sonnex-100">[100]</a><a href="#cite_note-Partridge2007-145">[145]</a>[<a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers">needs update</a>] Other studies analyzed urine, semen, and blood and found varying amounts of HPV,<a href="#cite_note-Dunne-135">[135]</a> but there is not a publicly available test for those yet. <div class="mw-heading mw-heading3"><h3 id="Other_testing">Other testing</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=33" title="Edit section: Other testing">edit</a>]</div> Although it is possible to test for HPV DNA in other kinds of infections,<a href="#cite_note-Dunne-135">[135]</a> there are no FDA-approved tests for general screening in the United States<a href="#cite_note-CDC_men-146">[146]</a> or tests approved by the Canadian government,<a href="#cite_note-147">[147]</a> since the testing is inconclusive and considered medically unnecessary.<a href="#cite_note-148">[148]</a> Genital warts are the only visible sign of low-risk genital HPV and can be identified with a visual check. These visible growths, however, are the result of non-carcinogenic HPV types. Five percent acetic acid (vinegar) is used to identify both warts and squamous intraepithelial neoplasia (SIL) lesions with limited success[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] by causing abnormal tissue to appear white, but most doctors have found this technique helpful only in moist areas, such as the female genital tract.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] At this time, HPV tests for males are used only in research.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Research into testing for HPV by antibody presence has been done. The approach is looking for an immune response in blood, which would contain antibodies for HPV if the patient is HPV positive.<a href="#cite_note-149">[149]</a><a href="#cite_note-150">[150]</a><a href="#cite_note-151">[151]</a><a href="#cite_note-152">[152]</a> The reliability of such tests has not been proven, as there has not been a FDA approved product as of August 2018;<a href="#cite_note-153">[153]</a> testing by blood would be a less invasive test for screening purposes. <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=34" title="Edit section: Prevention">edit</a>]</div> The <a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccines</a> can prevent the most common types of infection.<a href="#cite_note-CDC2015What-4">[4]</a> To be effective they must be used before an infection occurs and are therefore recommended between the ages of nine and thirteen. <a href="/wiki/Cervical_cancer_screening" class="mw-redirect" title="Cervical cancer screening">Cervical cancer screening</a>, such as with the <a href="/wiki/Papanicolaou_test" class="mw-redirect" title="Papanicolaou test">Papanicolaou test</a> (pap) or looking at the cervix after using <a href="/wiki/Acetic_acid" title="Acetic acid">acetic acid</a>, can detect early cancer or abnormal cells that may develop into cancer. This allows for early treatment which results in better outcomes.<a href="#cite_note-who-cervicalc-1">[1]</a> Screening has reduced both the number and deaths from cervical cancer in the developed world.<a href="#cite_note-Saw2015-15">[15]</a> Warts can be removed by <a href="/wiki/Cryotherapy" title="Cryotherapy">freezing</a>.<a href="#cite_note-Mil2015-5">[5]</a> <div class="mw-heading mw-heading3"><h3 id="Vaccines">Vaccines</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=35" title="Edit section: Vaccines">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccine</a></div> Three vaccines are available to prevent infection by some HPV types: <a href="/wiki/Gardasil" title="Gardasil">Gardasil</a>, <a href="/wiki/Gardasil" title="Gardasil">Gardasil 9</a> and <a href="/wiki/Cervarix" title="Cervarix">Cervarix</a>; all three protect against initial infection with HPV types 16 and 18, which cause most of the HPV-associated cancer cases. Gardasil also protects against HPV types 6 and 11, which cause 90% of genital warts. Gardasil is a recombinant quadrivalent vaccine, whereas Cervarix is bivalent, and is prepared from virus-like particles (VLP) of the L1 <a href="/wiki/Capsid_protein" class="mw-redirect" title="Capsid protein">capsid protein</a>. Gardasil 9 is nonavalent, having the potential to prevent about 90% of cervical, vulvar, vaginal, and anal cancers. It can protect for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58; the latter five cause up to 20% of cervical cancers which were not previously covered.<a href="#cite_note-154">[154]</a> The vaccines provide little benefit to women already infected with HPV types 16 and 18.<a href="#cite_note-155">[155]</a> For this reason, the vaccine is recommended primarily for those women not yet having been exposed to HPV during sex. The <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> position paper on HPV vaccination clearly outlines appropriate, cost-effective strategies for using HPV vaccine in public sector programs.<a href="#cite_note-156">[156]</a> There is high-certainty evidence that HPV vaccines protect against precancerous cervical lesions in young women, particularly those vaccinated aged 15 to 26.<a href="#cite_note-Kol2017-157">[157]</a> HPV vaccines do not increase the risk of serious adverse events.<a href="#cite_note-Kol2017-157">[157]</a> Longer follow-up is needed to monitor the impact of HPV vaccines on cervical cancer.<a href="#cite_note-Kol2017-157">[157]</a> The CDC recommends the vaccines be delivered in two shots at an interval of least 6 months for those aged 11–12, and three doses for those 13 and older.<a href="#cite_note-158">[158]</a> In most countries, they are funded only for female use, but are approved for male use in many countries, and funded for teenage boys in Australia. The vaccine does not have any therapeutic effect on existing HPV infections or cervical lesions.<a href="#cite_note-CDC_gardasil_reccomendations-159">[159]</a> In 2010, 49% of teenage girls in the US got the HPV vaccine.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Following studies suggesting that the vaccine is more effective in younger girls<a href="#cite_note-Dobson-160">[160]</a> than in older teenagers, the United Kingdom, Switzerland, Mexico, the Netherlands and Quebec began offering the vaccine in a two-dose schedule for girls aged under 15 in 2014.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Cervical cancer screening recommendations have not changed for females who receive HPV vaccine. It remains a recommendation that women continue cervical screening, such as Pap smear testing, even after receiving the vaccine, since it does not prevent all types of cervical cancer.<a href="#cite_note-CDC_gardasil_reccomendations-159">[159]</a><a href="#cite_note-161">[161]</a> Both men and women are carriers of HPV.<a href="#cite_note-162">[162]</a> The Gardasil vaccine also protects men against anal cancers and warts and genital warts.<a href="#cite_note-163">[163]</a> Duration of both vaccines' efficacy has been observed since they were first developed, and is expected to be longlasting.<a href="#cite_note-Deler-164">[164]</a> In December 2014, the <a href="/wiki/FDA" class="mw-redirect" title="FDA">FDA</a> approved a nine-valent Gardasil-based vaccine, Gardasil 9, to protect against infection with the four strains of HPV covered by the first generation of Gardasil as well as five other strains responsible for 20% of cervical cancers (HPV-31, HPV-33, HPV-45, HPV-52, and HPV-58).<a href="#cite_note-Gardasil9-165">[165]</a> <div class="mw-heading mw-heading3"><h3 id="Condoms">Condoms</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=36" title="Edit section: Condoms">edit</a>]</div> The <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> says that male "<a href="/wiki/Condom" title="Condom">condom</a> use may reduce the risk for genital human papillomavirus (HPV) infection" but provides a lesser degree of protection compared with other sexual transmitted infections "because HPV also may be transmitted by exposure to areas (e.g., infected skin or mucosal surfaces) that are not covered or protected by the condom."<a href="#cite_note-166">[166]</a> <div class="mw-heading mw-heading3"><h3 id="Disinfection">Disinfection</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=37" title="Edit section: Disinfection">edit</a>]</div> The virus is unusually hardy, and is immune to most common disinfectants. It is the first virus ever shown to be resistant to inactivation by <a href="/wiki/Glutaraldehyde" title="Glutaraldehyde">glutaraldehyde</a>, which is among the most common strong disinfectants used in hospitals.<a href="#cite_note-:3-167">[167]</a> Diluted <a href="/wiki/Sodium_hypochlorite" title="Sodium hypochlorite">sodium hypochlorite</a> bleach is effective,<a href="#cite_note-:3-167">[167]</a> but cannot be used on some types of re-usable equipment, such as ultrasound transducers.<a href="#cite_note-AH_Al._2019-87">[87]</a> As a result of these difficulties, there is developing concern about the possibility of transmitting the virus on healthcare equipment, particularly reusable gynecological equipment that cannot be <a href="/wiki/Autoclave" title="Autoclave">autoclaved</a>.<a href="#cite_note-Liu_Rashid_Nyitray_2016_p=10-168">[168]</a><a href="#cite_note-Sabeena2017p429-169">[169]</a> For such equipment, some health authorities encourage use of <a href="/wiki/Ultraviolet_germicidal_irradiation" title="Ultraviolet germicidal irradiation">UV disinfection</a><a href="#cite_note-:7-170">[170]</a> or a non-hypochlorite "oxidizing‐based high‐level disinfectant [bleach] with label claims for non‐enveloped viruses",<a href="#cite_note-171">[171]</a> such as a strong <a href="/wiki/Hydrogen_peroxide" title="Hydrogen peroxide">hydrogen peroxide</a> solution<a href="#cite_note-172">[172]</a><a href="#cite_note-:7-170">[170]</a> or <a href="/wiki/Chlorine_dioxide" title="Chlorine dioxide">chlorine dioxide</a> wipes.<a href="#cite_note-:7-170">[170]</a> Such disinfection methods are expected to be relatively effective against HPV.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=38" title="Edit section: Management">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Genital_warts" class="mw-redirect" title="Genital warts">Genital warts</a></div> There is currently no specific treatment for HPV infection.<a href="#cite_note-CDC-HPV-Fact-173">[173]</a><a href="#cite_note-CDC_HPV_Vacc-174">[174]</a><a href="#cite_note-ACS_CCRisk-175">[175]</a> However, the viral infection is usually cleared to undetectable levels by the immune system.<a href="#cite_note-176">[176]</a> According to the <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a>, the body's immune system clears HPV naturally within two years for 90% of cases (see <a href="#Clearance">Clearance subsection in Virology</a> for more detail).<a href="#cite_note-CDC-HPV-Fact-173">[173]</a> However, experts do not agree on whether the virus is eliminated or reduced to undetectable levels, and it is difficult to know when it is contagious.<a href="#cite_note-Gilbert2003-177">[177]</a>[<a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers">needs update</a>] Follow up care is usually recommended and practiced by many health clinics.<a href="#cite_note-178">[178]</a> Follow-up is sometimes not successful because a portion of those treated do not return to be evaluated. In addition to the normal methods of phone calls and mail, text messaging and email can improve the number of people who return for care.<a href="#cite_note-DesaiWoodhall2015-179">[179]</a> As of 2015 it is unclear the best method of follow up following treatment of <a href="/wiki/Cervical_intraepithelial_neoplasia" title="Cervical intraepithelial neoplasia">cervical intraepithelial neoplasia</a>.<a href="#cite_note-180">[180]</a> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=39" title="Edit section: Epidemiology">edit</a>]</div> Globally, 12% of women are positive for HPV DNA, with rates varying by age and country.<a href="#cite_note-:9-181">[181]</a> The highest rates of HPV are in younger women, with a rate of 24% in women under 25 years.<a href="#cite_note-Epidemiology_and_burden_of_HPV-rela-182">[182]</a> Rates decline in older age groups in Europe and the Americas, but less so in Africa and Asia. The rates are highest in Sub-Saharan Africa (24%) and Eastern Europe (21%) and lowest in North America (5%) and Western Asia (2%).<a href="#cite_note-:9-181">[181]</a> The most common types of HPV worldwide are HPV16 (3.2%), HPV18 (1.4%), HPV52 (0.9%), HPV31 (0.8%), and HPV58 (0.7%). High-risk types of HPV are also distributed unevenly, with HPV16 having a rate around 13% in Africa and 30% in West and Central Asia.<a href="#cite_note-Epidemiology_and_burden_of_HPV-rela-182">[182]</a> Like many diseases, HPV disproportionately affects low-income and resource-poor countries. The higher rates of HPV in Sub-Saharan Africa, for example, may be related to high exposure to <a href="/wiki/Human_Immunodeficiency_Virus" class="mw-redirect" title="Human Immunodeficiency Virus">human immunodeficiency virus</a> (HIV) in the region. Other factors that impact the global spread of disease are sexual behaviors including age of sexual debut, number of sexual partners, and ease of access to barrier contraception, all of which vary globally.<a href="#cite_note-:9-181">[181]</a><a href="#cite_note-183">[183]</a> <div class="mw-heading mw-heading3"><h3 id="United_States">United States</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=40" title="Edit section: United States">edit</a>]</div> <table class="wikitable sortable" style="float:right;"> <caption>HPV prevalence among women by age, including 20 low-risk types and 23 high-risk types<a href="#cite_note-Dunne_2007-184">[184]</a> </caption> <tbody><tr> <th>Age (years) </th> <th>Prevalence (%) </th></tr> <tr> <td>14 to 19</td> <td>24.5% </td></tr> <tr> <td>20 to 24</td> <td>44.8% </td></tr> <tr> <td>25 to 29</td> <td>27.4% </td></tr> <tr> <td>30 to 39</td> <td>27.5% </td></tr> <tr> <td>40 to 49</td> <td>25.2% </td></tr> <tr> <td>50 to 59</td> <td>19.6% </td></tr> <tr class="sortbottom"> <th>14 to 59</th> <th>26.8% </th></tr></tbody></table> HPV is estimated to be the most common sexually transmitted infection in the United States.<a href="#cite_note-Dunne_2007-184">[184]</a> Most sexually active men and women will probably acquire genital HPV infection at some point in their lives.<a href="#cite_note-Baseman-21">[21]</a> The <a href="/wiki/American_Social_Health_Association" class="mw-redirect" title="American Social Health Association">American Social Health Association</a> estimates that about 75–80% of sexually active Americans will be infected with HPV at some point in their lifetime.<a href="#cite_note-185">[185]</a><a href="#cite_note-186">[186]</a> By the age of 50 more than 80% of American women will have contracted at least one strain of genital HPV.<a href="#cite_note-Dunne_2007-184">[184]</a><a href="#cite_note-187">[187]</a> It was estimated that, in the year 2000, there were approximately 6.2 million new HPV infections among Americans aged 15–44; of these, an estimated 74% occurred to people between ages of 15 and 24.<a href="#cite_note-Weinstock04-188">[188]</a> Of the STIs studied, genital HPV was the most commonly acquired.<a href="#cite_note-Weinstock04-188">[188]</a> In the United States, it is estimated that 10% of the population has an active HPV infection, 4% has an infection that has caused cytological abnormalities, and an additional 1% has an infection causing genital warts.<a href="#cite_note-189">[189]</a> Estimates of HPV prevalence vary from 14% to more than 90%.<a href="#cite_note-190">[190]</a> One reason for the difference is that some studies report women who currently have a detectable infection, while other studies report women who have ever had a detectable infection.<a href="#cite_note-191">[191]</a><a href="#cite_note-192">[192]</a> Another cause of discrepancy is the difference in strains that were tested for.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] One study found that, during 2003–2004, <a href="/wiki/Prevalence" title="Prevalence">at any given time</a>, 26.8% of women aged 14 to 59 were infected with at least one type of HPV. This was higher than previous estimates; 15.2% were infected with one or more of the high-risk types that can cause cancer.<a href="#cite_note-Dunne_2007-184">[184]</a><a href="#cite_note-193">[193]</a> The prevalence for high-risk and low-risk types is roughly similar over time.<a href="#cite_note-Dunne_2007-184">[184]</a> Human papillomavirus is not included among the diseases that are typically reportable to the <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">CDC</a> as of 2011.<a href="#cite_note-194">[194]</a><a href="#cite_note-195">[195]</a> <div class="mw-heading mw-heading3"><h3 id="Ireland">Ireland</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=41" title="Edit section: Ireland">edit</a>]</div> On average 538 cases of HPV-associated cancers were diagnosed per year in Ireland during the period 2010 to 2014.<a href="#cite_note-:1-196">[196]</a> Cervical cancer was the most frequent HPV-associated cancer with on average 292 cases per year (74% of the female total, and 54% of the overall total of HPV-associated cancers).<a href="#cite_note-:1-196">[196]</a> A study of 996 cervical cytology samples in an Irish urban female, opportunistically screened population, found an overall HPV prevalence of 19.8%, HPV 16 at 20% and HPV 18 at 12% were the commonest high-risk types detected. In Europe, types 16 and 18 are responsible for over 70% of cervical cancers.<a href="#cite_note-197">[197]</a> Overall rates of HPV-associated invasive cancers may be increasing. Between 1994 and 2014, there was a 2% increase in the rate of HPV-associated invasive cancers per year for both sexes in Ireland.<a href="#cite_note-:1-196">[196]</a> As HPV is known to be associated with ano-genital warts, these are notifiable to the Health Protection Surveillance Centre (HPSC). Genital warts are the second most common STI in Ireland.<a href="#cite_note-198">[198]</a> There were 1,281 cases of ano-genital warts notified in 2017, which was a decrease on the 2016 figure of 1,593.<a href="#cite_note-:2-199">[199]</a> The highest age-specific rate for both male and female was in the 25–29 year old age range; 53% of cases were among males.<a href="#cite_note-:2-199">[199]</a> <div class="mw-heading mw-heading3"><h3 id="Sri_Lanka">Sri Lanka</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=42" title="Edit section: Sri Lanka">edit</a>]</div> In Sri Lanka, the prevalence of HPV is 15.5% regardless of their cytological abnormalities.<a href="#cite_note-200">[200]</a> <div class="mw-heading mw-heading3"><h3 id="Inner_Mongolia">Inner Mongolia</h3>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=43" title="Edit section: Inner Mongolia">edit</a>]</div> In the Autonomous Region of <a href="/wiki/Inner_Mongolia" title="Inner Mongolia">Inner Mongolia</a> overall HPV prevalence is 14.5% but shows substantial ethnical disparity, the prevalence in Mongolian women (14.9%) being much higher than that of Han participants (4.3%).<a href="#cite_note-201">[201]</a> Urbanization, the number of sex partners, and PAP history appear as risk factors for HPV infection in Han, but not in Mongolian women. The region is thus an important example that epidemiology of HPV is more related to cultural and ethnical factors and not to geography per se.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading2"><h2 id="History">History</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=44" title="Edit section: History">edit</a>]</div> In 1972, the association of the human papillomaviruses with <a href="/wiki/Skin_cancer" title="Skin cancer">skin cancer</a> in <a href="/wiki/Epidermodysplasia_verruciformis" title="Epidermodysplasia verruciformis">epidermodysplasia verruciformis</a> was proposed by <a href="/wiki/Stefania_Jab%C5%82o%C5%84ska" title="Stefania Jabłońska">Stefania Jabłońska</a> in Poland. In 1976 <a href="/wiki/Harald_zur_Hausen" title="Harald zur Hausen">Harald zur Hausen</a> published the hypothesis that human papilloma virus plays an important role in the cause of <a href="/wiki/Cervical_cancer" title="Cervical cancer">cervical cancer</a>. In 1978, Jabłońska and Gerard Orth at the <a href="/wiki/Pasteur_Institute" title="Pasteur Institute">Pasteur Institute</a> discovered HPV-5 in <a href="/wiki/Skin_cancer" title="Skin cancer">skin cancer</a>.<a href="#cite_note-202">[202]</a> In 1983 and 1984 zur Hausen and his collaborators identified HPV16 and HPV18 in cervical cancer.<a href="#cite_note-203">[203]</a> The <a href="/wiki/HeLa" title="HeLa">HeLa</a> cell line contains extra DNA in its <a href="/wiki/Genome" title="Genome">genome</a> that originated from HPV type 18.<a href="#cite_note-hela-204">[204]</a> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=45" title="Edit section: Research">edit</a>]</div> The <a href="/wiki/Ludwig-McGill_HPV_Cohort" title="Ludwig-McGill HPV Cohort">Ludwig-McGill HPV Cohort</a> is one of the world's largest longitudinal studies of the natural history of <a href="/wiki/Human_papillomavirus" class="mw-redirect" title="Human papillomavirus">human papillomavirus</a> (HPV) infection and <a href="/wiki/Cervical_cancer" title="Cervical cancer">cervical cancer</a> risk. It was established in 1993 by <a href="/wiki/Ludwig_Cancer_Research" title="Ludwig Cancer Research">Ludwig Cancer Research</a> and <a href="/wiki/McGill_University" title="McGill University">McGill University</a> in Montreal, Canada.<a href="#cite_note-205">[205]</a> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=46" title="Edit section: See also">edit</a>]</div> <ul><li><a href="/wiki/Human_betaherpesvirus_5" title="Human betaherpesvirus 5">Human betaherpesvirus 5</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=47" title="Edit section: References">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist 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Retrieved 10 September 2008. <q>Currently, in Canada there is an HPV DNA test approved for women but not for men.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Human+Papillomavirus+%28HPV%29+and+Men%3A+Questions+and+Answers&rft.date=2007&rft_id=http%3A%2F%2Fwww.phac-aspc.gc.ca%2Fstd-mts%2Fhpv-vph%2Fhpv-vph-man-eng.php&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHuman+papillomavirus+infection" class="Z3988"> </li> <li id="cite_note-148"><a href="#cite_ref-148">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20070407202850/http://www.thehpvtest.com/HPV-for-men-FAQ.html#testmen">"What Men Need to Know About HPV"</a>. 2006. Archived from <a rel="nofollow" class="external text" href="http://www.thehpvtest.com/HPV-for-men-FAQ.html#testmen">the original</a> on 7 April 2007. Retrieved 4 April 2007. <q>There is currently no FDA-approved test to detect HPV in men. 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(1999). <a rel="nofollow" class="external text" href="https://doi.org/10.1590%2Fs1020-49891999000900001">"Design and methods of the Ludwig-McGill longitudinal study of the natural history of human papillomavirus infection and cervical neoplasia in Brazil. Ludwig-McGill Study Group - PubMed"</a>. Revista Panamericana de Salud Pública. 6 (4): 223–233. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1590%2Fs1020-49891999000900001">10.1590/s1020-49891999000900001</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10572472">10572472</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Revista+Panamericana+de+Salud+P%C3%BAblica&rft.atitle=Design+and+methods+of+the+Ludwig-McGill+longitudinal+study+of+the+natural+history+of+human+papillomavirus+infection+and+cervical+neoplasia+in+Brazil.+Ludwig-McGill+Study+Group+-+PubMed&rft.volume=6&rft.issue=4&rft.pages=223-233&rft.date=1999&rft_id=info%3Adoi%2F10.1590%2Fs1020-49891999000900001&rft_id=info%3Apmid%2F10572472&rft.aulast=Franco&rft.aufirst=E.&rft.au=Villa%2C+L.&rft.au=Rohan%2C+T.&rft.au=Ferenczy%2C+A.&rft.au=Petzl-Erler%2C+M.&rft.au=Matlashewski%2C+G.&rft_id=https%3A%2F%2Fdoi.org%2F10.1590%252Fs1020-49891999000900001&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHuman+papillomavirus+infection" class="Z3988"> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2>[<a href="/w/index.php?title=Human_papillomavirus_infection&action=edit&section=48" title="Edit section: External links">edit</a>]</div> <ul><li><a rel="nofollow" class="external text" href="https://hpvcentre.net/">Information Centre on HPV and Cancer</a> – ICO</li> <li><a rel="nofollow" class="external text" href="https://www.cdc.gov/STD/HPV/">HPV Fact sheets</a> at the <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a></li> <li><a rel="nofollow" class="external text" href="https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet">"Human Papillomavirus (HPV) Vaccines"</a>, <a href="/wiki/National_Cancer_Institute" title="National Cancer Institute">National Cancer Institute</a> Fact Sheet, US National Institutes of Health, 25 May 2021.</li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid 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.navbox{display:none!important}}</style><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q184627" class="extiw" title="d:Q184627">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/B97.7">B97.7</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=078.1">078.1</a> <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=079.4">079.4</a></li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D030361">D030361</a></li><li><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb6032.htm">6032</a></li><li><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a>: <a rel="nofollow" class="external text" href="http://snomed.info/id/240532009">240532009</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/1037-overview">med/1037</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Human_papillomavirus" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Human_papillomavirus" title="Template:Human papillomavirus"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Human_papillomavirus" title="Template talk:Human papillomavirus"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Human_papillomavirus" title="Special:EditPage/Template:Human papillomavirus"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Human_papillomavirus" style="font-size:114%;margin:0 4em">Human papillomavirus</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a class="mw-selflink selflink">Related diseases</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Cancers</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cervical_cancer" title="Cervical cancer">Cervical cancer</a></li> <li><a href="/wiki/Squamous_cell_carcinoma" class="mw-redirect" title="Squamous cell carcinoma">cancers</a> <ul><li><a href="/wiki/Anal_cancer" title="Anal cancer">Anal</a></li> <li><a href="/wiki/Vaginal_cancer" title="Vaginal cancer">Vaginal</a></li> <li><a href="/wiki/Vulvar_cancer" title="Vulvar cancer">Vulvar</a></li> <li><a href="/wiki/Penile_cancer" title="Penile cancer">Penile</a></li> <li><a href="/wiki/Head_and_neck_cancer" title="Head and neck cancer">Head and neck cancer</a> (<a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">HPV-positive oropharyngeal cancer</a>)</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Wart" title="Wart">Warts</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><ul><li><a href="/wiki/Genital_wart" title="Genital wart">genital</a></li> <li><a href="/wiki/Plantar_wart" title="Plantar wart">plantar</a></li> <li><a href="/wiki/Verruca_plana" class="mw-redirect" title="Verruca plana">flat</a></li> <li><a href="/wiki/Laryngeal_papillomatosis" title="Laryngeal papillomatosis">Laryngeal papillomatosis</a></li> <li><a href="/wiki/Epidermodysplasia_verruciformis" title="Epidermodysplasia verruciformis">Epidermodysplasia verruciformis</a></li> <li><a href="/wiki/Heck%27s_disease" title="Heck's disease">Focal epithelial hyperplasia</a></li> <li><a href="/wiki/Papilloma" title="Papilloma">Papilloma</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Others</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">Acrochordon (<a href="/wiki/Skin_tag" title="Skin tag">skin tags</a>)</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vaccine" title="Vaccine">Vaccine</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccines</a> <ul><li><a href="/wiki/Cervarix" title="Cervarix">Cervarix</a></li> <li><a href="/wiki/Gardasil" title="Gardasil">Gardasil</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Screening_(medicine)" title="Screening (medicine)">Screening</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pap_test" title="Pap test">Pap test</a>: <ul><li><a href="/wiki/Papanicolaou_stain" title="Papanicolaou stain">stain</a></li></ul></li> <li><a href="/wiki/Bethesda_system" title="Bethesda system">Bethesda system</a> <ul><li><a href="/wiki/Cytopathology" title="Cytopathology">Cytopathology</a></li> <li><a href="/wiki/Cytotechnology" title="Cytotechnology">Cytotechnology</a></li></ul></li> <li>Experimental techniques: <ul><li><a href="/wiki/Speculoscopy" title="Speculoscopy">Speculoscopy</a></li> <li><a href="/wiki/Cervicography" title="Cervicography">Cervicography</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Colposcopy" title="Colposcopy">Colposcopy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Biopsy <a href="/wiki/Histology" title="Histology">histology</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cervical_intraepithelial_neoplasia" title="Cervical intraepithelial neoplasia">Cervical intraepithelial neoplasia (CIN)</a></li> <li><a href="/wiki/Koilocyte" title="Koilocyte">Koilocyte</a></li> <li><a href="/wiki/Vaginal_intraepithelial_neoplasia" title="Vaginal intraepithelial neoplasia"> Vaginal intraepithelial neoplasia (VAIN)</a></li> <li><a href="/wiki/Vulvar_intraepithelial_neoplasia" title="Vulvar intraepithelial neoplasia"> Vulvar intraepithelial neoplasia (VIN)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Treatment</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cervical_conization" title="Cervical conization">Cervical conization</a></li> <li><a href="/wiki/Loop_electrical_excision_procedure" title="Loop electrical excision procedure">Loop electrical excision procedure (LEEP)</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">History</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Georgios_Papanikolaou" title="Georgios Papanikolaou">Georgios Papanikolaou</a></li> <li><a href="/wiki/Harald_zur_Hausen" title="Harald zur Hausen">Harald zur Hausen</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r886047488">.mw-parser-output .nobold{font-weight:normal}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r886047488"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r886047488"></div><div role="navigation" class="navbox" aria-labelledby="Sexually_transmitted_infections_(STI)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:STD_and_STI" title="Template:STD and STI"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:STD_and_STI" title="Template talk:STD and STI"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:STD_and_STI" title="Special:EditPage/Template:STD and STI"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Sexually_transmitted_infections_(STI)" style="font-size:114%;margin:0 4em"><a href="/wiki/Sexually_transmitted_infection" title="Sexually transmitted infection">Sexually transmitted infections</a> (STI)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bacteria" title="Bacteria">Bacterial</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chancroid" title="Chancroid">Chancroid</a> (<a href="/wiki/Haemophilus_ducreyi" title="Haemophilus ducreyi">Haemophilus ducreyi</a>)</li> <li><a href="/wiki/Chlamydia_infection" class="mw-redirect" title="Chlamydia infection">Chlamydia</a>, <a href="/wiki/Lymphogranuloma_venereum" title="Lymphogranuloma venereum">lymphogranuloma venereum</a> (<a href="/wiki/Chlamydia_trachomatis" title="Chlamydia trachomatis">Chlamydia trachomatis</a>)</li> <li><a href="/wiki/Granuloma_inguinale" title="Granuloma inguinale">Donovanosis</a> (<a href="/wiki/Klebsiella_granulomatis" title="Klebsiella granulomatis">Klebsiella granulomatis</a>)</li> <li><a href="/wiki/Gonorrhea" title="Gonorrhea">Gonorrhea</a> (<a href="/wiki/Neisseria_gonorrhoeae" title="Neisseria gonorrhoeae">Neisseria gonorrhoeae</a>)</li> <li><a href="/wiki/Mycoplasma_hominis_infection" title="Mycoplasma hominis infection">Mycoplasma hominis infection</a> (<a href="/wiki/Mycoplasma_hominis" title="Mycoplasma hominis">Mycoplasma hominis</a>)</li> <li><a href="/wiki/Syphilis" title="Syphilis">Syphilis</a> (<a href="/wiki/Treponema_pallidum" title="Treponema pallidum">Treponema pallidum</a>)</li> <li><a href="/wiki/Ureaplasma_infection" class="mw-redirect" title="Ureaplasma infection">Ureaplasma infection</a> (<a href="/wiki/Ureaplasma_urealyticum" title="Ureaplasma urealyticum">Ureaplasma urealyticum</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Protozoa" title="Protozoa">Protozoal</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Trichomoniasis" title="Trichomoniasis">Trichomoniasis</a> (<a href="/wiki/Trichomonas_vaginalis" title="Trichomonas vaginalis">Trichomonas vaginalis</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Parasitism" title="Parasitism">Parasitic</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Crab_louse" title="Crab louse">Crab louse</a></li> <li><a href="/wiki/Scabies" title="Scabies">Scabies</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Virus" title="Virus">Viral</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HIV/AIDS" title="HIV/AIDS">AIDS</a> (<a href="/wiki/HIV" title="HIV">HIV-1/HIV-2</a>)</li> <li>Cancer <ul><li><a href="/wiki/Cervical_cancer" title="Cervical cancer">cervical</a></li> <li><a href="/wiki/Vulvar_cancer" title="Vulvar cancer">vulvar</a></li> <li><a href="/wiki/Penile_cancer" title="Penile cancer">penile</a></li> <li><a href="/wiki/Anal_cancer" title="Anal cancer">anal</a></li></ul></li> <li><a href="/wiki/Human_papillomavirus" class="mw-redirect" title="Human papillomavirus">Human papillomavirus (HPV)</a></li> <li><a href="/wiki/Genital_wart" title="Genital wart">Genital warts (condyloma)</a></li> <li><a href="/wiki/Hepatitis_B" title="Hepatitis B">Hepatitis B</a> (<a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">Hepatitis B virus</a>)</li> <li><a href="/wiki/Herpes" title="Herpes">Herpes simplex</a> <ul><li><a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">HSV-1 & HSV-2</a></li></ul></li> <li><a href="/wiki/Molluscum_contagiosum" title="Molluscum contagiosum">Molluscum contagiosum</a> (<a href="/wiki/Molluscum_contagiosum_virus" title="Molluscum contagiosum virus">MCV</a>)</li> <li><a href="/wiki/Zika_fever" title="Zika fever">Zika fever</a> (<a href="/wiki/Zika_virus" title="Zika virus">Zika virus</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">General <a href="/wiki/Inflammation" title="Inflammation">inflammation</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt>female</dt> <dd><a href="/wiki/Cervicitis" title="Cervicitis">Cervicitis</a></dd> <dd><a href="/wiki/Pelvic_inflammatory_disease" title="Pelvic inflammatory disease">Pelvic inflammatory disease (PID)</a></dd></dl> <dl><dt>male</dt> <dd><a href="/wiki/Epididymitis" title="Epididymitis">Epididymitis</a></dd> <dd><a href="/wiki/Prostatitis" title="Prostatitis">Prostatitis</a></dd></dl> <dl><dt>either</dt> <dd><a href="/wiki/Proctitis" title="Proctitis">Proctitis</a></dd> <dd><a href="/wiki/Urethritis" title="Urethritis">Urethritis</a>/<a href="/wiki/Non-gonococcal_urethritis" title="Non-gonococcal urethritis">Non-gonococcal urethritis (NGU)</a></dd></dl> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Infectious_diseases_–_viral_systemic_diseases" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Viral_systemic_diseases" title="Template:Viral systemic diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Viral_systemic_diseases" title="Template talk:Viral systemic diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Viral_systemic_diseases" title="Special:EditPage/Template:Viral systemic diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Infectious_diseases_–_viral_systemic_diseases" style="font-size:114%;margin:0 4em"><a href="/wiki/Infection" title="Infection">Infectious diseases</a> – <a href="/wiki/Viral_disease" title="Viral disease">viral systemic diseases</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Oncovirus" title="Oncovirus">Oncovirus</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd></dl></dd> <dd><a href="/wiki/Papillomaviridae" title="Papillomaviridae">HPV</a> <dl><dd><a href="/wiki/Cervical_cancer" title="Cervical cancer">Cervical cancer</a></dd> <dd><a href="/wiki/Anal_cancer" title="Anal cancer">Anal cancer</a></dd> <dd><a href="/wiki/Penile_cancer" title="Penile cancer">Penile cancer</a></dd> <dd><a href="/wiki/Vulvar_cancer" title="Vulvar cancer">Vulvar cancer</a></dd> <dd><a href="/wiki/Vaginal_cancer" title="Vaginal cancer">Vaginal cancer</a></dd> <dd><a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">Oropharyngeal cancer</a></dd></dl></dd> <dd><a href="/wiki/Kaposi%27s_sarcoma-associated_herpesvirus" title="Kaposi's sarcoma-associated herpesvirus">KSHV</a> <dl><dd><a href="/wiki/Kaposi%27s_sarcoma" title="Kaposi's sarcoma">Kaposi's sarcoma</a></dd></dl></dd> <dd><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">EBV</a> <dl><dd><a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">Nasopharyngeal carcinoma</a></dd> <dd><a href="/wiki/Burkitt%27s_lymphoma" class="mw-redirect" title="Burkitt's lymphoma">Burkitt's lymphoma</a></dd> <dd><a href="/wiki/Hodgkin_lymphoma" title="Hodgkin lymphoma">Hodgkin lymphoma</a></dd> <dd><a href="/wiki/Follicular_dendritic_cell_sarcoma" title="Follicular dendritic cell sarcoma">Follicular dendritic cell sarcoma</a></dd> <dd><a href="/wiki/Extranodal_NK/T-cell_lymphoma,_nasal_type" title="Extranodal NK/T-cell lymphoma, nasal type">Extranodal NK/T-cell lymphoma, nasal type</a></dd></dl></dd> <dd><a href="/wiki/Merkel_cell_polyomavirus" title="Merkel cell polyomavirus">MCPyV</a> <dl><dd><a href="/wiki/Merkel-cell_carcinoma" title="Merkel-cell carcinoma">Merkel-cell carcinoma</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd> <dd><a href="/wiki/Splenic_marginal_zone_lymphoma" title="Splenic marginal zone lymphoma">Splenic marginal zone lymphoma</a></dd></dl></dd> <dd><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a> <dl><dd><a href="/wiki/Adult_T-cell_leukemia/lymphoma" title="Adult T-cell leukemia/lymphoma">Adult T-cell leukemia/lymphoma</a></dd></dl></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Immune_disorder" title="Immune disorder">Immune disorders</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HIV" title="HIV">HIV</a> <ul><li><a href="/wiki/HIV/AIDS" title="HIV/AIDS">AIDS</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Central_nervous_system_viral_disease" title="Central nervous system viral disease">Central nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Viral_encephalitis" title="Viral encephalitis">Encephalitis</a>/ <a href="/wiki/Viral_meningitis" title="Viral meningitis">meningitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><a href="/wiki/Human_polyomavirus_2" title="Human polyomavirus 2">Human polyomavirus 2</a> <dl><dd><a href="/wiki/Progressive_multifocal_leukoencephalopathy" title="Progressive multifocal leukoencephalopathy">Progressive multifocal leukoencephalopathy</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><a href="/wiki/Measles_morbillivirus" class="mw-redirect" title="Measles morbillivirus">MeV</a> <dl><dd><a href="/wiki/Subacute_sclerosing_panencephalitis" title="Subacute sclerosing panencephalitis">Subacute sclerosing panencephalitis</a></dd></dl></dd> <dd><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">LCV</a> <dl><dd><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">Lymphocytic choriomeningitis</a></dd></dl></dd> <dd><a href="/wiki/Arbovirus_encephalitis" class="mw-redirect" title="Arbovirus encephalitis">Arbovirus encephalitis</a></dd> <dd><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a> (probable) <dl><dd><a href="/wiki/Encephalitis_lethargica" title="Encephalitis lethargica">Encephalitis lethargica</a></dd></dl></dd> <dd><a href="/wiki/Rabies_virus" title="Rabies virus">RV</a> <dl><dd><a href="/wiki/Rabies" title="Rabies">Rabies</a></dd></dl></dd> <dd><a href="/wiki/Chandipura_vesiculovirus" title="Chandipura vesiculovirus">Chandipura vesiculovirus</a></dd> <dd><a href="/wiki/Herpesviral_meningitis" class="mw-redirect" title="Herpesviral meningitis">Herpesviral meningitis</a></dd> <dd><a href="/wiki/Ramsay_Hunt_syndrome_type_2" title="Ramsay Hunt syndrome type 2">Ramsay Hunt syndrome type 2</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Myelitis" title="Myelitis">Myelitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Poliovirus" title="Poliovirus">Poliovirus</a> <ul><li><a href="/wiki/Polio" title="Polio">Poliomyelitis</a></li> <li><a href="/wiki/Post-polio_syndrome" title="Post-polio syndrome">Post-polio syndrome</a></li></ul></li> <li><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a> <ul><li><a href="/wiki/Tropical_spastic_paraparesis" title="Tropical spastic paraparesis">Tropical spastic paraparesis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Eye_disease" title="Eye disease">Eye</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a> <ul><li><a href="/wiki/Cytomegalovirus_retinitis" title="Cytomegalovirus retinitis">Cytomegalovirus retinitis</a></li></ul></li> <li><a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">HSV</a> <ul><li><a href="/wiki/Herpes_simplex_keratitis" title="Herpes simplex keratitis">Herpes of the eye</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a> <ul><li><a href="/wiki/Pericarditis" title="Pericarditis">Pericarditis</a></li> <li><a href="/wiki/Myocarditis" title="Myocarditis">Myocarditis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Respiratory_system" title="Respiratory system">Respiratory system</a>/ <a href="/wiki/Common_cold" title="Common cold">acute viral nasopharyngitis</a>/ <a href="/wiki/Viral_pneumonia" title="Viral pneumonia">viral pneumonia</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a> <ul><li><a href="/wiki/Epstein%E2%80%93Barr_virus_infection" title="Epstein–Barr virus infection">EBV infection</a>/<a href="/wiki/Infectious_mononucleosis" title="Infectious mononucleosis">Infectious mononucleosis</a></li></ul></li> <li><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/RNA_virus#Group_IV_–_positive-sense_ssRNA_viruses" title="RNA virus">IV</a>: <a href="/wiki/Human_coronavirus" class="mw-redirect" title="Human coronavirus">Human coronavirus</a> <a href="/wiki/Human_coronavirus_229E" title="Human coronavirus 229E">229E</a>/<a href="/wiki/Human_coronavirus_NL63" title="Human coronavirus NL63">NL63</a>/<a href="/wiki/Human_coronavirus_HKU1" title="Human coronavirus HKU1">HKU1</a>/<a href="/wiki/Human_coronavirus_OC43" title="Human coronavirus OC43">OC43</a> <ul><li><a href="/wiki/Common_cold" title="Common cold">Common cold</a></li></ul></li> <li><a href="/wiki/Middle_East_respiratory_syndrome%E2%80%93related_coronavirus" class="mw-redirect" title="Middle East respiratory syndrome–related coronavirus">MERS coronavirus</a> <ul><li><a href="/wiki/Middle_East_respiratory_syndrome" class="mw-redirect" title="Middle East respiratory syndrome">Middle East respiratory syndrome</a></li></ul></li> <li><a href="/wiki/Severe_acute_respiratory_syndrome_coronavirus" class="mw-redirect" title="Severe acute respiratory syndrome coronavirus">SARS coronavirus</a> <ul><li><a href="/wiki/Severe_acute_respiratory_syndrome" class="mw-redirect" title="Severe acute respiratory syndrome">Severe acute respiratory syndrome</a></li></ul></li> <li><a href="/wiki/SARS-CoV-2" title="SARS-CoV-2">SARS-CoV-2</a> <ul><li><a href="/wiki/COVID-19" title="COVID-19">COVID-19</a></li></ul></li></ul> <ul><li><a href="/wiki/RNA_virus#Group_V_–_negative-sense_ssRNA_viruses" title="RNA virus">V</a>, <a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a>: <a href="/wiki/Influenza_A_virus" title="Influenza A virus">Influenza virus A</a>/<a href="/wiki/Influenza_B_virus" title="Influenza B virus">B</a>/<a href="/wiki/Influenza_C_virus" title="Influenza C virus">C</a>/<a href="/wiki/Influenza_D_virus" title="Influenza D virus">D</a> <ul><li><a href="/wiki/Influenza" title="Influenza">Influenza</a>/<a href="/wiki/Avian_influenza" title="Avian influenza">Avian influenza</a></li></ul></li></ul> <ul><li>V, <a href="/wiki/Paramyxoviridae" title="Paramyxoviridae">Paramyxoviridae</a>: <a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Human parainfluenza viruses</a> <ul><li><a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Parainfluenza</a></li></ul></li> <li><a href="/wiki/Human_orthopneumovirus" class="mw-redirect" title="Human orthopneumovirus">Human orthopneumovirus</a></li> <li><a href="/wiki/Human_metapneumovirus" title="Human metapneumovirus">hMPV</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_digestive_system" title="Human digestive system">Human digestive system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pharynx" title="Pharynx">Pharynx</a>/<a href="/wiki/Esophagus" title="Esophagus">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li> <li><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a> <ul><li><a href="/wiki/Cytomegalovirus_esophagitis" title="Cytomegalovirus esophagitis">Cytomegalovirus esophagitis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastroenteritis#Viral" title="Gastroenteritis">Gastroenteritis</a>/ <a href="/wiki/Gastroenteritis#Virus" title="Gastroenteritis">diarrhea</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><a href="/wiki/Adenoviridae" title="Adenoviridae">Adenovirus</a> <dl><dd><a href="/wiki/Adenovirus_infection" title="Adenovirus infection">Adenovirus infection</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><a href="/wiki/Rotavirus" title="Rotavirus">Rotavirus</a> (<a href="/wiki/Rotaviral_gastroenteritis" class="mw-redirect" title="Rotaviral gastroenteritis">Gastroenteritis</a>)</dd> <dd><a href="/wiki/Norovirus" title="Norovirus">Norovirus</a></dd> <dd><a href="/wiki/Astrovirus" title="Astrovirus">Astrovirus</a></dd> <dd><a href="/wiki/Coronavirus" title="Coronavirus">Coronavirus</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Hepatitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a> (<a href="/wiki/Hepatitis_B" title="Hepatitis B">B</a>)</dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></dd> <dd><a href="/wiki/Hepatitis_A#Virology" title="Hepatitis A">HAV</a> (<a href="/wiki/Hepatitis_A" title="Hepatitis A">A</a>)</dd> <dd><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a> (<a href="/wiki/Hepatitis_C" title="Hepatitis C">C</a>)</dd> <dd><a href="/wiki/Hepatitis_D" title="Hepatitis D">HDV</a> (<a href="/wiki/Hepatitis_D" title="Hepatitis D">D</a>)</dd> <dd><a href="/wiki/Orthohepevirus_A" title="Orthohepevirus A">HEV</a> (<a href="/wiki/Hepatitis_E" title="Hepatitis E">E</a>)</dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Genitourinary_system" title="Genitourinary system">Urogenital</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/BK_virus" title="BK virus">BK virus</a></li> <li><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Skin_infections,_symptoms_and_signs_related_to_viruses" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Viral_cutaneous_conditions" title="Template:Viral cutaneous conditions"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Viral_cutaneous_conditions" title="Template talk:Viral cutaneous conditions"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Viral_cutaneous_conditions" title="Special:EditPage/Template:Viral cutaneous conditions"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Skin_infections,_symptoms_and_signs_related_to_viruses" style="font-size:114%;margin:0 4em"><a href="/wiki/Skin_infection" title="Skin infection">Skin infections</a>, symptoms and signs related to <a href="/wiki/Virus" title="Virus">viruses</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Herpesviridae" title="Herpesviridae">Herpesviridae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Alphaherpesvirinae" title="Alphaherpesvirinae">Alpha.</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">HSV</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Herpes" title="Herpes">Herpes simplex</a></li> <li><a href="/wiki/Herpetic_whitlow" title="Herpetic whitlow">Herpetic whitlow</a></li> <li><a href="/wiki/Herpes_gladiatorum" title="Herpes gladiatorum">Herpes gladiatorum</a></li> <li><a href="/wiki/Herpes_simplex_keratitis" title="Herpes simplex keratitis">Herpes simplex keratitis</a></li> <li><a href="/wiki/Herpes" title="Herpes">Herpetic sycosis</a></li> <li><a href="/wiki/Neonatal_herpes_simplex" class="mw-redirect" title="Neonatal herpes simplex">Neonatal herpes simplex</a></li> <li><a href="/wiki/Genital_herpes" title="Genital herpes">Genital herpes</a></li> <li><a href="/wiki/Cold_sore" title="Cold sore">Cold sore</a></li> <li><a href="/wiki/Eczema_herpeticum" title="Eczema herpeticum">Eczema herpeticum</a></li> <li><a href="/wiki/Herpes_esophagitis" title="Herpes esophagitis">Herpetiform esophagitis</a></li> <li><a href="/wiki/Herpetic_gingivostomatitis" title="Herpetic gingivostomatitis">Herpetic gingivostomatitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/B_virus" title="B virus">B virus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/B_virus" title="B virus">B virus infection</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Varicella_zoster_virus" title="Varicella zoster virus">VZV</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chickenpox" title="Chickenpox">Chickenpox</a></li> <li><a href="/wiki/Shingles" title="Shingles">Herpes zoster</a></li> <li><a href="/wiki/Ramsay_Hunt_syndrome_type_2" title="Ramsay Hunt syndrome type 2">Herpes zoster oticus</a></li> <li><a href="/wiki/Herpes_zoster_ophthalmicus" title="Herpes zoster ophthalmicus">Ophthalmic zoster</a></li> <li><a href="/wiki/Disseminated_herpes_zoster" class="mw-redirect" title="Disseminated herpes zoster">Disseminated herpes zoster</a></li> <li><a href="/wiki/Postherpetic_neuralgia" title="Postherpetic neuralgia">Zoster-associated pain</a></li> <li><a href="/wiki/Modified_varicella-like_syndrome" class="mw-redirect" title="Modified varicella-like syndrome">Modified varicella-like syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Betaherpesvirinae" title="Betaherpesvirinae">Beta.</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Human_herpesvirus_6" title="Human herpesvirus 6">Human herpesvirus 6</a>/<a href="/wiki/Roseolovirus" title="Roseolovirus">Roseolovirus</a> <ul><li><a href="/wiki/Roseola" title="Roseola">Exanthema subitum</a></li> <li><a href="/wiki/Roseola_vaccinia" title="Roseola vaccinia">Roseola vaccinia</a></li></ul></li> <li><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalic inclusion disease</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gammaherpesvirinae" title="Gammaherpesvirinae">Gamma.</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Kaposi%27s_sarcoma-associated_herpesvirus" title="Kaposi's sarcoma-associated herpesvirus">Kaposi's sarcoma-associated herpesvirus</a> <ul><li><a href="/wiki/Kaposi%27s_sarcoma" title="Kaposi's sarcoma">Kaposi's sarcoma</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Poxviridae" title="Poxviridae">Poxviridae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Orthopoxvirus" title="Orthopoxvirus">Ortho.</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Smallpox" title="Smallpox">Variola</a> <ul><li><a href="/wiki/Smallpox" title="Smallpox">Smallpox</a></li> <li><a href="/wiki/Alastrim" class="mw-redirect" title="Alastrim">Alastrim</a></li></ul></li> <li><a href="/wiki/Monkeypox_virus" title="Monkeypox virus">Monkeypox virus</a> <ul><li><a href="/wiki/Mpox" title="Mpox">Monkeypox</a></li></ul></li> <li><a href="/wiki/Cowpox" title="Cowpox">Cowpox</a></li> <li><a href="/wiki/Vaccinia_virus" class="mw-redirect" title="Vaccinia virus">Vaccinia virus</a> <ul><li><a href="/wiki/Vaccinia" title="Vaccinia">Vaccinia</a></li> <li><a href="/wiki/Generalized_vaccinia" title="Generalized vaccinia">Generalized vaccinia</a></li> <li><a href="/wiki/Eczema_vaccinatum" title="Eczema vaccinatum">Eczema vaccinatum</a></li> <li><a href="/wiki/Progressive_vaccinia" title="Progressive vaccinia">Progressive vaccinia</a></li></ul></li> <li><a href="/wiki/Buffalopox" title="Buffalopox">Buffalopox</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Parapoxvirus" title="Parapoxvirus">Para.</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Farmyard_pox" title="Farmyard pox">Farmyard pox</a>: <a href="/wiki/Milker%27s_nodule" title="Milker's nodule">Milker's nodule</a></li> <li><a href="/wiki/Bovine_papular_stomatitis" title="Bovine papular stomatitis">Bovine papular stomatitis</a></li> <li><a href="/wiki/Paravaccinia_virus" title="Paravaccinia virus">Pseudocowpox</a></li> <li><a href="/wiki/Orf_(disease)" title="Orf (disease)">Orf</a></li> <li><a href="/wiki/Sealpox" title="Sealpox">Sealpox</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Yatapoxvirus" title="Yatapoxvirus">Yatapoxvirus</a>: <a href="/wiki/Tanapox" title="Tanapox">Tanapox</a></li> <li><a href="/wiki/Yaba_monkey_tumor_virus" title="Yaba monkey tumor virus">Yaba monkey tumor virus</a></li> <li><a href="/wiki/Molluscum_contagiosum_virus" title="Molluscum contagiosum virus">Molluscum contagiosum virus</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Papillomaviridae" title="Papillomaviridae">Papillomaviridae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="HPV" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Papillomaviridae" title="Papillomaviridae">HPV</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Wart" title="Wart">Wart</a>/<a href="/wiki/Plantar_wart" title="Plantar wart">plantar wart</a></li> <li><a href="/wiki/Heck%27s_disease" title="Heck's disease">Heck's disease</a></li> <li><a href="/wiki/Genital_wart" title="Genital wart">Genital wart</a> <ul><li><a href="/wiki/Giant_condyloma_acuminatum" title="Giant condyloma acuminatum">giant</a></li></ul></li> <li><a href="/wiki/Laryngeal_papillomatosis" title="Laryngeal papillomatosis">Laryngeal papillomatosis</a></li> <li><a href="/wiki/Butcher%27s_wart" title="Butcher's wart">Butcher's wart</a></li> <li><a href="/wiki/Bowenoid_papulosis" title="Bowenoid papulosis">Bowenoid papulosis</a></li> <li><a href="/wiki/Epidermodysplasia_verruciformis" title="Epidermodysplasia verruciformis">Epidermodysplasia verruciformis</a></li> <li><a href="/wiki/Flat_wart" title="Flat wart">Verruca plana</a></li> <li><a href="/wiki/Pigmented_wart" title="Pigmented wart">Pigmented wart</a></li> <li><a href="/wiki/Verrucae_palmares_et_plantares" title="Verrucae palmares et plantares">Verrucae palmares et plantares</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bovine_papillomavirus" title="Bovine papillomavirus">Bovine papillomavirus</a> <ul><li><a href="/wiki/Equine_sarcoid" class="mw-redirect" title="Equine sarcoid">Equine sarcoid</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Parvoviridae" title="Parvoviridae">Parvoviridae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Parvovirus_B19" title="Parvovirus B19">Parvovirus B19</a> <ul><li><a href="/wiki/Fifth_disease" title="Fifth disease">Erythema infectiosum</a></li> <li><a href="/wiki/Reticulocytopenia" title="Reticulocytopenia">Reticulocytopenia</a></li> <li><a href="/wiki/Papular_purpuric_gloves_and_socks_syndrome" class="mw-redirect" title="Papular purpuric gloves and socks syndrome">Papular purpuric gloves and socks syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Polyomaviridae" title="Polyomaviridae">Polyomaviridae</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Merkel_cell_polyomavirus" title="Merkel cell polyomavirus">Merkel cell polyomavirus</a> <ul><li><a href="/wiki/Merkel-cell_carcinoma" title="Merkel-cell carcinoma">Merkel cell carcinoma</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Paramyxoviridae" title="Paramyxoviridae">Paramyxoviridae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Measles_morbillivirus" class="mw-redirect" title="Measles morbillivirus">MeV</a> <ul><li><a href="/wiki/Measles" title="Measles">Measles</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rubivirus" title="Rubivirus">Matonaviridae</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Rubella_virus" title="Rubella virus">Rubella virus</a> <ul><li><a href="/wiki/Rubella" title="Rubella">Rubella</a></li> <li><a href="/wiki/Congenital_rubella_syndrome" title="Congenital rubella syndrome">Congenital rubella syndrome</a> ("German measles")</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Alphavirus" title="Alphavirus">Togaviridae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alphavirus_infection" title="Alphavirus infection">Alphavirus infection</a></li> <li><a href="/wiki/Chikungunya" title="Chikungunya">Chikungunya fever</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Picornavirus" title="Picornavirus">Picornaviridae</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Coxsackie_A_virus" title="Coxsackie A virus">Coxsackie A virus</a> <ul><li><a href="/wiki/Hand,_foot,_and_mouth_disease" title="Hand, foot, and mouth disease">Hand, foot, and mouth disease</a></li> <li><a href="/wiki/Herpangina" title="Herpangina">Herpangina</a></li></ul></li> <li><a href="/wiki/Foot-and-mouth_disease_virus" title="Foot-and-mouth disease virus">Foot-and-mouth disease virus</a></li> <li><a href="/wiki/Boston_exanthem_disease" title="Boston exanthem disease">Boston exanthem disease</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Ungrouped</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Asymmetric_periflexural_exanthem_of_childhood" title="Asymmetric periflexural exanthem of childhood">Asymmetric periflexural exanthem of childhood</a></li> <li><a href="/wiki/Post-vaccination_follicular_eruption" title="Post-vaccination follicular eruption">Post-vaccination follicular eruption</a></li> <li><a href="/wiki/Lipsch%C3%BCtz_ulcer" title="Lipschütz ulcer">Lipschütz ulcer</a></li> <li><a href="/wiki/Eruptive_pseudoangiomatosis" title="Eruptive pseudoangiomatosis">Eruptive pseudoangiomatosis</a></li> <li><a href="/wiki/Trichodysplasia_spinulosa" title="Trichodysplasia spinulosa">Viral-associated trichodysplasia</a></li> <li><a href="/wiki/Gianotti%E2%80%93Crosti_syndrome" title="Gianotti–Crosti syndrome">Gianotti–Crosti syndrome</a></li></ul> </div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1130092004">.mw-parser-output .portal-bar{font-size:88%;font-weight:bold;display:flex;justify-content:center;align-items:baseline}.mw-parser-output .portal-bar-bordered{padding:0 2em;background-color:#fdfdfd;border:1px solid #a2a9b1;clear:both;margin:1em auto 0}.mw-parser-output .portal-bar-related{font-size:100%;justify-content:flex-start}.mw-parser-output .portal-bar-unbordered{padding:0 1.7em;margin-left:0}.mw-parser-output .portal-bar-header{margin:0 1em 0 0.5em;flex:0 0 auto;min-height:24px}.mw-parser-output .portal-bar-content{display:flex;flex-flow:row wrap;flex:0 1 auto;padding:0.15em 0;column-gap:1em;align-items:baseline;margin:0;list-style:none}.mw-parser-output .portal-bar-content-related{margin:0;list-style:none}.mw-parser-output .portal-bar-item{display:inline-block;margin:0.15em 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