HPV virus and the leading cause of Ca Cx!!. But can we identify and combat the co factors?? How many of us believe that genital HPV infection is the most common viral sexually transmitted infection and affects roughly 80 % of sexually active people.

What are  oncogenic HPV?? :- Most of us are aware that HPV has an immense role in the etiology of cervical neoplasia and later Cancer cervix -15 genotypes of carcinogenic hpv causes almost all cases of cervical cancer.Chronic infection with oncogenic HPV is a necessary but insufficient cause for the development of cervix cancer. Cervical cancer arises through a series of four steps HPV transmission  1) viral persistenceà 2)  progression of a clone of persistently infected cellsà  to 3)  pre cancer and finally à 4)  then and then invasion. Presence of co factors is very important A)  as high parity B) smoking C)  nutritional deficiency D)  hormonal contraceptive use and E)  presence of other sexually transmitted infections increase the risk. Genital HPV infection is the most common viral sexually transmitted infection and affects roughly 80 % of sexually active people. In most cases HPV infection is cleared by the cell mediated immune system within 1-2 years of exposure. The median time of clearance of HPV infections detected during screening studies is 6-18 months. The small proportion of carcinogenic infections persisting for several years is strongly linked to a high absolute risk of diagnosis of pre cancer. The average time between HPV infection and pre cancer is about 7-10 years . Both mild and moderate dysplasia are more likely to regress than to progress. There is only 1 % risk per year of progression from mild to severe dysplasia or worse but the risk of progression from moderate to severe dysplasia is 16 % within 2 years and 25 % within 5 years.

 More than 100 hpv types have been characterised molecularly and about 40 are known to infect the genital tract. Persistent infection with one of the 15 genotypes of carcinogenic hpv causes almost all cases of cervical cancer. Seventy percent of cervical cancers and about 50 % of cervical intraepithelial neoplasia be attributed to two most carcinogenic hpv types , hpv 16 and hpv 18 while HPV 6 NS HPV 11 are responsible for about 90 % of genital warts,

Most of the pre malignant and malignant lesions are of the squamous type but around 15 % are of the glandular type hpv 16 is associated to a greater extent with squamous cell carcinomas while hpv 18 to adenocarcinoma, Hence in women with persistent hpv 18 findings even in the absence of other cytologic or colposcopic abnormalities a thorough examination of the endocervix should be conducted to exclude hidden lesions. Hpv is found in more than 90 % of cervical cancers 94.7 % of the cervical cancers and 84.4 % of the HSILs among women in rural western india were positive for hpv infection . Presence of hpv express the oncogenic proteins E6 and E7 that inactivate the host regulatory proteins p53 and pRb respectively . Worldwide interest has grown in the potential for hpv testing in cervical cancer prevention programmes.