Human Papillomavirus

A 32-year-old HIV-positive man (CD4 count 150 cells/μL) presents with extensive, treatment-resistant genital warts that have failed topical podophyllotoxin and cryotherapy over 6 months. Which agent is most appropriate as the next-line therapy?

A 35-year-old woman from Mumbai undergoes routine cervical screening and is found to have HPV-16 positive, high-grade squamous intraepithelial lesion (HSIL) on liquid-based cytology. Colposcopy with directed biopsy confirms cervical intraepithelial neoplasia grade 2 (CIN 2). She is otherwise healthy with no immunosuppression. What is the most appropriate next step in management?

The E6 and E7 oncoproteins of high-risk HPV types exert their transforming effect primarily by inactivating which two tumor suppressor proteins?

A 28-year-old woman from Delhi presents with vaginal bleeding and postcoital spotting for 3 months. On speculum examination, a friable, bleeding cervical lesion is noted. Pap smear shows atypical squamous cells of undetermined significance (ASCUS). HPV testing by PCR is positive for HPV-16. Colposcopy-directed cervical biopsy reveals cervical intraepithelial neoplasia grade 2 (CIN 2). Which HPV type is most likely responsible for her cervical pathology, and what is the oncogenic mechanism?

A 35-year-old man from Mumbai presents with a painless, warty growth on the glans penis for 6 months. Histopathology shows koilocytic changes and hyperkeratosis. HPV PCR is positive for HPV-6 and HPV-11. He is otherwise healthy with no systemic symptoms. What is the most appropriate management, and what is the risk of malignant transformation?