Genital tract HPV types: LOW RISK: 6, 11, 40, 42, 43, 44;

Genital tract HPV types: LOW RISK: 6, 11, 40, 42, 43, 44; INTERMEDIATE RISK: 31, 33, 35, 51, 52; HIGH RISK: 16, 18, 45, 56

HPV-Induced Oncogenesis: Viral Events HPV-Induced Oncogenesis: Viral Events Integration at the E2 site leads to its deactivation Integration at the E2 site leads to its deactivation

and release of E6 and E7 gene inhibitionand release of E6 and E7 gene inhibition

HPV-Induced Oncogenesis: Cellular Events E6 binds to p53 and induces its degradation. E7 binds the Rb gene

product, causing the transcription factor E2F-1 to become unbound and free to induce cell cycle activation/growth.

This algorithm generally depicts standard management options for abnormal Pap smears. Options include management of the first ASCUS smear and

management of low-grade lesions (LGSIL). Atypical glandular cells of undetermined significance (AGCUS) should lead to consideration of

colposcopy, endocervical curettage (ECC), and possibly cone biopsy (Bx).