Misc. HPV thread.

[Minuteman]

A thread for collating in one place miscellaneous information about human papillomavirus (HPV) not immediately applicable to circumcision, but which may prove useful to have.

Hariri S, Unger ER, Sternberg M, Dunne EF, Swan D, Patel S, Markowitz LE (2011) Prevalence of genital human papillomavirus among females in the United States, the National Health And Nutrition Examination Survey, 2003-2006 J Infect Dis. 2011 Aug 15;204(4):566-73 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21791659

BACKGROUND:

Genital human papillomaviruses (HPV) include >40 sexually transmitted viruses. Most HPV infections do not progress to disease, but infection with certain types of HPV can cause cervical and other anogenital and oropharyngeal cancer, and other types of HPV are associated with anogenital warts. HPV vaccines prevent infection with HPV 16 and 18, which account for 70% of cases of cervical cancer, and HPV 6 and 11, which cause 90% of the cases of anogenital warts.
METHODS:

Using data and self-collected cervicovaginal specimens from 4150 females, 14-59 years of age, from consecutive National Health and Nutrition Examination Surveys (2003-2006), we estimated the prevalence of type-specific HPV DNA and examined sociodemographic and sexual determinants.
RESULTS:

The overall prevalence of HPV was 42.5% in females 14-59 years of age and varied significantly by age, race or ethnicity, and number of sex partners. Individual type prevalence was less than 7%, ranging from <0.5% through 6.5%. The most common type was nononcogenic HPV 62 (found in 6.5% of subjects), followed by HPV 53 and HPV 16 (4.7%), both of which are oncogenic types. The most prevalent species was nononcogenic α3.
CONCLUSIONS:

HPV infection is common among US females, with the highest burden of infection found in young females 20-24 years of age. Monitoring trends in HPV type distribution will contribute to our understanding of the early impact of HPV vaccines.

Also used to create this graph on the CDC website:

http://www.cdc.gov/std/stats10/figures/49.htm



* HPV = human papillomavirus.

NOTE: Error bars indicate 95% confidence interval. Both high-risk and low-risk HPV types were detected in some females.

[Minuteman]

"Second HPV Vaccine Shows Early Positive Results" National Cancer Institute (NCI) Clinical Trials page 2 December 2011.

http://www.cancer.gov/clinicaltrials...pv-vaccine0707

Adapted from the NCI Cancer Bulletin.

Positive interim results for a candidate vaccine to prevent persistent infections by human papillomavirus (HPV) types 16 and 18 were published in the June 30, 2007, issue of The Lancet (see the journal abstract). The vaccine Cervarix® was 90 percent effective in preventing grade 2 or 3 cervical intraepithelial neoplasia (CIN2+) that contained DNA from either virus type.

The results come from a large international trial of 18,644 women aged 15-25 sponsored by the drug's manufacturer, GlaxoSmithKline Biologicals (see the protocol summary). The trial design called for analysis of early results after 23 cases of CIN2+ were detected. Two of these cases were among the 9,258 women receiving the vaccine, and 21 were among the 9,267 controls who received a hepatitis A vaccine. The mean follow-up time was 14.8 months.

In an editorial, Drs. Jessica A. Kahn of the University of Cincinnati and Robert D. Burk of the Albert Einstein College of Medicine in New York wrote, "These interim data are encouraging." But they noted that the paper does not provide information about the public health impact of vaccination "in real world settings" because the report does not provide estimates of the reduction in overall rates of CIN2+. They stress that vaccination of young adolescents is likely to have the greatest public health benefit, but that continued screening will still be required after vaccination.

A separate phase III trial testing Cervarix, cosponsored by the National Cancer Institute with support from the National Institutes of Health's Office for Research on Women's Health and the Costa Rica Ministry of Health, is now underway in Costa Rica. This trial should provide additional information about the public health impact and efficacy of the vaccine.

Longer-term data on the vaccine's overall efficacy (see the journal abstract) and efficacy against other oncogenic HPV types (see the journal abstract) were subsequently published in Lancet Oncology.

[Minuteman]

"Preventing Cervical Cancer" HealthDay News 16 December 2011.

http://liveweb.archive.org/http://ww...al_121611.html

Transcript:

Protecting young women from cervical cancer may be even easier than experts thought.

A virus called HPV causes almost all cases of cervical cancer. Vaccines can protect girls and women from some of the most threatening types of HPV. However, the vaccines are given in three doses, and in the United States most women don't complete the three-dose regimen

A new study suggests they may not need to.

In the study, reported in the Journal of the National Cancer Institute, researchers looked at thousands of women who received one to three doses of an HPV vaccine. The researchers followed them for about 4 years, taking note of women who had an HPV infection that lasted at least 10 months.

The vaccine seemed to be about as effective whether women had one, two, or three doses. As a result, the researchers point out that one or two doses might offer as much protection as all three. However, more research is needed to show whether the three-dose schedule offers longer protection, and whether these results apply to other HPV vaccines.

I'm Dr. Cindy Haines of HealthDay TV, with the health news that matters to you.

[Minuteman]

"HPV Infection Lasts Longer in Young Black Women: Study" HealthDay News 1 April 2012.

http://www.nlm.nih.gov/medlineplus/n...ry_123620.html Accessed: 2012-04-02. Archived by WebCite at http://www.webcitation.org/66dXEZTZh

Human papillomavirus infection tends to lasts longer in college-aged black women than whites, possibly setting them up for a higher risk of cervical cancer, according to a new study.

The researchers also found that black women are 70 percent more likely to have an abnormal Pap test -- the screening for cervical cancer -- than their white counterparts. Human papillomavirus, or HPV, which is a sexually transmitted infection, can cause genital warts and is responsible for many cases of cervical cancer.
...
"We are beginning to understand that HPV may behave differently in different ethnic groups," she said. "This study is very provocative, but the jury is still out on screening and treatment, and we have to be careful about drawing too many conclusions."

Data and conclusions of research presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal.

[Minuteman]

"HPV-Related Head, Neck Cancers on the Rise" HealthDay News 4 April 2012.

http://www.healthfinder.gov/news/new...x?Docid=663305 Accessed: 2012-04-04. Archived by WebCite at http://www.webcitation.org/66gaMlLW5

Excerpt:

The incidence of head and neck cancers related to the human papillomavirus (HPV) is rising in the United States, with the greatest increase among middle-aged white men, a new study finds.

Tobacco and alcohol are the leading risk factors for head and neck cancers, but the sexually transmitted infection HPV is becoming an important risk factor as well, according to researchers from the Louisiana State University Health Sciences Center in New Orleans.

For the study, Edward Peters, associate professor and director of the epidemiology program at the university's School of Public Health, and colleagues analyzed data from 40 U.S. cancer registries from 1995 to 2005 and found a significant overall increase in head and neck cancers in areas of the body strongly associated with HPV infection, and a significant decline in head and neck cancers in sites not associated with the virus.

The three sites associated with HPV infection are the tonsil, the base of the tongue and lingual tonsil, and parts of the oropharynx, according to the report published online March 20 in the journal PLoS One.

[Minuteman]

"HPV Vaccination Sends Genital Wart Cases Plummeting: Study" HealthDay News 18 April 2013.

http://www.nlm.nih.gov/medlineplus/n...ry_136053.html

Excerpt:

In the five years since launching a nationwide human papillomavirus (HPV) vaccination program among girls between the ages of 12 and 26, Australia has seen a huge drop in the number of cases of genital warts, new research reveals.

Among Australian girls in the targeted age range for vaccination, the country saw genital wart cases plummet by 59 percent within just the first two years of the program's launch in 2007.

By aggressively vaccinating girls against HPV (which is responsible for 90 percent of genital wart diagnoses), Australia appears to have offered considerable protection not just to its female population but also its men as well.
...
Commenting on the report, Dr. Jocylen Glassberg, an obstetrician/gynecologist at Scott and White Healthcare in Round Rock, Texas, said that "the take-home message is the vaccine is obviously working."

"It will take many more years to see the same decline in cervical cancer rates due to the naturally slow progression of that disease process," she said. "But the vaccine works. The fact that genital wart rates were virtually zero after such a short time in women and men, even in a program just aimed at vaccinated women, is a phenomenal result."