Human Papilloma Virus (HPV) is the most common sexually transmitted disease worldwide. It is spread by genital skin-to-skin contact, and can cause both genital warts (benign) and cervical cancer. HPV infection has also been linked to cancer of the vulva and vagina in women and cancer of the penis in men. It is also linked to mouth and throat cancer as well as cancer of the anus in both men and women.
Seventy-five percent of sexually active adults contract HPV before they turn 50. Most patients infected with HPV have no signs or symptoms, and 90% of infections clear within 2 years without any treatment. In 10% to 20% of women, the HPV infection does not clear up. This raises the risk of pre-cancer and then cancer of the cervix.
There are over 100 types of HPV. HPV is classified as either high-or low-risk based upon whether it can cause cervical cancer.
At least 13 of the HPV virus types can cause cervical cancer.
HPV types 16 and 18 cause 70% of cervical cancer.
Types 31, 33, 45, 52, and 58 are also high-risk, and are responsible for 19% of cervical cancer cases.
HPV types 6 and 11 cause 90% of genital warts.
HPV is responsible for virtually ALL cases of cervical cancer. Cervical cancer is the 4th most common cancer in women, with about 500,000 new cases per year worldwide. More than 270,000 women die every year from cervical cancer. Most (85%) of these deaths occur in low- and middle-income countries. Cancer associated with HPV takes 15-20 years to develop, and early testing can help detect it. Early treatment of pre-cancerous lesions prevents 80% of cervical cancer later on.
There are 3 vaccines currently available that protect against becoming infected with HPV. The first vaccine was approved by the FDA in 2006. These vaccines are made in a lab from virus-like particles and contain NO DNA or live viruses. They do NOT treat HPV infection or cancer. After vaccination, protection has been shown to last for up to 8-10 years, and longer studies are ongoing. The vaccines are most effective when given PRIOR to exposure—before first sexual activity. The World Health Organization recommends vaccinating girls between the ages of 9 to 13, before they become sexually active. For females under 15 years of age, a 2-dose schedule over 6 months is recommended. For females 15 or older, a 3-dose schedule over 6 months is recommended. In studies, HPV vaccines show nearly 100% efficiency at preventing precancerous lesions of the cervix.
There are 3 available vaccines against HPV, and they each protect against different strains of the virus:
Protects against infection from HPV types 6, 11, 16 and 18
Protects against infection from HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58
Protects against infection from HPV types 16 and 18
Like all vaccines, the HPV vaccine can have side effects. Most common are injection site pain and swelling. So far, there have been no serious side effects caused by the vaccine.
Recently, there has been exciting news published on the benefits of the quadrivalent (Gardasil®, 6/11/16/18) vaccine after a decade of experience with its use. Over 6 years, infection with HPV (types 6/11/16/18) went down by about 90% in females vaccinated in Australia and the United States.After years of the vaccine being used in Australia, there was an estimated 90% reduction in genital warts. Reductions in precancerous lesions are different depending upon where the study was and the group studied. In areas with high levels of immunizations, there was up to an 85% reduction in precancerous lesions. Reductions favor those vaccinated at younger ages. While reductions in cervical cancer rates will take more time to know for sure, this 10 years of information is very good news.
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