Human Papilloma Virus
Key Questions (by Danielle Plattenburg)
HPV or human papilloma virus can cause genital HPV infection and describes a common virus group which includes more than 100 types or strains. The virus is sexually transmitted. Most of the viruses are relatively harmless, like the ones that cause warts on the hands and feet. In most people, the body’s defenses are enough to clear the virus without any medical treatment. If not cleared by the body, some HPV types can cause genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped. Other types can cause abnormal changes in the cells lining the cervix that can lead to pre-cancers and even turn into cervical cancer.
According to the Department of Health and Human Services Centers for Disease Control and Prevention, HPV infection is the most common sexually transmitted infection in the United States. At least 50 percent of sexually active people will get HPV at some time in their lives. Every year in the U.S., about 6.2 million people get HPV. HPV is most common in young women and men who are in their late teens and early 20s.
Both men and women are affected – men are carriers of strains linked to cervical cancer.
Between 9% and 18% of those who have HPV have genital warts.
One out of every 1000 women with HPV will get cervical cancer.
In June 2006, the Food and Drug Administration approved Gardasil, the first vaccine developed to prevent cervical cancer, precancerous genital lesions, and genital warts due to HPV. Gardasil is a recombinant (contains no live virus) vaccine that prevents infection with four HPV types: 6, 11, 16, and 18. Types 6 and 11 are low risk HPV types, associated with 90 percent of genital warts. Types 16 and 18 are high risk HPV types which together cause 70 percent of the cases of cervical cancer.
Gardasil may not fully protect everyone and does not prevent all types of cervical cancer, so it is important for women to continue regular cervical cancer screenings. Gardasil is given as 3 injections over 6 months and can cause pain, swelling, itching, and redness at the injection site, fever, nausea, and dizziness.
Prepubertal females represent the group most likely to benefit from vaccination with the newly licensed HPV vaccine, and the makers of the vaccine recommend it for girls and women ages 9 to 26. The Advisory Committee on Immunization Practices (ACIP) voted to recommend that a the be routinely given to girls when they are 11-12 years old. The ACIP recommendation also allows for vaccination of girls beginning at nine years old as well as vaccination of girls and women 13-26 years old. Women who are pregnant or allergic should not receive the vaccine. Young men are also potentially good candidates for this protection since both men and women are carriers of HPV, but at this time the FDA has not included young men in approved populations to receive the vaccine. Barriers to vaccination include the cost of the vaccine ($300 to $500) and cultural acceptance regarding women’s sexual behaviors.
New York Times (2/17/07) has published a map of states that are considering legislation to require HPV vaccination, use state funding or insurance to pay for the vaccine, and/or education programs to encourage HPV vaccination.