Posted on 02/27/2007 8:53:16 PM PST by neverdem
ABC News Medical Unit
HPV Is the Most Common Sexually Transmitted Disease, New Research Suggests
More than a quarter of teenage girls and women in the United States may have a common sexually transmitted virus. And most may not even know they have it.
A study published today in the Journal of the American Medical Association, which looked at nearly 2,000 women and girls aged 14 to 59 years, showed 27 percent overall were infected with one or more strains of human papillomavirus (HPV), making it the most common sexually transmitted disease (STD) in the United States.
The research also found that HPV is even more common in younger age groups, with nearly half of all women in their early 20s infected.
According to the study authors, "Our data indicate that the burden of prevalent HPV infection among women was higher than previous estimates."
Recent debate over proposed state programs mandating vaccinations with the HPV vaccine Gardasil for preteen girls has brought the virus into the national spotlight.
Public health experts say the move could protect many of these girls from cervical cancer, which can be caused by certain types of the virus. About 10,000 women in the United States are diagnosed with cervical cancer each year, and 3,700 women die from it.
Approximately 2 percent of women in the study were infected with one of the cancer-causing subtypes. Not all women who are infected with these subtypes will get cervical cancer, but the infection puts them at greater risk.
Doctors Not Surprised
Many doctors say the findings are not shocking.
"We already knew this infection was common," says Dr. Kevin Ault, associate professor of gynecology and obstetrics at Emory University School of Medicine. "This just adds urgency to getting the vaccine to adolescents and young women."
Dr. Lisa Jones, a gynecologist in New Bedford, Mass., says she hopes the media coverage of HPV and its vaccine will help educate people about how widespread the virus is.
"It is not just 'bad girls' that get HPV," Jones says. "Even women with one partner in their lifetime are also at risk; all it takes is for their partner to have had one other partner."
But even though the findings were little surprise to doctors, they could come as a shock to the public.
"This is a more recent study, and it more accurately reflects what we're seeing in terms of sexual behavior," said Dr. Carol Brown of Memorial Sloan-Kettering Cancer Center in an interview with ABC medical correspondent John McKenzie.
And the figures could have the greatest implications for younger women. Researchers found that among females 14 to 24 years of age, 34 percent were infected with HPV. That suggests 7.5 million teens and young women infected nationwide -- much more than the 4.6 million in previous estimates.
"I think it's really shocking that the virus is so common," Brown told McKenzie.
"It horrifies me. I have a daughter, 18, and a daughter, 22."
Vaccine Debate Continues
Public health experts say information about the prevalence, or infection rate, of HPV is helpful at a time when young women are starting to be vaccinated against the disease.
In an editorial that accompanies the study, Susan Weller and Dr. Lawrence Stanberry of the Sealy Center for Vaccine Development in Galveston, Texas, say the study may provide a helpful baseline to later determine whether or not vaccination programs work.
Such findings may also help determine whether it is cost effective to vaccinate all young women, Weller and Stanberry say.
The vaccine targets four specific subtypes of the virus -- types 6, 11, 16 and 18.
HPV types 16 and 18 cause 70 percent of cervical cancer cases. Types 6 and 11, on the other hand, while much more common are responsible only for genital warts.
The infection rate of the four HPV types contained in the HPV vaccine was 3.4 percent, which suggests that 3.1 million women in the United States may be infected with these strains.
Much of the debate surrounding the HPV vaccine concerns the young age at which females are recommended to receive the shots.
The Centers for Disease Control and Prevention (CDC) currently recommends that all girls ages 11 to 12 be vaccinated. This is because the vaccine works best if the recipient has not yet been exposed to the virus.
According to a CDC spokesperson, the results of the study will not change their vaccination recommendation.
However, some opponents of mandatory vaccination programs for preteen girls argue that vaccinating these girls may encourage them to be sexually active at a younger age.
But previous studies have shown that some girls even younger than 14 are infected with HPV. Dr. Diane Harper, a gynecologist at Dartmouth Medical School, reports, "There is no one age at which all females are not infected with HPV."
And in the current study, at least one of the four HPV types in the vaccine was detected in 6.2 percent of females ages 14 to 19 years.
Vaccine Is No Substitute for Pap Smear
Harper says vaccination against HPV does not provide 100 percent protection against cervical cancer, and women still need to have regular Pap smears as recommended by their doctor to allow for early detection of changes in the cervix.
"Vaccination is not a substitute or a replacement for Pap testing," she says. "Vaccination without Pap testing will lead to an increase in cervical cancers in the U.S."
Dr. Steven Goldstein, professor of obstetrics and gynecology at the New York University School of Medicine, agrees. "The Pap smear is the greatest triumph epidemiologically in modern medicine, and this whole HPV vaccine threatens to undermine that."
Copyright © 2007 ABC News
An issue which is inherently argumentative with regards to the prospective vaccine.
Still, some of us aren't surprised... Only one-quarter?
I notice that they leave out that the vaccine is only effective for 5 years.
That's all.
My sarcasm was meant to be implicit.
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The sad part is, as you say, the percentage of women involved. But what troubles is me is the lack of coverage of the men involved..their exposure and their ability to further the disease.
No, the vaccine has been tested for a period of 5-years. There's nothing known that limits its effectiveness to that; Merck just can't make a cliam that it will last longer, and it has yet to be deterimined if booster shots will be needed.
Virtually all cervical cancers come from HPV infections. There are many, many, many strains of HPV, though only a few are at high risk to develop into cervical cancer.
The HPV vaccine you hear about vaccinates against the two strains that are responsible for 70% of cervical cancers. It also targets several that form less than appearling warts (i.e. condyloma accuminata).
The problem is that the "warts" of the strains that cause cancer are very small and very easy to miss. Just because you don't see warts doesn't mean that you don't have HPV.
That said, assuming you got the virus from your ex (a very, very high probability if you were having genital contact (condoms do not prevent the spread of HPV well), then you could also bring it into any future relationship. It should be noted that the majority of the high risk strains that do cause cancer will go away on their own with time (usually before causing cancer), but you can spread them up to that time.
The vaccine can't do anything for someone who already has a strain of the virus (other than vaccinate against strains that person does not have).
It's probably wise for all women to have routine pap smears done every two years or so, especially with HPV exposure.
It's possible.
It's possible that you are a carrier. Unfortunately, there's no approved test and none that is very sensitive at all for men - lots of false negatives.
A few years ago, I tried to find testing for the husband of a woman with early cancerous changes to a urologist, The one who agreed to see the man said he couldn't help us except to look for tiny visible warts - which aren't the kind that cause the cancer, anyway.
The vaccine probably won't do any good against any virus that you've already had. However, we believe that women can be reinfected and it appears that the vaccine is more able to provide long-term immunity. If that's the case, then I'm not sure why the vaccine wouldn't prevent future reinfections.
Isn't it great that it's free?
I spoke to a local Republican club last night and was struck by how many of the women mentioned the risk of sexual abuse.
Coincidentally, the estimate is 1 in 3 women have been molested, 1 in 4 to 1 in 5 raped. I ask women most of the time, and it's about 1 in 2 who have migraines or any sort of sexual dysfunction, and almost 100% of the women who are very uncomfortable during the pelvic exam.
As well as many cancers of the vulva/vagina, penis, anus, tonsil, and conjunctiva. (all of which are greatly increased in the HIV+ population that have HPV)
Smoking also acts synergistically with HPV and women who have HPV and smoke, are at the very highest risk for developing cervical cancer. It is thought that smoking interferes with local epithelial immunity againsst the HPV virus. There is also some evidence that oral sex (thank you president Clinton) can spread the virus.
Gosh- I can't understand why it's so high- it just couldn't be because our freakin schools teach sex ed to gradeschoolers, hand out condoms to highschoolers, encourage sex and abortions and teach that it's alright to be a slut before the kids even reach puberty.
The stinkin sex revolution agendists have brought this problem on our society and now they want to mandate HPV virus innoculation against a parents wishes? Oh, but they'll tell you there is no connection between promiscuity encouragement in schools and the increase in cancer- oh no, it's gottas be sdomething else.
In terms of reinfection....once infected, do you have it forever?
This information about the virus wasn't all that well-known before. If it was known to the medical community, it wasn't taught. I went to a school that didn't promote promiscuity, and I have it. You don't have to be a slut to get the virus.
The past research I've seen showed that about 60% of US women have either an active infection or antibodies evidencing a past infection. I don't know why anyone is "shocked" at this study.
Your body can wall it off so that you either don't have it any more or we can't find it. Most people will clear their infection in 2 years. Unfortunately, most people will also have more than one type at anytime and can become reinfected with other strains, at least.
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