HPV Sexually Transmitted Disease

HPV Sexually Transmitted Disease - Article in German

Joura EA. Abteilung fur Gynakologie und gynakologische Onkologie, Universitatsklinik fur Frauenheilkunde, Wien, Osterreich. elmar.joura@meuniwien.ac.at

The very close relation between human papillomavirus (HPV) and cervical cancer is evident. A vaccine has been awaited for a longtime. After excellent results of phase II trials, a large worldwide phase III trial on a vaccine against HPV of high (types 16, 18) and low malignant potential (types 6, 11) is ongoing. If the vaccine is effective, registered and launched, at least three decades will pass until the incidence of invasive cervical cancer will drop significantly. The prevalence of premalignant lesions and genital warts may be reduced earlier. As, due to the high number of different oncogenic HPV types, complete prevention can hardly be achieved, screening will be necessary in the future. The screening intervals have to be redefined since the risk will decrease.

Curr Opin Mol Ther. 2004 Apr;6(2):206-11.

Technology evaluation: HPV vaccine (quadrivalent), Aventis Pasteur MSD/CSL.

Reinis M. Academy of Sciences of the Czech Republic, Insititute of Molecular Genetics, Flemingovo nam 2, Prague 6 CZ 16637, Czech Republic. reinis@img.cas.cz

CSL, licensee of UniQuest's HPV technology, and Aventis Pasteur MSD (a joint venture between Merck & Co and Aventis) are jointly developing a vaccine for the potential prophylaxis of genital warts and cervical cancer caused by human papilloma virus infection. Enrollment for a phase III trial has been completed.

Publication Types:
• Evaluation Studies

Obstet Gynecol Clin North Am. 2003 Dec;30(4):809-17.

Human papillomavirus infections: diagnosis, treatment, and hope for a vaccine.

Ault KA. Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA. Kevin-ault@uiowa.edu

HPV infections are common, with millions of Americans infected. Common gynecologic manifestations of HPV infection include genital warts and cervical neoplasia. The CDC recently issued guidelines for the treatment of genital warts. Gynecologists should be familiar with these therapies and their potential short-comings. A recently reported clinical trial has raised hopes that HPV and its sequelae may be prevented by vaccination.

Publication Types:
• Review
• Review, Tutorial

Crum CP, Rivera MN. Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA. ccrum@partners.org

Human papillomaviruses (HPVs) are responsible for the nearly 450,000 cervical cancers that occur each year throughout the world. In the United States, the cancer rate is low (13,500 cases per year); nevertheless, HPVs affect millions of men and women annually in the form of genital warts and preinvasive diseases of the cervix and anogenital region. The expense of cancer prevention via precancer and cancer management is high, yet most HPV infections resolve spontaneously as a result of a successful host immune response. Recently, the discovery of methods to reproduce HPV virions (viral-like particles) in vitro has resulted in a successful clinical trial of preventing HPV infection and its associated precursor lesions. Although prevention is type-specific and duration of immunity is unknown, these results validate a vaccine strategy targeting prepubertal children that could prevent a significant proportion of genital warts and cervical precancers and cancers from occurring during reproductive life. Reversing advanced preinvasive and invasive cervical neoplasia with immunotherapeutics is a more difficult challenge, inasmuch as little or no evidence for natural immune-mediated regression of these diseases exists. Nonetheless, recent controlled trials have shown some success in inducing precursor regression with vaccines targeting viral oncoproteins. Anecdotal reports of therapies that augmentcellular immunity raise hopesthattherapeutics targeting multiple pathways of anti-viral or anti-tumor immunity will be beneficial to women with established cervical cancer. However, success will require identifying and circumventing the mechanisms by which tumor cells evade the immune system.

Publication Types:
• Review
• Review, Tutorial

HPV Sexually Transmitted Disease - Vaccination against Cancer Links

Cervical Cancer Prevention: Key Issues - This section provides brief summaries of some of the major research areas related to cervical cancer control in low-resource settings.

Unanswered Questions - New facts concerning HPV vaccine.