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HPV vaccine does not appear to be effective for treating pre-existing HPV infection
August 15, 2007For women with human papillomavirus (HPV) infection, use of the HPV-16/18 vaccine will not accelerate reduction of the virus and should not be used to treat the infection, according to a study in the August 15 issue of JAMA.
HPV vaccines were designed to prevent HPV infection and the development of cervical precancers and cancer. Some research has suggested that HPV vaccines could help clear the virus in women already infected, according to background information in the article.
Allan Hildesheim, Ph.D., of the National Cancer Institute, Bethesda, Md., and colleagues conducted a study to address the question of whether women positive for HPV DNA should be encouraged to receive HPV-16/18 vaccination to induce or accelerate clearance of their infections. The trial was conducted in two provinces of Costa Rica and included 2,189 women age 18 to 25 years who were positive for HPV DNA. Participants were randomly assigned to receive three doses of HPV-16/18 vaccine (n = 1,088) or a control hepatitis A vaccine (n = 1,101) over 6 months.
There was no evidence that HPV vaccination significantly altered rates of viral clearance. At the 6-month visit, rates of clearance were 33.4 percent vs. 31.6 percent for HPV-16/18 among participants who received the HPV vaccine and the control vaccine, respectively. At the 12-month visit, rates of clearance among participants in the HPV group and the control group, respectively, were 48.8 percent vs. 49.8 percent for HPV-16/18.
There was no evidence of vaccine effects with further analysis on selected study entry characteristics reflective of disease extent, including HPV-16/18 antibody results, cytologic results, and HPV viral load. Similarly, no evidence of vaccine effects was observed in analyses stratified by other study entry parameters thought to potentially influence clearance rates and efficacy of the vaccine, including time since sexual initiation, oral contraceptive use, cigarette smoking, and concomitant infection with Chlamydia trachomatis or Neisseria gonorrhoeae.
"These findings have important clinical implications. For example, in countries where HPV DNA testing is incorporated in cervical cancer screening and prevention efforts, adult women who have abnormal Papanicolaou test results induced by HPV infection and/or who test positive for an oncogenic HPV type using the clinically available HC2 test might be interested in receiving the HPV vaccine to treat their existent infection," the authors write. "-our results demonstrate that in women positive for HPV DNA, HPV-16/18 vaccination does not accelerate clearance of the virus and should not be used for purposes of treating prevalent infections."
JAMA and Archives Journals
There was no evidence that HPV vaccination significantly altered rates of viral clearance. At the 6-month visit, rates of clearance were 33.4 percent vs. 31.6 percent for HPV-16/18 among participants who received the HPV vaccine and the control vaccine, respectively. At the 12-month visit, rates of clearance among participants in the HPV group and the control group, respectively, were 48.8 percent vs. 49.8 percent for HPV-16/18.
There was no evidence of vaccine effects with further analysis on selected study entry characteristics reflective of disease extent, including HPV-16/18 antibody results, cytologic results, and HPV viral load. Similarly, no evidence of vaccine effects was observed in analyses stratified by other study entry parameters thought to potentially influence clearance rates and efficacy of the vaccine, including time since sexual initiation, oral contraceptive use, cigarette smoking, and concomitant infection with Chlamydia trachomatis or Neisseria gonorrhoeae.
"These findings have important clinical implications. For example, in countries where HPV DNA testing is incorporated in cervical cancer screening and prevention efforts, adult women who have abnormal Papanicolaou test results induced by HPV infection and/or who test positive for an oncogenic HPV type using the clinically available HC2 test might be interested in receiving the HPV vaccine to treat their existent infection," the authors write. "-our results demonstrate that in women positive for HPV DNA, HPV-16/18 vaccination does not accelerate clearance of the virus and should not be used for purposes of treating prevalent infections."
JAMA and Archives Journals
HPV Current Events and HPV News RSSPMH finding may help some tonsil cancer patients avoid chemotherapy
Clinical researchers at Princess Margaret Hospital (PMH) have confirmed that patients with oropharyngeal squamous cell cancer ("tonsil cancer") harbour a common type of human papilloma virus (HPV16), but also that such cancers are very sensitive to radiation.
M. D. Anderson redefines screening guidelines for breast, cervical and colorectal cancers
Drawing on years of experience in cancer research and patient care, The University of Texas M. D. Anderson Cancer Center released today the most comprehensive, risk-based screening guidelines publicly available to date for breast, cervical and colorectal cancers.
UIC study finds girls aware of HPV vaccine's benefits
Contrary to concerns that the human papillomavirus vaccine might promote promiscuity, a national survey of girls and young women found that the majority of respondents did not believe the HPV vaccine protected them against other sexually transmitted infections.
Scientists identify common HPV genotypes in northern India, encourage vaccination
Although a wide spectrum of human papillomavirus is seen across the population of India, HPV-16 and HPV-18 are the most common types and a vaccination targeting these types could eliminate 75 percent of the cervical cancers in the region.
Vaccinating boys against human papillomavirus not cost-effective
Persistent infection with high-risk types of human papillomavirus (HPV), a sexually transmitted virus, is known to be a cause of cervical cancer.
Genes signal late-stage laryngeal cancer, poorer outcome
Researchers at Henry Ford Hospital have identified tumor-suppressing genes that may provide a more accurate diagnosis of disease stage and survival for laryngeal cancer patients than current standards.
Rare head and neck cancer linked to HPV, study finds
An increase in cases of a rare type of head and neck cancer appears to be linked to HPV, or human papillomavirus, according to a new study from researchers at the University of Michigan Comprehensive Cancer Center.
Vaccination and testing for the human papilloma virus could eradicate cervical cancer
Cervical cancer could be eradicated within the next 50 years if countries implement national screening programmes based on detection of the human papilloma virus (HPV), which causes the disease, together with vaccination programmes against the virus, according to a cervical cancer screening expert.
An HIV-blocking gel for women
University of Utah scientists developed a new kind of "molecular condom" to protect women from AIDS in Africa and other impoverished areas. Before sex, women would insert a vaginal gel that turns semisolid in the presence of semen, trapping AIDS virus particles in a microscopic mesh so they can't infect vaginal cells.
More than half of Texas physicians do not always recommend HPV vaccine to girls
The Advisory Committee on Immunization Practices recommends the human papillomavirus vaccination for all 11- and 12-year-old girls, but results of a recent survey showed that more than half of Texas physicians do not follow these recommendations.
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