Reviews for Primary Care - Fall 2007 - (Page 64) UPDATE IN PREVENTION Human Papillomavirus (HPV), HPV-Related Disease, and the HPV Vaccine Kari P. Braaten, MD, MPH, Marc R. Laufer, MD Division of Gynecology, Department of Surgery, Children’s Hospital Boston, Boston, MA; Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, and persistent HPV infection is strongly associated with risk of cervical cancer and genital warts. The recently approved quadrivalent HPV vaccine targets the HPV strains responsible for approximately 70% of cervical cancers and 90% of genital warts. It is also effective in reducing the incidence of HPV-related conditions, especially when given prior to exposure to HPV. The vaccine is recommended for all girls aged 11 to 12, with catch-up vaccination for women up to age 26; and most insurance plans cover the vaccine. A second bivalent HPV vaccine is currently pending approval by the US Food and Drug Administration. HPV vaccination reduces the incidence of HPV-related cancers and precancerous lesions in the United States and abroad, though decisions regarding implementation of vaccination remain. © 2008 MedReviews, LLC uman papillomavirus (HPV) is the most common sexually transmitted infection in the United States with approximately 80% of women having acquired an infection by the age of 50.1 Although most HPV infections clear, persistent HPV infection is strongly associated with risk of cervical cancer and genital warts. The recently approved quadrivalent (types 6, 11, 16, and 18) HPV vaccine targets the HPV strains responsible for approximately 70% of cervical cancers and 90% of genital warts. It is also effective in reducing the incidence of HPV-related conditions, including cervical intraepithelial neoplasia (CIN) grades I, H VOL. 1 NO. 1 2008 REVIEWS FOR PRIMARY CARE 64
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