Delaware County Medicine & Health Spring 2017 - 6
FEATURE
Straight Talk
about HPV
By: June Elcock-Messam, MD, FAAP
H
uman Papillomavirus (HPV) is the most
common sexually transmitted infection (STI)
in the United States. At some point in time,
almost everyone engaging in sexual activity
will be exposed to HPV. It is estimated that currently,
approximately 80 million people in the U.S. - about one
in four - are infected with HPV. (Centers for Disease
Control and Prevention - CDC) It does not matter if you
have only had sex with one person. You're still at risk, and
why should you care? Sexually transmitted HPV falls into
two categories: low risk HPVs which cause skin warts or
anogenital warts and high risk HPVs which cause cancer.
High risk HPV infections can cause cancers of the cervix,
vagina and vulva in women, cancers of the penis in men
and cancers of the anus and back of the throat in men and
women. According to the CDC, HPV causes 30,700 cancers
in men and women every year in the United States. Most
of the cancers listed above are caused by HPV types 16 and
18. Because we know this, scientists found a way to target
these specific types of HPV so that we can protect our
children from developing these deadly cancers in the future.
There are three vaccines that have been approved by
the Food and Drug Administration (FDA) to prevent
high risk, cancer causing HPV infections: Gardasil,
Gardasil 9, and Cervarix. Gardasil was approved by
the FDA in 2006, Cervarix in 2009 and Gardasil 9 in
2014. While all three of these vaccines provide strong
protection from new HPV infections, they are not
effective at treating already established infections. It is
for this reason that HPV vaccines are recommended for
our children BEFORE they become sexually active.
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DELAWARE COUNTY MEDICINE & HEALTH
spring 2017
In my pediatric practice, many parents have raised concerns
that the HPV vaccines themselves "cause cancer." This is
absolutely not true. Some parents have said, "You're injecting
small amounts of the virus to cause an immune reaction
so you are exposing my child to the HPV virus." This is
also not true. The three current HPV vaccines contain
virus-like particles (VLPs) that are formed by HPV surface
components. These VLPs are not infectious because they
do not have the viruses' DNA. However, because they so
closely resemble the natural virus, when our bodies make
antibodies to the VLPs, these antibodies are also active
against the natural viruses. These immunizations trick
our bodies into developing antibodies to the real HPV
viruses and these antibodies protect us from cancer causing
infections in the future if and when we are exposed.
Another concern raised by parents in my practice
is: how effective are these vaccines? The answer is very
effective if used prior to engaging in sexual activity. In
clinical trials that led to the approval of Gardasil and
Cervarix, there was almost 100% protection against
persistent cervical infections with HPV types 16 and
18 - the two types of HPV that account for the majority
of cancers caused by HPV. The trials that led to the
approval of Gardasil 9 found it to be 97% effective in
preventing cervical, vulvar and vaginal infections caused
by five additional HPV types. (NIH: National Cancer
Institute. Human Papillomavirus (HPV) Vaccines)
Table of Contents for the Digital Edition of Delaware County Medicine & Health Spring 2017
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