HPV Human Papilloma Virus

1
HPV (Human Papilloma Virus) Cervical Cancer

• Halifax Med
• Sarah C. Hibbitts
• James Madison University
• November 16, 2006 700pm

2
What is the most common sexually transmitted
disease?

• HPV- Human Papilloma Virus
• Estimated 20 million people currently infected
  with this virus
• 6.2 million new infections in the U.S. every
  year!
• By age 50, 80 of men women will have acquired
  genital HPV infection
• 3 out of 4 people who have sexual intercourse
  will encounter the virus at some point in their
  lifetime

3
What is Genital HPV infection?

• HPV Human Papilloma Virus
• Sexually transmitted infection caused by HPV
  virus
• gt100 different types of HPV
• gt30 types are sexually transmitted
• Infections of the skin of the penis, vulva, anus,
  the linings of the vagina, cervix, or rectum

4
What is Genital HPV infection?

• MOST infected people DO NOT have any symptoms and
  clear the infection on their own
• Symptoms
• Genital warts if you have been exposed to those
  types of the HPV virus.
• Cervical changes- low grade to high grade

5
So what are the types of this virus that I need
to worry about?

• Low risk types
• HPV-6 HPV-11
• Known to cause MILD pap test abnormalities and
  low grade cervical changes
• Can cause genital warts of the cervix, vulva,
  vagina, anus or penis

• High risk types
• HPV-16 HPV-18
• Known to cause LOW or HIGH grade cervical changes
• Can cause cancer of the cervix, vulva, vagina,
  anus, or penis

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Risk factors for HPV virus infection

• Women
• Young age
• Sexual behavior
• Immune Status

• Men
• Greater lifetime number of sex partners
• Greater number of recent sex partners
• Being uncircumcised

7
HPV virus and Cervical Cancer?

• Cervical cancer is the 2nd most common cancer in
  women WORLDWIDE
• The single most important risk factor for
  cervical cancer
• HPV infection that continues (that is not cleared
  by the immune system)

8
How much of cervical cancer is caused by the HPV
virus?

• HPV is present in almost all (99.7) of all
  cervical cancers.1
• Walboomers JM et al. J Pathol. 1999 189 12-19

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HPV virus is very common!

• 80 of sexually active women and men contract HPV
  at some point in their life
• Intercourse begins early (2)
• -26 by age 15
• -77 by age 19
• (2)National Center for Health Statistics. 2002
  Survey of Family Growth

10
How do I get tested for this virus? Regular Pap
Smear from your Gynecologist

• For women lt30 years old
• Within 3 years of onset of vaginal intercourse
• Begin by age 21
• Repeat annually

• For women gt30 years young
• If you have 3 consecutive normal Pap smears, then
  repeat every 2-3 years.

11
Whats this I hear about a new vaccine for this
virus?

• On June 8, 2006, an HPV vaccine, Gardasil, was
  licensed by the Food and Drug Administration
  (FDA) for use in males and females.
• The vaccine protects against the four types of
  the HPV virus that are known to cervical cancer
  genital warts.

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Does the vaccine really work?

• So far, so good
• The vaccine was tested in 11,000 girls and proved
  to be 100 effective against the four types of
  the virus known to cause genital warts and
  cervical cancer

13
Who can receive the vaccine?

• On June 29, 2006, the Federal Advisory Committee
  on Immunization Practices (ACIP) voted to
  recommend the use of Gardasil in females, ages
  9-26.
• The vaccine is designed for girls who have not
  yet been sexually active.
• But the vaccine is also effective for girls who
  have been sexually active, as they may not have
  encountered the types of virus that the vaccine
  protects against.

14
Is the vaccine safe?

• The most common side effect of the vaccine was
  injection site pain.
• The vaccine does NOT contain thimerosol

15
What about boys?I havent heard the mention of
vaccinating boys

• Youre paying attention!
• Even though the FDA has approved the vaccine for
  use in males, there is no published data as of
  yet.
• They are working on it!

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How long does this vaccine protect against the
HPV virus

• Five years
• Studies are being conducted to determine if this
  is longer.

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Details about the vaccine

• Gardasil is given at month 0, 2, 6 months.
• Three injections
• 120/injection 360 total
• Most insurance companies in this area will cover
  the cost of the vaccine but not the office visit.
• After the age of 26, most insurance companies
  will not cover the cost of the vaccine
• Check with your insurance company and/or provider
  for more information

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Whos giving the vaccine in this area?

• Fuller Roberts- both the Pediatric and Ob-Gyn
  clinic
• Dr. Rosche

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Additional information

• Very important!- The vaccine does not eliminate
  the need for regular gynecological exams and
  sexually transmitted disease testing
• Want more information on the vaccine or anything
  else?
• Ask now or come and ask me questions after the
  talk!

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Additional information

• www.cdc.gov
• www.merckvaccines.com
• www.fda.org

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Acknowledgments

• Dr. Parker- youre the coolest
• Nick Long _at_ WHLF-FM for radio announcements
• Merck Company- for providing refreshments and
  vaccine information

• Local Newspapers-The Gazette and News Record
• Community for allowing me to put this on!