HPV vaccine may benefit HIV infected women

Women with HIV may benefit from a vaccine for human papillomavirus (HPV), despite having already been exposed to HPV, a study finds. Although many may have been exposed to less serious forms of HPV, more than 45 percent of sexually active young women who have acquired HIV appear never to have been exposed to the most common high-risk forms of HPV.

HPV is the most common sexually transmitted infection in the world. The virus can infect the anal and genital areas, mouth and throat of males and females. High-risk forms of the virus can cause cancer, including cancer of the cervix.

The researchers noted that earlier studies had found many women with HIV were more likely than were women who did not have HIV to have conditions associated with HPV, such as precancerous conditions of the cervix, as well as for cervical cancer.

“Health care providers may hesitate to recommend HPV vaccines after a girl starts having sex,” said study first author Jessica Kahn, M.D., M.P.H. of Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine. “However, our results show that for a significant number of young women, HPV vaccine can still offer benefits. This is especially important in light of their HIV status, which can make them even more vulnerable to HPV’s effects.”

The Centers for Disease Control and Prevention recommends HPV vaccination for girls ages 11-26. If an individual has not been exposed to the virus, approved HPV vaccines can protect against four types of the virus. Two HPV types, HPV-16 and HPV-18, cause 70 percent of cervical cancers. Two others, HPV-6 and HPV-11, cause 90 percent of genital warts.

At the time the women in the study received their first HPV vaccination, the researchers found that 12 percent had an existing HPV-16 infection and 5 percent had an HPV-18 infection. Because of their HIV status, these women may be more likely to develop cervical cancer or to develop a cancer that is hard to treat, the researchers said.

“Cervical cancer screening for sexually active young women is an important clinical priority, but our findings suggest it is especially so for women at risk of HIV,” said study co-author Bill G. Kapogiannis, M.D., of the Pediatric, Adolescent and Maternal AIDS Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), one of six NIH institutes supporting the study.

Drs. Kahn and Kapogiannis conducted the research in collaboration with colleagues at the NICHD and Albert Einstein College of Medicine, New York City; Jefferson Medical College of Thomas Jefferson University, Philadelphia; New York University School of Medicine; Westat, Inc., Rockville, Md.; and the University of Alabama at Birmingham.

The research was conducted at a network of hospitals affiliated with the NICHD-funded Adolescent Medicine Trials Network for HIV/AIDS Interventions. Also supporting the study were the National Institute on Drug Abuse, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, National Cancer Institute and National Center for Research Resources.

The findings appear in the Journal of Acquired Immune Deficiency Syndromes.

Source: National Institutes of Health, USA



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