by Darian Peters

Created on: May 04, 2007   Last Updated: October 28, 2008

Human papillomavirus (HPV) is a disease that comes in around 130 different forms that causes infection of skin and mucous membranes. HPV is a DNA based virus and the main characteristic symptom is a type of warts, known as papillomas, from where the name of the disease comes from. Prevalence estimates are very high, with possibly even a quarter of females aged 14-59 in the USA infected with some strain of the disease at any one time, with prevalence in the 20-24 group as much as 45%.

Around 30-40 of the 130 or so different forms of HPV are classified as sexually transmitted diseases (STDs). These cause anogential infection and, although some forms may cause genital warts, other forms may go unnoticed. Some varieties can cause abnormalities of the cervix that could possibly lead to cervical cancer in those who have persistent cases of HPV infection. Indeed HPV is cited as a cause in most cases of cervical cancer.

Detection of the disease is through two procedures. Ordinary HPV testing can screen people for HPV more generally but a pap smear is the more important test, as it identifies the cancer implicated strains. If the cellular abnormalities that are the precursor to cervical cancer can be identified early enough then surgery can be performed to remove the infected tissue before the cancer can emerge and grow. This form of testing has significantly cut cervical cancer deaths in the developed world and needs to be increasingly introduced elsewhere in the world to cut death rates in the developing world and in the third world as well.

There are is an HPV vaccine available, called Gardasil (another vaccine called Cervarix is currently waiting for approval). The vaccine particularly targets the most aggressive forms of sexually transmitted HPV. Gardasil is a prophylactic and is aimed at preventing types 6, 11, 16, and 18. Types 6 and 11 are implicated in 90% of cases of genital warts, whilst types 16 and 18 are responible for 70% of cervical cancer incidents.

The vaccine is thought to be 100% effective in stopping the development of genital warts and the abnormalities of the cervix that are the precursor to cervical cancer. They provide protection for at least 4.5 years. Gardasil is not a cure, it is preventative. It is aimed at uninfected females between 11 and 26 years of age and has few side effects. The mode of action of the vaccine is to elicit an immune response that produces antibodies that are capable of neutralizing the virus before infection can take hold.

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