Ongoing Studies Addressing Questions About HPV In Men, Effect On Women

Main Category: Cervical Cancer / HPV Vaccine
Also Included In: Men's health;  Women's Health / Gynecology;  Pediatrics / Children's Health
Article Date: 21 Mar 2007 - 6:00 PDT


The Los Angeles Times on Monday examined how several ongoing studies are examining the human papillomavirus among men and if Merck's HPV vaccine Gardasil also will be effective for them. Some new data confirms that HPV is "not just a women's issue," and some experts have said that vaccinating both men and women against HPV will "turn out to be the most successful approach" in reducing cervical cancer rates, the Times reports (Roan, Los Angeles Times, 3/19). Gardasil and GlaxoSmithKline's HPV vaccine Cervarix in clinical trials have been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. FDA in July 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine. GSK in April plans to file for FDA approval of Cervarix, and it expects approval by the end of this year (Kaiser Daily Women's Health Policy Report, 3/16). According to data not yet published, as many as 60% of men ages 18 to 70 carry HPV, the Times reports. In addition, HPV infection is common in men of all ages, while the highest rates of infection in women usually occur in the early 20s before decreasing and then rising again in women in their 40s to 50s. Several studies are attempting to address HPV in men, whether HPV vaccination will be effective and about which strains of HPV are most common in men, the Times reports. "We know [men] transmit it to women, but what is the rate of transmission?" Anna Giuliano -- a researcher at the H. Lee Moffitt Cancer Center and Research Institute who is leading three government-funded studies on HPV infection in men -- said, adding, "We're seeing a really high prevalence in men, and we see little change in prevalence across the age span. We need to know if women in their 40s and 50s are acquiring new infections from their partners." The data will be published later this spring in the journal Cancer Epidemiology Biomarkers & Prevention. Merck also is conducting studies of Gardasil's ability to prevent HPV infection in boys and men. Some studies of Gardasil indicate that the vaccine initiates a stronger immune response in boys than in girls, which suggests that the vaccine also might prevent HPV infections, Dean Blumberg, an associate professor of pediatric infectious disease at University of California-Davis, said. "If you decrease HPV infection in men, then there will be decreased transmission to women also," Blumberg said. However, Merck has not been able to show that boys are protected from HPV infection at satisfactory rates, according to the Times. Data on the Merck trials might be available later this year, and the company hopes to apply to market Gardasil to boys and men in 2008 (Los Angeles Times, 3/19).

AP/North County Times Examines Issues Related to HPV, Vaccine
The AP/North County Times on Thursday examined issues related to HPV and HPV vaccines. Although some experts say young adults are at an increased risk of contracting HPV because they tend to be the most sexually active age group, Elizabeth Poynor, a gynecological oncologist practicing in New York City, said that most of her young adult patients are unfamiliar with the virus and the HPV vaccine, the AP/Times reports. Many people know little about HPV because it often is overshadowed by more well-known sexually transmitted infections, such as HIV and herpes, Poynor said. Some people also have said that when Merck began marketing Gardasil, it chose to focus on the potential for cervical cancer rather than HPV itself. In addition, there is a "gender divide" related to the virus, the AP/Times reports. Although both men and women can have high-risk and low-risk types of HPV, high-risk strains pose more health risks for women, experts say. Men often carry HPV without exhibiting symptoms and can unknowingly transmit HPV to their sexual partners. Some doctors recommend that women who already have HPV get vaccinated to protect them against other strains of the virus. Regular Pap tests, early treatment and condoms remain keys to fighting the virus, doctors say (Irvine, AP/North County Times, 3/15). In related news, the AP/County Times on Saturday examined issues related to state HPV vaccination mandates. The fact that HPV is an STI has "elevated it to another level," Alina Salganicoff, director of women's health policy at the Kaiser Family Foundation, said. According to the AP/County Times, some advocates of HPV vaccine mandates say that such requirements would ensure wider access to the vaccines. Opponents of the mandates say that HPV vaccines could give teenagers a misleading sense of security and undermine abstinence-only education and parental authority, the AP/County Times reports (Irvine, AP/North County Times, 3/17).

NPR's "Talk of the Nation" on Friday included a discussion about state HPV vaccination mandates. The segment includes comments from Arthur Allen, author of Vaccine: The Controversial Story of Medicine's Greatest Lifesaver; James Colgrove, author of State of Immunity: The Politics of Vaccination in Twentieth-Century America and an assistant professor of sociomedical sciences at the Columbia University Mailman School of Public Health; and Moira Gaul, director of women's and reproductive health at the Family Research Council (Flatow, "Talk of the Nation," NPR, 3/16). Audio of the segment is available online.

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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