Human Papilloma Virus - HPV - Prevention

Mandic A, Vujkov T. Institute of Oncology, Sremska Kamenica, Yugoslavia.

Cervical cancer is the major cause of death in women of reproductive age in parts of the developing world. Thanks to the effectiveness of national screening programs, the incidence and mortality rates for cervical cancer have declined dramatically in developed countries. According to many researchers, human papillomavirus (HPV) infection has an important role in the development of cervical neoplasm. The effects of HPV infection on the oncogenesis of cervical carcinoma can be explained to a large degree by the regulation and function of the two viral oncogenes, E6 and E7. About 25 of >80 types infect the genital tract. HPV types are stratified into low, intermediate- and high-risk categories. Today, vaccines are available against many serious human pathogens. It is accepted worldwide that cervical carcinoma is a consequence of infection with HPV viruses. Therefore it is reasonable to assume that vaccine that prevents infection will reduce the incidence of cervical cancer. Virus-like particles are empty viral capsids, and are the leading candidate vaccines for the treatment or prevention of cervical cancer in humans. The HPV type 16 (HPV16) L1 virus-like particle vaccines have been shown to be generally well tolerated and they generate high levels of antibodies against HPV16. Since approximately 50% of cervical cancers are associated with HPV16 infection, the administration of this type of vaccine to young women could reduce the incidence of HPV16 infection, which is related to cervical dysplasia and cervical neoplasm. Vaccination against HPV infection could reduce the risk of infection and, most importantly, decrease the incidence of cervical cancer. A vaccine for cervical cancer is not a dream in the far future, it is happening today.

Publication Types:
• Review
• Review, Tutorial

Cancer Causes Control. 2003 Nov;14(9):859-70.

Diet and premalignant lesions of the cervix: evidence of a protective role for folate, riboflavin, thiamin, and vitamin B12.

Hernandez BY, McDuffie K, Wilkens LR, Kamemoto L, Goodman MT. Cancer Research Center of Hawaii, University of Hawaii, 1236 Lauhala Street, Honolulu, Hawaii 96813, USA.

OBJECTIVE: A case-control study was conducted among a population of multiethnic women identified from clinics on Oahu, Hawaii between 1992 and 1996 to explore the relationship between diet and cervical dysplasia. METHODS: Two-hundred and fourteen women with biopsy-confirmed high and low grade squamous intraepithelial lesions of the cervix (SIL) and 271 controls were identified. Exfoliated cervical cells were collected for HPV DNA testing. Surveys were administered to assess non-dietary risk factors and intake of nutrients from over 250 specific food items as well as nutritional supplements. RESULTS: Riboflavin and thiamin from food sources, vitamin B12 supplements, and total (food and supplements) folate displayed inverse, dose-responsive associations with high-grade SIL (HSIL). Riboflavin from food sources and total folate also demonstrated inverse, dose-responsive associations with low-grade SIL (LSIL). The odds ratios for LSIL and HSIL were reduced by 50-90% for the highest compared to the lowest levels of intake of these nutrients. A number of major food sources of these vitamins, including all types of breads, bran cereal, and fruit juice, also demonstrated inverse associations with HSIL. There was some evidence that the increased risk of HSIL associated with low nutrient intake was most pronounced among drinkers and smokers. CONCLUSIONS: This investigation provides evidence that thiamin, riboflavin, folate, and vitamin B12 may play a protective role in cervical carcinogenesis.

Eur J Cancer Prev. 2003 Oct;12(5):383-90.

Protective effects of green tea extracts (polyphenon E and EGCG) on human cervical lesions.

Ahn WS, Yoo J, Huh SW, Kim CK, Lee JM, Namkoong SE, Bae SM, Lee IP. Department of Obstetrics and Gynaecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

We investigated clinical efficacy of green tea extracts (polyphenon E; poly E and (-)-epigallocatechin-3-gallate [EGCG]) delivered in a form of ointment or capsule in patients with human papilloma virus (HPV) infected cervical lesions. Fifty-one patients with cervical lesions (chronic cervicitis, mild dysplasia, moderate dysplasia and severe dysplasia) were divided into four groups, as compared with 39 untreated patients as a control. Poly E ointment was applied locally to 27 patients twice a week. For oral delivery, a 200 mg of poly E or EGCG capsule was taken orally every day for eight to 12 weeks. In the study, 20 out of 27 patients (74%) under poly E ointment therapy showed a response. Six out of eight patients under poly E ointment plus poly E capsule therapy (75%) showed a response, and three out of six patients (50%) under poly E capsule therapy showed a response. Six out of 10 patients (60%) under EGCG capsule therapy showed a response. Overall, a 69% response rate (35/51) was noted for treatment with green tea extracts, as compared with a 10% response rate (4/39) in untreated controls (P<0.05). Thus, the data collected here demonstrated that green tea extracts in a form of ointment and capsule are effective for treating cervical lesions, suggesting that green tea extracts can be a potential therapy regimen for patients with HPV infected cervical lesions.

Publication Types:
• Clinical Trial
• Randomized Controlled Trial

Eur J Obstet Gynecol Reprod Biol. 2003 Aug 15;109(2):219-23.

Cervical response to vaccination against HPV16 E7 in case of severe dysplasia.

Simon P, Buxant F, Hallez S, Burny A, Fayt I, Anaf V, Noel JC. Department of Obstetrics and Gynaecology, CUB Hopital Erasme, Route de Lennik 808, 1070 Brussels, Belgium.

OBJECTIVE: To evaluate the tolerance to vaccination against human papillomavirus (HPV)16 E7 (in SB adjuvant ASO2B) and its histological and immunohistological effects on HPV16 associated high-grade cervical dysplasias associated with HPV16. STUDY DESIGN: Five patients with histologically demonstrated severe cervical dysplasia (CIN3) HPV16 positive were injected three times before conization was performed 2 months after the first injection. We studied cytological, histological, proliferative pattern and immune profile before and after vaccination. The slides were compared with those obtained from non-injected patients. RESULTS: The injections were well tolerated and the specimens displayed a limited regression of the lesions. Nevertheless, massive CD4 and CD8 T cell lymphocytic infiltration was noticed after vaccination. DISCUSSION: We conclude that the vaccination we used provides an obvious immune histological reaction in the HPV infected cervix and that the 2 months delay before the final step (conization) is done is probably too short.

Publication Types:
• Clinical Trial
• Controlled Clinical Trial

Ginekol Pol. 2002 Nov;73(11):939-44.

Frequency of HPV infection of the uterine cervix among perimenopausal women in Wielkopolska Region.

Human Papilloma Virus - HPV - Article in Polish

OBJECTIVES: Human papillomavirus (HPV) is one of the main causes of cervical neoplasia. There is now consistent evidence that Human Papillomavirus (HPV) has a causal role in the etiology of cervical cancer and that sexual habits and reproductive/hormonal factors are associated with the risk of invasive cervical cancer. In our investigation we estimated the frequency of HPV infection in uterine cervix in women gathered in perimenopausal and postmenopausal groups. MATERIALS AND METHODS: We screened 90 women in western Poland to obtain cytological smears, and tested all smears for 33 types of HPV with a polymerase chain reaction-based system. All women were classified according to age into three groups. RESULTS: HPV infections peaked in the group of 45 to 49 year old (48.5% using universal starters) and decreased in 56 year or olders (26.1% using universal starters) with predominantly non-cancer-associated types of HPV and uncharacterized HPV types. CONCLUSIONS: We confirm the decline of HPV infection with age. But note increased prevalence after menopause, which could be related to a second peak of HSILs, an observation that warrants further investigation. At least 80% of HPVs involved in cervical carcinogenesis in this population have been characterized. Polyvalent vaccines including the main cancer-associated HPV types may be able to prevent most cases of cervical disease in this region.

hpv human papilloma viruses - HPV Prevention Links

Forces of Nature - Read about Warts-no-more and other medicines for treating and prevention of HPV manifestations.

HPV and Genital Warts Prevention - Information about physical and health issues for women concerning HPV and genital warts.