Current vaccines cover only a minority of human papillomavirus (HPV) subtypes associated with cancer and genital warts

Effective vaccination exists for two sexually transmittable viruses, human papilloma virus (HPV) and hepatitis B virus (HBV). Other viruses have proved more problematic. A recent study in the New England Journal of Medicine showed, yet again, that a vaccine for herpes virus remains elusive. The same is true for hepatitis C and even more for HIV.

Thus identifying at risk groups for HPV and HBV is essential for targeting vaccination strategies. Particularly as persistent infection with high-risk sexually transmitted HPVs (HR-HPV) can lead to development of cervical and other cancers, while low-risk types (low-risk HPV) may cause genital warts. In a recent publication by Ann Johnson and colleagues at University College London they explored the epidemiology of different HPV types in men and women in the UK and their association with demographic and behavioural variables.

Data collected for the British National Survey of Sexual Attitudes and Lifestyles, a cross-sectional survey undertaken in 1999–2001 were analysed. Half of all sexually experienced male and female respondents aged 18–44 years were invited to provide a urine sample. They tested 3123 stored urine samples for HPV DNA.

HPV infection, was prevalent in this population, detected in 29% of samples from women and 17% from men. Significantly 13 high risk HPV subtypes were detected in 16% of women and 10% of men. HPV subtypes, HPV types 16/18, which for part of the two available vaccines in the market, were found in only 5% of women and 3% of men. Types 6/11 which are responsible for most cases of genital warts were isolated in in 5% of women and 2%  of men. In multivariate analysis, HR-HPV was associated with new partner numbers, in women with younger age, single status and partner concurrency, and in men with number of partners without using condom(s) and age at first intercourse.

They concluded that HPV DNA was detectable in urine of a high proportion of the sexually active British population. In both genders, HR-HPV was strongly associated with risky sexual behaviour. The minority of HPV infections were of vaccine types that are currently used in the two available vaccines. These cover HPV 16/18 and 6/11 only.

The authors pointed out t is important to monitor HPV prevalence and type distribution following the introduction of vaccination as vaccination itself may alter the prvalence of the difefrent sun

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