February 28, 2007 in Nation/World

Study finds high HPV rate

David Brown Washington Post

at a glance

A widespread virus

Human papilloma virus (HPV) is one of the most common causes of sexually transmitted infection (STI) in the world. Health experts estimate there are more cases of genital HPV infection than any other STI in the United States. According to the Centers for Disease Control and Prevention, approximately 6.2 million new cases of sexually transmitted HPV infections are reported every year. At least 20 million people in this country are already infected.

National Institutes of Health

WASHINGTON – More than one-third of American women are infected by human papilloma virus (HPV), which in rare cases can lead to cervical cancer, by the time they are 24 years old, according to a study being published today.

The new estimates suggest that there are 7.5 million girls and women ages 14 to 24 infected with the microbe – about two-thirds more than an earlier but less broad-based study had found.

Overall, about one-quarter of women under age 60 are infected at any given time, making HPV by far the most common sexually transmitted disease in the country.

News of the higher-than-expected prevalence of HPV infection was balanced by the discovery that only 2.2 percent of women were carrying one of the two virus strains most likely to lead to cervical cancer – about half the rate found in previous surveys.

The lead researcher cautioned the findings don’t mean that HPV infection rates are rising, only that they are higher than thought.

“For us, it’s just a different measurement – and a more accurate one,” said Eileen F. Dunne, a physician and epidemiologist at the Centers for Disease Control and Prevention.

The estimate comes from the federal government’s ongoing National Health and Nutrition Examination Survey, which provides the clearest snapshot of the American population’s health through dozens of measurements, laboratory tests, and survey questions.

The new findings, published in the Journal of the American Medical Association, are likely to further encourage use of a vaccine against HPV approved in June by the Food and Drug Administration for females ages 9 to 26. Its maker, Merck & Co., until recently was lobbying state legislatures to mandate vaccination of middle school girls – a step that more than 18 states are moving toward.

In its just-completed session, Virginia’s General Assembly enacted legislation, which is now before the governor, requiring the vaccine in schoolgirls. Texas’s governor last month issued an executive order doing the same thing.

“Our perspective is that many women would benefit from the protection that (the vaccine) would provide,” said Richard Haupt, the executive director for medical affairs at Merck Vaccines. The company is running studies trying to prove the vaccine’s usefulness in women ages 25 to 45, and also in boys and men ages 9 to 23.

Some parents have objected to school mandates for HPV vaccination of girls, arguing that because the infection is transmitted only through sexual contact, it can be avoided by choice. Others believe the vaccine may lower inhibitions against sexual activity, although there is no evidence that fear of HPV infection is a reason many teenagers abstain.

There are dozens of strains of HPV, but only some can lead to cancer. Two – HPV-16 and HPV-18 – are responsible for about 70 percent of cervical cancers worldwide. The Merck vaccine protects against both, as well as two other strains that cause genital warts.

Most of the time a woman’s immune system clears the virus within weeks, although repeated reinfections are possible. In some cases, however, the virus becomes incorporated in cervical cells and can cause malignant changes.

Cervical cancer was once the leading cause of cancer death in American women. Routine screening with Pap smears has reduced deaths dramatically in the past three decades. Last year, there were about 9,700 new cases of cervical cancer in the United States and 3,700 deaths. About 85 percent of the women who died had never had a Pap smear.

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