Human Papillomavirus and HPV Vaccines

1. Allison Eliscu, MD* 1. *Stony Brook Children’s Hospital, Stony Brook, NY 1. 1. Kimberlin DW, 2. Brady MT, 3. Jackson MA, 4. Long SS Human Papillomavirus. American Academy of Pediatrics. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book 2015 Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2015:576–583 2. 1. Workowski KA, 2. Bolan GA Sexually Transmitted Diseases Treatment Guidelines, 2015. Workowski KA, Bolan GA; Centers for Disease Control and Prevention. MMWR Recomm Rep. 2015;64(RR-3):1–137. Erratum in MMWR Recomm Rep. 2015;64(33):924 [OpenUrl][1][CrossRef][2][PubMed][3] 3. 1. Markowitz LE, 2. Dunne EF, 3. Saraiya M, 4. et al Human Papillomavirus Vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Markowitz LE, Dunne EF, Saraiya M, et al. MMWR Recomm Rep . 2014;63(RR-05):1–30 4. Human Papillomavirus: Know the Facts. Centers for Disease Control and Prevention; 2017. Available at: http://www.cdc.gov/hpv/hcp/know-facts.html. Accessed January 26, 2016 5. 1. Joura EA, 2. Giuliano AR, 3. Iversen OE, 4. et al A 9-Valent HPV Vaccine Against Infection and Intraepithelial Neoplasia in Women. Joura EA, Giuliano AR, Iversen OE, et al. N Engl J Med . 2015;372(8):711–723 Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, with more than 14 million new cases each year. Most infections are subclinical and undiagnosed, so the exact prevalence is unknown. However, it has been suggested that almost all sexually active individuals acquire HPV at some point during their lifetimes. Factors that increase an individual’s risk of becoming infected with HPV include age younger than 25 years, sexual debut before 16 years of age, having multiple sexual partners, and having a partner who has had multiple partners. More than 120 strains of HPV have been identified, more than 40 of which are sexually transmitted and can infect the genital regions. HPV strains are divided into oncogenic (high-risk) types and nononcogenic (low-risk) types based on their potential to cause cancer. Infection with high-risk or oncogenic types (most commonly types 16 and 18) may lead to cellular changes of the cervix, which can be detected on Papanicolaou smear. These cellular changes are asymptomatic and usually self-resolve, especially among healthy adolescent females. In a study of 187 adolescent females with low-grade squamous intraepithelial lesions on Papanicolaou smear, the median time to complete resolution of the lesions was 8 months, and only 3% of the study participants progressed to a high-grade squamous intraepithelial lesion. Furthermore, a high percentage of high-grade lesions also self-resolve in this age group, with very few females younger than age 21 years progressing to cervical cancer (0.15 per 100,000 females). Because most HPV-induced cellular changes are transient and rates of cervical cancer in this population are low, initial … [1]: {openurl}?query=rft.jtitle%253DMMWR%2BRecomm%2BRep%26rft.volume%253D64%26rft.spage%253D1%26rft.atitle%253DSEXUALLY%2BTRANSMITTED%2BDISEASES%2BTREATMENT%2BGUIDELINES%2B2015%26rft_id%253Dinfo%253Adoi%252F10.15585%252Fmmwr.rr6404a1%26rft_id%253Dinfo%253Apmid%252F26042815%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.15585/mmwr.rr6404a1&link_type=DOI [3]: /lookup/external-ref?access_num=26042815&link_type=MED&atom=%2Fpedsinreview%2F38%2F9%2F443.atom