HPV Vaccine for Boys? It Just Might Happen (HealthDay)

SATURDAY, June 14 (HealthDay News) -- More than half of allpeople will have a sexually transmitted disease or infection at some pointin their life, the American Social Health Association reports.

One of the least noticeable, but potentially most life-threateninginfections, is the human papillomavirus, or HPV.

Most HPV carriers are never diagnosed and never realize they carry thevirus.

"It's never detected, they are never aware of it, and their immunesystem suppresses it before they ever know about it in the vast majorityof cases," said Fred Wyand, spokesman for the American Social HealthAssociation.

In this way, HPV is a silent killer. It's the leading cause of cervicalcancer and has become the second-leading cause of cancer death for womenaround the globe.

Doctors have responded to the threat of HPV by fighting it in a wayunusual among sexually transmitted diseases -- through a vaccine. Thevaccine, Gardasil, is proven to prevent infection from four particularlydangerous strains of HPV in women. The U.S. Centers for Disease Controland Prevention has recommended that 11- and 12-year-old girls beginreceiving the vaccine as part of school vaccination efforts.

Now researchers are looking into whether the vaccine should be given toboys as well, both to prevent the transmission of HPV, and to prevent therarer, but no less deadly, cancers that can occur in men from thevirus.

"There is probably no reason to think it would not be effective inboys, and because HPV is passed back and forth, immunizing a large part ofthe population would limit transmission," said Dr. Jonathan L. Temte,associate professor in the Department of Family Medicine at the Universityof Wisconsin School of Medicine and Public Health.

"However, we're still very early in the life span of this vaccine. It'sbeen less than a year since a recommendation was issued. It is prematureto discuss giving it to boys until there's proof of its efficacy," addedTemte, who also serves as the American Academy of Family Practitioners'liaison to the Advisory Committee on Immunization Practices.

Studies have shown HPV to kill an estimated 240,000 women worldwideeach year through cervical cancer. And infection with HPV via oral sexalso has been proven to be the leading cause of throat cancer, striking11,000 American men and women each year.

Research continues to find that Gardasil is very effective inpreventing HPV-caused cervical cancer. Two studies last year involvingalmost 18,000 girls and women found that Gardasil was nearly 100 percenteffective in preventing precancerous cervical lesions from the four HPVstrains targeted by the vaccine. Though there are at least 15 strains ofgenital HPV, Gardasil targets the four strains thought to cause 70 percentof cervical malignancies.

The studies also found that Gardasil is much more effective when givento girls or young women before they become sexually active.

Although men don't risk cervical cancer, they are half of the equationwhen it comes to sexually transmitted diseases. They also face increasedrisks for throat, genital and anal cancers from HPV infection.

The maker of Gardasil, Merck & Co., is accumulating data toconsider whether boys should receive the inoculation as well.

"Nobody will be surprised if someday it is recommended for boys, butit's premature to make that call now," Wyand said. "The early returns I'maware of with boys are positive. The vaccine appears to trigger an immuneresponse similar to that of girls."

Gardasil isn't the only development on the vaccine front -- othervaccines for sexually transmitted diseases are being studied as well,Temte said. A second HPV vaccine, this one from GlaxoSmithKline, iscurrently awaiting FDA approval, he said.

And researchers are also looking at a vaccine that could prevent herpessimplex, the cause of genital herpes. "There are going to be a few yearsout before we see anything like that," Temte said.

Other news involving sexually transmitted disease is lessencouraging.

The CDC estimates that approximately 19 million new sexuallytransmitted infections occur each year, almost half of them among youngpeople ages 15 to 24. Direct medical costs associated with STDs consume upto $14.7 billion annually in the United States.

And, in 2006, there were increases in chlamydia, gonorrhea, andsyphilis in the United States, according to the CDC.

More than 1.03 million cases of chlamydia were reported in 2006, upfrom 976,445 in 2005. Gonorrhea has increased for two years in a row,following a 74 percent decline in its reported rate for two decades. Andthe national syphilis rate increased 13.8 percent between 2005 and 2006,again reversing what had been years of decline.

Doctors are investigating what these increases mean, Wyand said.

"They aren't sure if those were true increases, or if people are beingtested with better and more specific technologies," he said, noting thateach of the STDs tend to be chronically underreported.

More information

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