Human Papilloma Virus and Vaccines

Image HPV in Electron MicroscopeThere are varieties of papilloma viruses, from those human papilloma viruses (HPV) form a group. There are at least 200 types of HPVs, amongst which about 100 are fully studied by the researchers. Broadly these form two large groups; those affect cells on skin surface and others, which affect such type of cells in the natural orifices like vagina, mouth and inside of penile skin etc. Some give rise to low risk lesions like skin warts and others high risk lesions having potential to turn into cancers, like cancer cervix.

About 40 types are found in the genital tract. Low risk HPVs like 6 and 11 cause 90% of genital infection, whereas some high risk group of HPVs like 16 and 18 cause 10% of infections. Other HPVs those can cause cancer are, 31, 33, 35, 52, 58, 39, 45, 59, 56, 66 and 51. However, HPV 16 is responsible for 50% of cancers followed by HPV 18 in 7 to 20% in a study; scientists say.

At present at least two types of vaccine are available, one manufactured by GlaxoSmithKline (GSK) and other by Merck Vaccine. The vaccine by GSK has been developed from parts of two viruses, HPV 16 and 18, whereas that from Merck Vaccine is from HPVintraepithelial cancer (CIN); vulvar and vaginal intra-epithelial neoplasia; and genital warts. 16/18/6/11. Both are being sold in many countries, are very much effective in preventing cervical

 Image via Wikipedia, A wart

It is expected that the antibody level so produced after vaccination may last at par, as seen in case of natural infection by HPV, to be around 10 years. It is also seen by researchers that there is some cross-protection from some other types of HPVs like 31, 45, 52 and 58 after immunization by these vaccines.

Protective effect of these vaccines in HIV infected persons is doubtful as well as in immune compromised patents.

Vaccines best works best in 9 to 12 years of pre-pubertal girls; but, can be extended up to 23 years of sexually inactive women, without antibody in the blood. This vaccine though has not been prescribed for boys, but can have potential benefit of prevention of genital warts; and seen to have good antibody status by the researchers.

This vaccination may have immense benefits in the long term in preventing as many as 80% of cervical cancers, 60% of vulval and 90% of anal cancers in women. There is likely to be major improvement for human health and well-being of women every-where.

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Retention Of Urine In Boy

A 12 years old boy came crying along with his mother. On inquiry, the boy showed the swollen end of his penis and inability to pass urine for sometime. His mother told that the boy had faced similar problem since some months back, when the skin of penis was opened, which enabled him to pass urine. He was also advised surgery in the coming winter. Why in winer I do not understand. Somehow people here prefer winter season to undergo surgery. The opening in the prepuce, penile foreskin was not visible and the prepuce seen distended with fluid inside it. It was painful to touch. The opening was seen closed with a flimsy adhesion, after clearing it, collected urine from the under the prepuce came out and the boy got relief. He further was able to pass urine comfortably. A small nodule was felt inside the prepuce. After some blood test the boy was advised a surgery, when the prepuce would be excised, a circumcision. My concern was the nodule inside the prepuce, because the carcinoma penis grows under cover of prepuce. The age factor was going against the diagnosis. So, I thought there could be a papilloma at least.




A circumcision was performed next day under local anesthesia. It was uneventful. It was noticed that there was a rough area in the inner side of the foreskin and it was reddish. It seems due to an inflammatory process following irritation. However the excised specimen was sent for histopathological study. The boy was sent home. I am waiting for the biopsy report. In India people till now, have not accepted circumcision as an aesthetic measure. Muslims take up it as a custom. Now it was in news that a Human Papilloma virus Vaccine has got FDA node for administration in boys. But it has been well documented that a circumcision in the early childhood prevents cancer of penis, as seen in Jews.

Genital Warts on male.

Human papilloma virus is linked to the cancer of cervix in female. Vaccination against it may be an attempt to make the male free from the disease which may also prevent its spread to female partner. Also it will prevent the papilloma in male.

clipped from www.medpagetoday.com FDA Approves HPV Vaccine for Men and Boys WASHINGTON -- The FDA approved Merck's Gardasil vaccine against human papillomavirus (HPV) for boys and men, the same day that it okayed a competing vaccine for use in females. Gardasil was approved for males ages 9 to 26 for prevention of genital warts. The approval did not address claims that the vaccine in this population may help prevent transmission to girls and women. The new indication for Gardasil was based on two trials: a randomized trial in 4,055 males ages 16 through 26 testing the vaccine's effectiveness in preventing genital warts, and a study in boys ages 9 to 15 that measured immune responses. The second trial showed that the immune response was as good as that found in the older age group, indicating that the vaccine should have similar effectiveness, the FDA said.

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A STEP TOWARDS PREVENTING CERVICAL CANCER

Image via Wikipedia

Cancer cervix of uterus seen mostly in elderly ladies.It is a treatable cancer if detected early.Whitish watery discharge, post menopausal bleeding and thereafter pain back are some of the symptoms of it.But are usually late.The disease occurs from bad hygiene,multiple child birth and as a result of papilloma and herpes virus infection apart from other causes.These aforesaid causes can be treated leading to a step in preventing the disease.At present screening tests base upon taking out scrapping of  the cells from cervix and examining what is called PAP smear.Also can be tested for the presence of virus but has not been performed in large scale.Recently a DNA test is coming up. After screening test the patient is subjected to cone biopsy of cervix and a host of other imaging studies for conformation of disease and planning of treatment.
Now researchers say ladies can be vaccinated against Human Papilloma Virus(HPV) so that immunity develops and a fraction of disease can be prevented in this way.Maintaining hygiene which is not practiced in India very much mainly due to poverty. and limiting child birth will also go a long way in preventing a further chunk of this disease.
So early detection through the srreening tests and the preventive  
measures will save or enhance the quality of life of these victims.  

Removed cancer cervix with uterus

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