Word: gardasil
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...hard to ignore the letters H-P-V in a headline. Much has been written about HPV, or human papillomavirus, which infects some 20 million people in the U.S. and causes cervical cancer and genital warts. Even more has been written about the HPV vaccine, Gardasil, which was approved by the government last summer and is widely recommended for girls and women aged 11 to 26. But many consumers still have questions: for starters, can the vaccine help women who are already infected? Can it help older women over the age of 26? And can it do anything for boys...
...virus-load in women already infected with HPV. According to the study's authors, past trials have suggested that HPV vaccination boosts the body's immune response to infection, and some researchers thought that it might work as a form of therapy for HPV-positive women. Like its cousin, Gardasil (Merck), Cervarix is designed to protect against HPV virus types 16 and 18, which together cause 70% of all cervical cancers. But Hidesheim's study of more than 2,100 women aged 18 to 25 in Costa Rica found that Cervarix - like Gardasil - doesn't fight HPV or change...
...Gardasil protects against four strains of HPV: 6 and 11, which cause genital warts, and 16 and 18, which cause cancer. It makes sense for young women to get vaccinated before exposure to any of these strains. But should they still get vaccinated if they have already acquired one or two of the strains - especially the ones that cause cancer - but not the others? The answer might appear to be yes, but Hildesheim says the issue is still unsettled. "Once sexual debut occurs, the less the benefit of the vaccine will be," he says, pointing to the fact that...
...Gardasil has become a vaccine rock star, but vaccines to fight HPV are still in their infancy. Another study in this week's NEJM points out that while the preventative vaccine works 98% of the time to protect girls not yet infected with HPV-16 and HPV-18, the vaccine is only 17% effective against cancer precursors overall. These findings could undercut the argument ensuing in more than 15 states to make the vaccine mandatory for young girls...
...Gardasil and some vaccines in clinical trial are preventative, but drug companies such as MGI Pharma are studying therapeutic vaccines to treat those already infected with the virus. "We need to come up with better vaccines - and we need to study them in men," says Haddad. Gardasil has not been tested against oral HPV, but Dr. Douglas Lowy, laboratory chief at the National Cancer Institute, says that there is every reason to think that, in principle, "the vaccine should be able to have an impact on oral cancers attributable to HPV." Lowy says that the next studies might start with...