A recent study conducted by the University of Manchester in England has revealed that an HIV drug may be able to prevent cervical cancer in HPV patients by killing the virus that causes the disease. According to researchers, the drug lopinavir kills cells infected with HPV while leaving healthy cells relatively uncompromised. This discovery marks a major development in the treatment of HPV in women.

HPV Prevalence in the U.S.

An estimated 20 million Americans currently have HPV, while there are approximately 6 million new HPV cases in the U.S. each year, 75 percent of which occur in 15 to 24 year olds. Annual STD testing for HPV is recommended for all sexually active females and is usually performed via a Pap smear during a yearly gynecology exam. Male HPV testing is not readily available since HPV in men is benign and self-resolving in the vast majority of cases.

HPV in Women

Though sexually active women are exposed to a host of STDs, HPV in women is a major concern due to the risk of cervical cancer. Every year, about 12,000 U.S. women are diagnosed with cervical cancer. Though symptoms of STDs in women can sometimes point to infection, in most cases of HPV-related cervical cancer, symptoms will not appear until the disease has progressed to advanced stages. Women are encouraged to have a yearly Pap test and cervical cancer screening through their gynecologist for early detection.

HPV in Men

Much of the attention surrounding HPV is directed towards women since they are the disproportionally impacted.  Unlike women who are routinely screened for HPV through a Pap test, there is no routine examination in place for men. HPV testing in men is not a major health concern; in the vast majority of cases, HPV will self resolve in men without causing any harm.

Rarely, men can develop HPV-related cancers. Approximately 800 U.S. males are diagnosed with HPV-related penile cancer each year, while 1,100 men are diagnosed with HPV-related anal cancer. Additionally, about 5,700 men are diagnosed annually with HPV-related cancers of the head and neck.

Preventing HPV

There are two vaccines available to prevent HPV in women: Gardasil and Cervarix. Both vaccines protect against the strains causing cervical cancer, while only Gardasil prevents most cases of genital warts. The CDC recommends that all women aged 9 to 26 are vaccinated against HPV. Females under the age of 9 and above the age of 26 are not eligible to receive the vaccine at this time.

Recently, Gardasil was approved to prevent HPV genital warts in men aged 9 to 26. Evidence suggests it can prevent against HPV-related cancers that affect men, particularly anal cancer in men who have sex with men. Though Cervarix has been proven effective in preventing HPV in women, it cannot be administered to men.

Understanding HPV

There are over 100 strains of the HPV virus, 40 of which affect the genital area. Several of which are considered high risk HPV because of their link to cervical cancer. It is these specific strains of the virus that vaccines such as Gardasil and Cervarix target.

Monitoring HPV in Women

Following a positive HPV diagnosis, most physicians will recommend more frequent Pap tests to check for signs of abnormal cell changes in the cervical region, as these could point to cervical cancer. Removing abnormal cervical cells is generally the next line of defense if such cells are detected. Researchers suggest that the new drug lopinivar may be an effective treatment in combating HPV in women who were never vaccinated and were subsequently infected.

Staying Healthy with HPV

With proper monitoring, HPV patients can minimize their risk of unwanted side effects, including associated cancers. Depending on contributing risk factors, those with HPV may be advised to undergo additional screenings to rule out other STDs, such as an HIV test. Additionally, physical symptoms of HPV such as genital warts can be alleviated via medication or in-office treatments.

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Genital warts, a known symptom of sexually transmitted HPV, may become more easily treatable. Recently, the FDA approved the use of 3.75% imiquimod cream for patients 12 years of age and older experiencing external genital warts (1). This latest genital warts treatment works in about half the time as  previously established treatments.

New Genital Warts Treatment Works

In clinical studies, imiquimod cream applied once daily for up to 8 weeks resulted in complete clearance of exterior genital warts in 28.3 percent of patients who followed a treatment regimen. Among those whose genital warts cleared up completely, only 15 percent experienced a recurrence within 12 weeks of treatment. Additionally, the cream produced better outcomes for genital warts in women, with symptoms completely disappearing in 37 percent of female patients following treatment. Only 19 percent of experienced similar results.

Old vs. New Genital Warts Treatment

Previously, to eliminate genital warts, a patient would need to apply cream to the genitals three days a week and leave it on for six to ten hours at a time. Treatment would often take up to 16 weeks, and during this time, abstinence from sexual activity would be required. With this latest imiquimod cream, patients can apply a thin layer once each day for up to eight weeks or until all genital warts have cleared, thereby cutting treatment time in half.

Genital Warts Treatment May Produce Side Effects

As is the case with many medical treatments on the market, this new genital warts cream may result in unwanted side effects. These can include skin irritation, flu-like symptoms, fatigue, headache, and pain at the site of application. During clinical trials, less than one percent of patients discontinued treatment as a result of side effects.

STD Testing Necessary for Genital Warts

As genital warts can often be mistaken for other conditions, such as syphilis or genital herpes, STD testing should be administered following the presence of new genital bumps or lesions. STD testing can rule out other STDs, but there is no blood or urine test to detect genital warts in men and women. A physician can diagnose the virus based on a physical exam. Also, it is important to get tested for HIV before using this medication. Since imiquimod treatment works by activating immune cells, patients with preexisting autoimmune conditions, such as HIV, may need to exercise caution when using the cream to treat genital warts. If an STD test reveals the presence of HIV, which affects the immune system, genital warts treatment should be discussed with a medical professional before a regimen commences.

Sources:    accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory#apphist