HPV Vaccine Still Beneficial in Sexually Active Women

Human papillomavirus (HPV) vaccination may be beneficial for women with HIV infection even after previous exposure to HPV, according to the findings of a new study.¹

The HPV vaccine, which is recommended for girls aged 11 to 26 years, can protect against 4 high-risk types of the virus-HPV-6, HPV-11, HPV-16, and HPV-18. HPV serotypes 6 and 11 cause 90% of all cases of genital warts, and HPV serotypes 16 and 18 cause 70% of cervical cancers. To better understand the prevalence and risk factors for HPV among young women with HIV infection, researchers tested for cervicovaginal HPV DNA (41 types, including 13 high-risk types) and HPV serology (4 vaccine types) in 99 women aged 16 to 23 years with HIV infection.

Researchers discovered that 75% of the women had an existing HPV infection with at least 1 serotype, with 54% having a high-risk type. However, the findings showed that more than 45% of the women have never been exposed to either HPV-16 or HPV-18. When testing specifically for these high-risk serotypes, nearly 75% of the women had no current HPV-18 infection and no indicators of previous exposure, and 56% of women had no evidence of current infection or previous exposure to HPV-16.

When the women in the study received their first HPV vaccination, 12% had an active HPV-16 infection and 5% had an existing HPV-18 infection. The researchers stated that because these women also had HIV infection, HPV-related cancer may not only be more likely to develop but also be more difficult to treat.^1,2 Therefore, cervical cancer screening is especially important in women with HIV infection or at risk for HIV infection, said study coauthor Bill G. Kapogiannis, MD.²

“Health care providers may hesitate to recommend HPV vaccines after a girl starts having sex,” said first author Jessica Kahn, MD, MPH.² “However, our results show that for a significant number of young women, HPV vaccine can still offer benefits. This is especially important in light of their HIV status, which can make them even more vulnerable to HPV’s effects.” Kahn also advises that “[e]ven among women who test positive for one type of HPV, the vaccine may effectively prevent infection with others-especially high-risk forms that cause cancer. It’s important that doctors don’t withhold the vaccine in these cases, thinking that it’s too late for a vaccine to be effective.”

Pertinent Points:
- HPV vaccines in young women who have an existing HPV infection can still protect against other types of HPV infection, including high-risk forms.
- Women with HIV infection or a preexisting HPV infection should be vaccinated against HPV infection to offer maximum protection against the high-risk types of HPV.

References:

1. Kahn JA, Burk RD, Squires KE, et al. Prevalence and risk factors for HPV in HIV-positive young women receiving their first HPV vaccination. J Acquir Immune Defic Syndr. 2012;61:390-399.
2. U.S. Department of Health and Human Services, National Institutes of Health. HPV vaccine may benefit HIV-infected women. Available at: http://www.nih.gov/news/health/nov2012/nichd-08.htm. Accessed December 19, 2012.