Human papillomavirus prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Most people become infected with various cutaneous HPV types during childhood. Papillomaviruses have a sturdy outer protein shell or "capsid" that renders them capable of lingering in the environment for long periods of time. Avoiding contact with contaminated surfaces, such as the floors of communal showers or airport security lines, might reduce the risk of cutaneous HPV infection. Treating common warts soon after they first appear may also reduce the spread of the infection to additional sites.

Genital HPV infections may be distributed widely over genital skin and mucosal surfaces, and transmission can occur even when there are no overt symptoms. Several strategies should be employed to minimize the risk of developing diseases caused by genital HPVs:

Prevention

Primary preventive measures to prevent HPV infection include the following:[1][2][3][4][5][6][7][8][9]

Primary Prevention Recommendations
HPV vaccine
  • Recommended in both males hand females[9]
  • Started at age 11 or 12
  • Females can get vaccinated through age 26, males through 21
  • Three doses of vaccine, at 1-2 months apart with third dose at 6 months
  • Two types of vaccine available
  • Gardasil (HPV4), quadrivalent (6,11,16,18)
  • Cervarix (HPV2), bivalent (16,18)
Other lifestyle measures
  • Abstinence from sex
  • Avoiding high-risk sexual behaviors(MSM)
  • Regular use of condoms[10]
  • Male circumcision[11]
  • Avoid sexual contact with a person having HPV infection
  • Following regular screening recommendations

Risk for travellers

Transmission of HPV occurs most commonly through sexual activity.

Vaccine

Two vaccines against HPV infection are available.

The vaccines are intended primarily for girls 9-14 years of age.

References

  1. Harper DM, Franco EL, Wheeler CM; et al. (2006). "Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial". Lancet. 367 (9518): 1247–55. doi:10.1016/S0140-6736(06)68439-0. PMID 16631880.
  2. "STD Facts - HPV Vaccine". 2006-08-01. Retrieved 2007-08-17.
  3. "Cervical Cancer Vaccine Approved". WebMD. Retrieved 2007-08-17.
  4. Holmes KK, Levine R, Weaver M (2004). "Effectiveness of condoms in preventing sexually transmitted infections". Bull. World Health Organ. 82 (6): 454–61. PMID 15356939.
  5. Winer RL, Hughes JP, Feng Q; et al. (2006). "Condom use and the risk of genital human papillomavirus infection in young women". N. Engl. J. Med. 354 (25): 2645–54. doi:10.1056/NEJMoa053284. PMID 16790697.
  6. Bleeker MC, Berkhof J, Hogewoning CJ; et al. (2005). "HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions". Br. J. Cancer. 92 (8): 1388–92. doi:10.1038/sj.bjc.6602524. PMID 15812547.
  7. Moscicki AB (2005). "Impact of HPV infection in adolescent populations". The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 37 (6 Suppl): S3–9. PMID 16310138.
  8. Bleeker MC, Berkhof J, Hogewoning CJ; et al. (2005). "HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions". Br. J. Cancer. 92 (8): 1388–92. doi:10.1038/sj.bjc.6602524. PMID 15812547.
  9. 9.0 9.1 Giuliano AR, Palefsky JM, Goldstone S, Moreira ED, Penny ME, Aranda C; et al. (2011). "Efficacy of quadrivalent HPV vaccine against HPV Infection and disease in males". N Engl J Med. 364 (5): 401–11. doi:10.1056/NEJMoa0909537. PMC 3495065. PMID 21288094. Review in: Ann Intern Med. 2011 May 17;154(10):JC5-10 Review in: Evid Based Med. 2011 Oct;16(5):157-8
  10. Winer RL, Hughes JP, Feng Q, O'Reilly S, Kiviat NB, Holmes KK; et al. (2006). "Condom use and the risk of genital human papillomavirus infection in young women". N Engl J Med. 354 (25): 2645–54. doi:10.1056/NEJMoa053284. PMID 16790697.
  11. Tobian AA, Serwadda D, Quinn TC, Kigozi G, Gravitt PE, Laeyendecker O; et al. (2009). "Male circumcision for the prevention of HSV-2 and HPV infections and syphilis". N Engl J Med. 360 (13): 1298–309. doi:10.1056/NEJMoa0802556. PMC 2676895. PMID 19321868.

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