Prevention of HPV Infection and Related Diseases
Three HPV vaccines (Cervarix, Gardasil, and Gardasil 9) are available to help protect against anogenital infections and HPV-related diseases. A recent study showed reductions in the rates of severe cervical dysplasia cases that may be related to the introduction of HPV vaccines. All available vaccines are given intramuscularly (IM) as a three-dose series.[16–18] The vaccines vary according to covered HPV genotypes, indicated population, and administration schedule. Differences among the vaccines are highlighted in Table 2. It is important to note that Cervarix is approved solely for use in females, as it protects only against the two genotypes responsible for cervical cancer. Gardasil and Gardasil 9 provide additional protection against other genotypes that are responsible for anogenital warts and related diseases (e.g., anal cancer), which allows for potential benefit in male patients.[16–18]
The CDC recommends routine vaccination for children (male and female) 11 to 12 years of age, in an attempt to vaccinate prior to onset of sexual activity. Catch-up vaccination is recommended for females aged 13 to 26 years, males aged 13 to 21 years, and immunocompromised males or men who have sex with men up to age 26. Females who have received the HPV vaccine should still be routinely screened for cervical cancer, as it can be caused by other genotypes not covered by the vaccine.[3,19]
The genotypes (16 and 18) covered by the HPV vaccines are responsible for the majority of cervical cancer cases. Studies have shown the vaccine efficacy rate to be above 90% in preventing infection caused by covered genotypes. If an individual is already infected with a specific genotype, the vaccine is not beneficial for that specific type, as it not indicated for treatment purposes. However, the vaccine can still be beneficial against other covered genotypes.
Abstinence is an additional strategy for prevention of HPV infection. For those engaging in sexual activity, it is important to utilize safe practices to help reduce transmission of HPV or other STIs. Barrier contraception is preferred, with latex male condoms being the most effective, followed by polyurethane and female condoms. Spermicides are not recommended for reducing transmission.
US Pharmacist. 2015;40(9):HS-22--24. © 2015 Jobson Publishing