SATURDAY, June 14 (HealthDay News) -- More than half of all
people will have a sexually transmitted disease or infection at
some point in their life, the American Social Health Association
reports.
One of the least noticeable, but potentially most
life-threatening infections, is the human papillomavirus, or
HPV.
Most HPV carriers are never diagnosed and never realize they
carry the virus.
"It's never detected, they are never aware of it, and their
immune system suppresses it before they ever know about it in the
vast majority of cases," said Fred Wyand, spokesman for the
American Social Health Association.
In this way, HPV is a silent killer. It's the leading cause of
cervical cancer and has become the second-leading cause of cancer
death for women around the globe.
Doctors have responded to the threat of HPV by fighting it in a
way unusual among sexually transmitted diseases -- through a
vaccine. The vaccine, Gardasil, is proven to prevent infection from
four particularly dangerous strains of HPV in women. The U.S.
Centers for Disease Control and Prevention has recommended that 11-
and 12-year-old girls begin receiving the vaccine as part of school
vaccination efforts.
Now researchers are looking into whether the vaccine should be
given to boys as well, both to prevent the transmission of HPV, and
to prevent the rarer, but no less deadly, cancers that can occur in
men from the virus.
"There is probably no reason to think it would not be effective
in boys, and because HPV is passed back and forth, immunizing a
large part of the population would limit transmission," said Dr.
Jonathan L. Temte, associate professor in the Department of Family
Medicine at the University of Wisconsin School of Medicine and
Public Health.
"However, we're still very early in the life span of this
vaccine. It's been less than a year since a recommendation was
issued. It is premature to discuss giving it to boys until there's
proof of its efficacy," added Temte, who also serves as the
American Academy of Family Practitioners' liaison to the Advisory
Committee on Immunization Practices.
Studies have shown HPV to kill an estimated 240,000 women
worldwide each year through cervical cancer. And infection with HPV
via oral sex also has been proven to be the leading cause of throat
cancer, striking 11,000 American men and women each year.
Research continues to find that Gardasil is very effective in
preventing HPV-caused cervical cancer. Two studies last year
involving almost 18,000 girls and women found that Gardasil was
nearly 100 percent effective in preventing precancerous cervical
lesions from the four HPV strains targeted by the vaccine. Though
there are at least 15 strains of genital HPV, Gardasil targets the
four strains thought to cause 70 percent of cervical
malignancies.
The studies also found that Gardasil is much more effective when
given to girls or young women before they become sexually
active.
Although men don't risk cervical cancer, they are half of the
equation when it comes to sexually transmitted diseases. They also
face increased risks for throat, genital and anal cancers from HPV
infection.
The maker of Gardasil, Merck & Co., is accumulating data to
consider whether boys should receive the inoculation as well.
"Nobody will be surprised if someday it is recommended for boys,
but it's premature to make that call now," Wyand said. "The early
returns I'm aware of with boys are positive. The vaccine appears to
trigger an immune response similar to that of girls."
Gardasil isn't the only development on the vaccine front --
other vaccines for sexually transmitted diseases are being studied
as well, Temte said. A second HPV vaccine, this one from
GlaxoSmithKline, is currently awaiting FDA approval, he said.
And researchers are also looking at a vaccine that could prevent
herpes simplex, the cause of genital herpes. "There are going to be
a few years out before we see anything like that," Temte said.
Other news involving sexually transmitted disease is less
encouraging.
The CDC estimates that approximately 19 million new sexually
transmitted infections occur each year, almost half of them among
young people ages 15 to 24. Direct medical costs associated with
STDs consume up to $14.7 billion annually in the United States.
And, in 2006, there were increases in chlamydia, gonorrhea, and
syphilis in the United States, according to the CDC.
More than 1.03 million cases of chlamydia were reported in 2006,
up from 976,445 in 2005. Gonorrhea has increased for two years in a
row, following a 74 percent decline in its reported rate for two
decades. And the national syphilis rate increased 13.8 percent
between 2005 and 2006, again reversing what had been years of
decline.
Doctors are investigating what these increases mean, Wyand
said.
"They aren't sure if those were true increases, or if people are
being tested with better and more specific technologies," he said,
noting that each of the STDs tend to be chronically
underreported.
More information
To learn more about sexually transmitted diseases, visit the
American Social
Health Association.