Virus World

No cervical cancer cases were detected in Scotland in women born between 1988-1996 and fully vaccinated against HPV between ages 12 to 13, study says. A historic new study out of Scotland shows the real-world impact of vaccines against the human papillomavirus: The country has detected no cases of cervical cancer in women born between 1988-1996 who were fully vaccinated against HPV between the ages of 12 and 13. Many previous studies have shown that HPV vaccines are extremely effective in preventing cervical cancer. But the study, published on Monday in the Journal of the National Cancer Institute, is the first to monitor a national cohort of women over such a long time period and find no occurrence of cervical cancer.

“The study is super exciting. It shows that the vaccine is extremely effective,” said Kathleen Schmeler, a professor of gynecologic oncology at the University of Texas MD Anderson Cancer Center, who was not involved in the research. “It’s obviously early. We’re just starting to see the first data of the impact of the vaccine because it takes so long from the time of the vaccine to the effects.” The results underscore the importance of working to increase uptake of the HPV vaccine in the U.S., said Schmeler. Scotland, for example, introduced routine immunization in schools in 2008, and close to 90% of students in their fourth year of secondary school (equivalent to 10th grade in the U.S.) in the 2022-2023 school year had received at least one dose of the vaccine. In the U.S., where HPV vaccines are not administered in school, uptake among adolescents ages 13 to 17 is a little over 60%....

Study available here (jan. 22, 2024):

https://doi.org/10.1093/jnci/djad263

The HPV vaccine is one of only two vaccines that prevent cancer but is underutilized in the United States. Despite its proven success at preventing cancer, many adolescents are still not getting the HPV vaccine. A new study from the University of Colorado School of Medicine at the Anschutz Medical Campus shows that physicians’ delivery and communication practices must improve to boost vaccination completion rates. Health care providers must also learn to deal with parents hesitant to get their children vaccinated with HPV vaccine.

The study, to be published tomorrow (September 16, 2019) in Pediatrics, is the first to examine pediatricians and family physicians’ delivery practices for the vaccine since the new 2-dose schedule came out for adolescents 11 or 12-years-old. “A physician recommendation is one of the most important factors in vaccine acceptance by parents,” said Allison Kempe, MD, MPH, lead author and professor of pediatrics at the University of Colorado School of Medicine. “However, we’re seeing a lack of understanding from healthcare providers about the need for vaccination early in adolescence and high rates of refusal on the part of parents. The vaccine is underutilized, with less than half of American adolescents completing the vaccination. We need to maximize methods of introducing the vaccine that we know to be more effective, as well as the use of reminder and delivery methods at the practice in order to improve this rate.”

Every year, HPV causes over 33,500 cases of cancer in women and men in the United States, according to the Centers for Disease Control and Prevention.

“The earlier someone is vaccinated, the better the immune system responds. It also increases the chances of being vaccinated before having exposure to HPV strains,” Kempe said. “If we can increase the rate of vaccination in early adolescence, then we can prevent cancers that develop in later years.”

The study surveyed 588 pediatricians and family physicians and found that refusal rates from parents remain high, especially for 11 to 12-year-olds, the target population for vaccination. But physicians who use a `presumptive style’ approach have higher acceptance rates. Presumptive style means physicians introduce the HPV vaccine and recommend it in the same manner and as strongly as the other recommended adolescent vaccines for meningitis and Tdap. For example, a doctor could say, “We’ve got three vaccines today: Tdap, HPV and Meningitis,” rather than isolating HPV as an option that is not as important.

Still, the survey found some encouraging signs:

• Despite a high refusal rate, pediatricians who strongly recommend the vaccine increased from 60% in 2013 to 85% in 2018 for 11 or 12-year-old females and from 52% to 83% for 11 to 12-year-old males.
• Some 89% of pediatricians and 79% of family pediatricians reported more adolescents under age 15 are completing the HPV series now that only 2 doses are recommended.

Along with improving physician communication styles, HPV delivery could also be optimized by increased use of standing orders and alert systems in the medical record to remind providers of the need for vaccination at the point of care.

Study published on Sept. 16 in the jopurnal Pediatrics:

https://doi.org/10.1542/peds.2019-1475

More than 100,000 cases of cancer will be prevented under plans to give boys the HPV jab as well as girls, UK health officials have said. 

Giving boys the vaccine protects girls from the human papilloma virus (HPV), which is passed on through sexual contact. And it will also protect them from a range of other forms of the disease, including some cancers of the head and neck, and penile, anal and genital cancers. Scientists hope that cervical cancer could be eradicated within decades, because of the success of the jabs. Since the vaccine was introduced for teenage girls in 2008, cases of HPV have fallen by 86 per cent among the age groups vaccinated.

Professor Beate Kampmann, director of the vaccine centre at the London School of Hygiene and Tropical Medicine, said: "This decision is a triumph for gender equality in cancer prevention.

"It's pleasing to see the UK follow the example of other countries like Australia, where the vaccine has been implemented for girls since 2007 and for boys since 2013."

Estimates from the University of Warwick suggest the vaccine will prevent 64,138 cervical cancers and 49,649 non-cervical cancers in the UK by 2058.  This will include 3,433 cases of penile cancer and 21,395 cases of head and neck cancer, such as throat cancer, in men.

UK Health report available at:

 https://www.gov.uk/government/organisations/public-health-england 

In a recent study published in the journal Scientific Reports, researchers used a nationwide case-control study of Taiwanese residents to investigate the association between human papillomavirus (HPV) and thyroid cancer. Analyses of the 3,062 thyroid cancer patients and 9,186 healthy controls revealed that individuals with a prior HPV infection had more than double the likelihood of developing thyroid cancer than those without the infection (odds ratios 2.199 for HPV patients). This research presents the first concrete evidence of a carcinogen for thyroid cancer, the most common endocrine cancer and a growing concern worldwide.

Human Papilloma Virus or HPV has been known to be transmitted between humans via sexual contact and HPV has been known to be a sexually transmitted disease or STD. The Centers for Disease Control and Prevention (CDC) states that HPV is one of the commonest STDs among humans. It affects around 79 million individuals in the United States. In most cases the infection may pass unnoticed and may resolve on its own. However HPV has been associated with the later development of cervival cancers in women and oral and throat cancers among men and women.

A new study however reveals that rabbit and mice papilloma viruses are capable of spreading via contaminated blood from one to another. The study from Pennsylvania State researchers titled, “Papillomavirus can be transmitted through the blood and produce infections in blood recipients: Evidence from two animal models” was published in the recent issue of the journal Emerging Microbes & Infections. The researchers warned that this study could be a basis for the hypothesis that HPV could also be transmitted between humans via blood.

Study leader Jiafen Hu, assistant professor of pathology and laboratory medicine at Penn State College of Medicine called for more research to confirm that papilloma viruses are capable of transmission via blood especially blood transfusions. He said that the blood prepared for receive blood transfusions may require a screening for HPV if this is proven to be true. Hu said, “People who are receiving blood transfusions typically have immune systems that aren't working optimally, so their systems are more vulnerable. We might want to think about adding HPV to the list of viruses for which blood donations are screened, as well as researching whether the typical viral load of HPV in human blood would be sufficient to cause infection.”

Hu explained that the team came across a case in 2005 where a similar transmission was seen. He said, “Some years ago, researchers were looking at blood samples from a group of HIV-positive children, and as they were testing those samples, they found that some of them were also positive for HPV. Because these children were so young, it prompted the question of whether the virus could have come from blood transfusions, which some of the children had undergone.”

Since it is difficult to check for HPV on animal models, the team decided to perform their experiments on other forms of papilloma viruses. “HPV is strictly species-specific,” they wrote, “and thus, cannot be studied directly in animals. Our laboratory has two preclinical animal models with their own naturally occurring papillomaviruses.”

The team used Cottontail Rabbit Papillomavirus which is commonly used for researching HPV infections in humans because of its similarity with HPV. For their experiments the team first injected the rabbit papilloma virus into the bloodstreams of the lab rabbits. The rabbits were then monitored for four weeks when they were found to develop tumours. This proved that the virus had travelled via the blood stream to cause the tumours in the rabbits said Hu. The team found that several genetic expressions were lower in these rabbit tumours similar to actual sexually transmitted tumours. They wrote, “The rabbit skin tumours induced via blood infection displayed decreased expression of SLN, TAC1, MYH8, PGAM2, and APOBEC2 and increased expression of SDRC7, KRT16, S100A9, IL36G, and FABP9, as seen in tumours induced by local infections.”

Hu explained that in this experiment they had used a large amount of the virus to be injected into the rabbits. This infection due to the injection of the viruses could be due to the heavy viral load, he added. In a normal case of blood borne infection, the dose of the virus could be significantly lower. Thereafter the team reduced the viral load injected by five times. This time the tumours were still seen in 18 out of the 32 animals. Hu said, “We were able to show that the virus in the blood caused tumors, but what about blood transfusions? People receiving a transfusion may only get a very small amount of the virus. To simulate this, we injected the virus into one animal, took 10 millilitres of blood and transfused it into a second animal. We still saw tumors.”

The next question the researchers addressed was if the blood borne infection could cause tumours and cancerous changes in the cervix as the sexually transmitted infection was capable of. Now they repeated their experiment using mice model. When injected with the papilloma virus into lab mice, the team found that the virus and viral warts and tumours were found in the tongue and genital mucosa of the mice. They also found the virus in the stomach mucosa of the mice. This proved that the virus was capable of travelling from the blood stream into oral and genital mucosa as well as into the gastric mucosal surfaces.

Findings published in the Journal of Emerging Microbes and Infections:

https://doi.org/10.1080/22221751.2019.1637072