Have you had your HPV (Human Papilloma Virus) course of vaccinations yet? It’s time to consider getting it for you and your friends and family too.

Human Papilloma Virus (HPV) has been recognised as the leading cause of cervical cancer, which in turn is the fourth-most prevalent cancer among women worldwide¹. The World Health Organization’s (WHO) South East Asia Region (SEAR) and Western Pacific Region (WPR) have two of the highest burdens of cervical cancer^1,2,3. In Southeast Asia, it is the second most common cancer in women, with roughly 175,000 new diagnoses annually⁴.

It is important to note that Human Papilloma Virus (HPV) is not the same virus as the HIV (Human Immunodeficiency Virus) and HSV (Herpes Simplex Virus). This is because it is so common that most sexually active men and women has gotten it at some point.

Human Papilloma Virus (HPV) typically goes away but in cases where it doesn’t, it could cause genital warts and cancer. More specifically, Human Papilloma Virus (HPV) infection can cause⁵:

• cancers of the cervix, vagina, and vulva in women
• cancers of the penis in men
• cancers of the anus and back of the throat, including the base of the tongue and tonsils (oropharynx), in both women and men

It is spread via unprotected sexual contact and cervical cancer takes about 10 years to develop after infection of Human Papilloma Virus (HPV). However, it must be said that not all HPV infections will develop into cervical cancer.

Lower Your Risk

According to the Centers for Disease Control and Prevention (CDC USA), there are a few things that could lower your chance of contracting HPV. If you are sexually active, use latex condoms properly to lower your risk of being infected. Do note that Human Papilloma Virus (HPV) can infect areas that’s not covered by a condom so it’s also important to be in a mutually monogamous relationship to prevent the spread of the virus.

Most importantly, get screened for cervical cancer especially if you’re a woman aged 21 to 65 years old who is sexually active. It is recommended for sexually active women to get pap smears to screen for cervical cancer within the first three years of having sexual intercourse and afterwards, once every three years to follow up. In fact, to encourage women to get pap smears, they are offered for free at government hospitals and clinics (note : public health policy differs from one country to another, so you need to check with your local hospital or clinic).

Another way to lower your chance of contracting Human Papilloma Virus (HPV) is to get vaccinated. Since 2006, the vaccine has been approved for use in over 100 countries. The HPV vaccine protects both men and women against diseases caused by the virus. This vaccine will also help to protect against genital warts.

Go Get Vaccinated!

The United States was the first country to introduce a publicly funded HPV immunisation program⁶. Within the South East Asia region, Bhutan, Malaysia, Philipines and Singapore have incorporated Human Papilloma Virus (HPV) vaccines into their national immunization plans⁴.

Under the National Immunisation Programme of Malaysia, free HPV vaccines have been provided to female form one students since 2010 but it’s important to get all boys and girls aged 11 or 12 years old to get vaccinated.

Men up to 21 years old should get vaccinated if they weren’t vaccinated at a younger age and the same goes to women but for the fairer sex, it’s up to 26 years old.

There are 3 licensed vaccines (2 WHO-prequalified or PQ) which protect against HPV 16 and 18 (cause ~70% cervical cancers)⁷ :

• Bivalent vaccine or Cervarix (HPV 16, 18) – WHO PQ
• Quadrivalent vaccine or Gardasil (HPV 6, 11, 16, 18) – WHO PQ
• 9-valent vaccine (HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58)

The HPV vaccine is given in 3 doses. After the first dose, the second dose should be one months after the first dose and its third dose is given six months after the first dose. Thus, the vaccination should be completed within a six month period.

Do check with your gynaecologist if you have more questions about the Human Papilloma Virus (HPV) vaccines and a paediatrician will be able to advise whether it’s alright to vaccinate your child, male or female, against HPV.

Pregnancy And HPV

Pregnant women are not eligible for the HPV vaccine. In the event that you are pregnant and have Human Papilloma Virus (HPV), it’s possible to develop genital warts or abnormal cell changes of the cervix. It is advised for pregnant women to get routine cervical cancer screening for prevention purposes.

References:

1. GLOBOCAN 2012: Estimated Cancer Incidence, M. A. P. W. Cervical Cancer, Estimated Incidence, Mortality and Prevalence Worldwide in 2012,  http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx (2012).

2. Hendry, M., Lewis, R., Clements, A., Damery, S. & Wilkinson, C. “HPV? Never heard of it!”: a systematic review of girls’ and parents’ information needs, views and preferences about human papillomavirus vaccination. Vaccine 31, 5152–5167,  https://doi.org/10.1016/j.vaccine.2013.08.091 (2013).

3. World Health Organization. Sexually transmitted infection (STI) Fact Sheet,  http://www.who.int/mediacentre/factsheets/fs110/en/ (2016).

4. American Foundation for AIDS Research (amfAR) "Cervical Cancer, Human Papillomavirus (HPV), and HPV Vaccines in Southeast Asia"

5. Centers for Disease Control and Prevention (CDC) "HPV Vaccines: Vaccinating Your Preteen or Teen"

6. Bruni, L. et al. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. The Lancet Global Health 4, e453–e463,  https://doi.org/10.1016/S2214-109X(16)30099-7.

7. James Heffelfinger, MD, MPH Expanded Programme on Immunization WHO Regional Office for the Western Pacific "HPV Vaccination in the Western Pacific and South-East Asia Regions: Overview, Challenges and Opportunities"