October 10, 2008

Best of: OB/GYN on HPV

In Grand Rounds for OB/GYN, a lecturer talking about vaccinations for young women said something that I thought was totally hilarious. My vague recollection of the quote goes something like this:
A study showed that 32% (95% CI 22.5-44%)of men in a university setting (n=240) had detectable HPV DNA on their hands. (1) That's not necessarily saying anything about their sexual habits...


He went on to say "It just goes to show that HPV is more prevalent than people think. And it can easily spread through hand-shaking." This does raise the distinct possibility of the hand-genital route as well, suggested in an earlier article. (2)

As funny as I found this initial statement to be, it's a serious and sobering topic. Especially since we have the HPV vaccine that can prevent cervical cancer with about 70% coverage. (Not good enough, by Dino's standards.) According to this week's Morbity and Mortality Weekly Report, "an assessment of HPV4 coverage, which is reported for the first time, showed that "25.1% of adolescent females initiated [Gardasil], the vaccine series (>1 dose) in 2007." Yay!

The Health Science Report shares information about the transmission of HPV in general, which can happen through other routes than sexual contact.

A report in 1/08 from the Journal of Infectious Diseases suggests that young women have an increased risk for HPV infection when their first male partner was sexually experienced with a Hazard ratio of 8.5 (95%CI 3.1-23) for 3+ previous partners, 3.6 (95% CI 1-12) for 2 partners and just 0.4 for 1 previous partner (95% CI 0-3.3) with 1.0 Hazard ratio as the reference for first sexual partner. (3)

References
1. JM Partridge - JOURNAL OF INFECTIOUS DISEASES, 2007. Genital Human Papillomavirus Infection in Men: Incidence and Risk Factors in a Cohort of University Students.
2. C. Sonnex. Detection of human papillomavirus DNA on the fingers of patients with genital warts. Sex Transm Infect. 1999 October; 75(5): 317–319.
3. Winer RL. Risk of female human papillomavirus acquisition associated with first male sex partner. J Infect Dis. 2008 Jan 15;197(2):279-82.

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