HPV

Genital Human Papilloma Virus (HPV) infection is the commonest Viral STI in the UK and the majority of sexually active individuals will have HPV infection at some point in their lives.

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Human papillomavirus (HPV) is a very common virus with over 200 strains, most of which are harmless. 80% of people will get a HPV infection at some point in their lives. Your immune system will be able to fight the infection most of the time, however on some occasions the HPV infection may stay and may potentially lead to some types of cancer. It can also lead to genital warts.

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Transmission

HPV is transmitted by sexual activity, including oral, anal and vaginal sex. Infection is most common in those whom begin sexual activity and condoms although can reduce transmission, it does not completely protect against developing the infection. 

 

Genital HPV - The risk of exposure, is related to the number of sexual partners, the introduction of a new sexual partner, and the sexual history of any partner.

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Symptoms

Majority of people become infected with the HPV virus but do not suffer with symptoms and often their immune system clears the infection. However on some occasions the HPV infection may stay and may potentially lead to some types of cancer. It can also lead to genital warts.

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Genital Warts

HPV strains 6 and 11 are the generally responsible for causing genital warts 90% of the time. They present as bumps or lumps found around the genital regions. They appear in various sizes, there can be multiple at a time and shaped like cauliflowers. Although they are generally harmless, due to their appearance they can be quite embarrassing. Strains 6 and 11 are 

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Cervical Cancer

The most common cancer in women under the age of 35 and strains 16 and 18 are responsible for 70% of cervical cancers. Cancerous changes occur over many years when infected with HPV.  

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Other Cancers

Cancers linked to high risk HPV include:

• Anal cancer - Risk is increased in men who have sex with men.

• Penile cancer

• Vulvar cancer

• Vaginal cancer

• Some types of head and neck cancer

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Detection

It is essential to partake in cervical screening programmes as this allows early detection and treatment of precancerous changes to the cervix.

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HPV Vaccine

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Treatment & Prevention

There's no treatment for HPV. Most HPV infections do not cause any problems and are cleared by your body within 2 years.

Treatment is needed if HPV causes problems like genital warts or changes to cells in the cervix.

You cannot fully protect yourself against HPV, but there are things that can help.

• Condoms can help protect you against HPV, but they do not cover all the skin around your genitals, so you're not fully protected.

• The HPV vaccine protects against the types of HPV that cause most cases of genital warts and cervical cancer, as well as some other cancers. It does not protect against all types of HPV.

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Exclusion criteria

• Under the age of 9.

• Allergic reaction to either Gardasil (4 valent) or Gardasil 9

• Previous history of severe allergic reaction to any of the ingredients of the vaccine, including yeast (see FAQ section).

• Acute illness with fever (greater than 38.5 degrees Celsius).

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Pregnancy & Breastfeeding

Due to insufficient data around the vaccine and pregnancy, it is best to postpone the vaccination until after delivery. 

There is sufficient evidence from clinical studies showing that the vaccine did not cause any adverse effects in infants who were breast fed during the vaccination course. Thus, the vaccine can be given safely to breast feeding mothers.

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Common Side Effects

Generally the vaccine has been known to be well tolerated. However, common side effects include:

• headache, dizziness, nausea, pyrexia, myalgia, fatigue

• Local injection site reactions-redness, swelling and pain

• Rare side effects - loss of consciousness at the time of the vaccine administration.

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Interactions with Other Vaccines

HPV Vaccine-9 can be given at the same time as:

• Diphtheria, tetanus, inactivated polio and pertussis

There is no data on administration with other vaccines. If given at the same time as other vaccines, it should be administered in a separate limb.

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Important considerations

• The HPV vaccine is used for prevention only and cannot treat existing HPV infection. 

• Gardasil®9 has replaced Gardasil® as the only HPV vaccine supplied. The two vaccines are considered interchangeable by the JCVI. For those individuals who started the schedule with Gardasil® the course can be completed with Gardasil®9. The course should be completed according to the advised vaccination schedule.

• Yeast allergy is not a contraindication to the HPV vaccine. Even though Gardasil® and Gardasil®9 are grown in yeast cells, the final vaccine product does not contain yeast as an excipient/ingredient, and at most would only contain very small trace amounts of yeast protein (<0.007 micrograms).

• There is no interaction between HPV Vaccine 9 and hormonal contraception.