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http://www.figo.org/news/hiv-drug-could-avert-cervical-cancer-003611
We haven't heard much new about HPV over the last several months. Mostly, it's been minor news about specifically which category of person the FDA has approved to take the various HPV vaccines (girls and boys under 30, but not over 30) or new home test kits that haven't yet made it to market.
Reminder: the vaccine being "approved" for a certain category doesn't mean those not in that category CAN'T take it, it means that the company can't make any claims of successful treatment for those categories, and, consequently, many insurance plans won't cover it for those category. The current evidence suggests that efficacy is decreased with age (because of likely previous exposure), but not eliminated. So if you have the cash but are not in the "approved" category, I still recommend you find a doctor to give it to you "off-label" (which is completely legal).
Anyway, while testing an anti-HIV drug, researchers discovered that a drug called Lopinavir actually kills HPV-infected, pre-cancerous cells while leaving uninfected adjoining cells alone.
This could be extremely exciting news if it follows through on its promises and scales up to humans. So far, this drug works in petri dishes on actual human HPV-infected cells that have not yet turned cancerous but are the closest thing to pre-cancerous. In order to work on HPV, the cells require 15 times more drug than the HIV-infected cells, so this will not be available in pill form, but researchers speculate that a topical cream could deliver the appropriate dose.
At the moment, the US has a backwards system, in part because of the awesome work that was done in the past with making female reproductive health care such a priority. Currently, women get a pap smear done, which is collecting cells directly from the cervix and then looking at them under a microscope to see if there are any abnormal ones. Then, if there are, several tests are done to figure out why they are abnormal and if that abnormality is bad, including an HPV DNA test. The research community believe this is the wrong order, but the medical practice community is slow to change (partly because of financial concerns) with the newly available HPV tests.
The research community thinks that we should be having the HPV DNA test done first, to see who is even at risk for cervical cancer, and then when we have determined who actually has HPV, those women would go on a frequent pap smear schedule to watch for changes in the cervix, so they can be treated immediately, while those without HPV can go on a longer pap smear schedule (like HPV-infected women get paps every year or 6 months and women without HPV get them every 2 or 3 years, for example).
Then, with this new drug, should it pan out, instead of bothering with frequent pap smears, women who test positive for HPV DNA could just get the cream, kill all the affected cells, do another DNA test to make sure it's gone, then go back to the more infrequent schedule.
Paps would still be important, however, because HPV is responsible for something like 70% of all cervical cancers and is now the leading cause of oral cancers (thanks to smoking dropping in popularity), but that still leaves 30% of cancers that are not caused by HPV (I may have my percentages wrong, but the point is the same - some cancers are not caused by HPV). And it is our collective access to pap smears & LEEP procedures that make the mortality rate of cervical cancer so very low in this country (no thanks to the GOP defunding Planned Parenthood).
We haven't heard much new about HPV over the last several months. Mostly, it's been minor news about specifically which category of person the FDA has approved to take the various HPV vaccines (girls and boys under 30, but not over 30) or new home test kits that haven't yet made it to market.
Reminder: the vaccine being "approved" for a certain category doesn't mean those not in that category CAN'T take it, it means that the company can't make any claims of successful treatment for those categories, and, consequently, many insurance plans won't cover it for those category. The current evidence suggests that efficacy is decreased with age (because of likely previous exposure), but not eliminated. So if you have the cash but are not in the "approved" category, I still recommend you find a doctor to give it to you "off-label" (which is completely legal).
Anyway, while testing an anti-HIV drug, researchers discovered that a drug called Lopinavir actually kills HPV-infected, pre-cancerous cells while leaving uninfected adjoining cells alone.
This could be extremely exciting news if it follows through on its promises and scales up to humans. So far, this drug works in petri dishes on actual human HPV-infected cells that have not yet turned cancerous but are the closest thing to pre-cancerous. In order to work on HPV, the cells require 15 times more drug than the HIV-infected cells, so this will not be available in pill form, but researchers speculate that a topical cream could deliver the appropriate dose.
At the moment, the US has a backwards system, in part because of the awesome work that was done in the past with making female reproductive health care such a priority. Currently, women get a pap smear done, which is collecting cells directly from the cervix and then looking at them under a microscope to see if there are any abnormal ones. Then, if there are, several tests are done to figure out why they are abnormal and if that abnormality is bad, including an HPV DNA test. The research community believe this is the wrong order, but the medical practice community is slow to change (partly because of financial concerns) with the newly available HPV tests.
The research community thinks that we should be having the HPV DNA test done first, to see who is even at risk for cervical cancer, and then when we have determined who actually has HPV, those women would go on a frequent pap smear schedule to watch for changes in the cervix, so they can be treated immediately, while those without HPV can go on a longer pap smear schedule (like HPV-infected women get paps every year or 6 months and women without HPV get them every 2 or 3 years, for example).
Then, with this new drug, should it pan out, instead of bothering with frequent pap smears, women who test positive for HPV DNA could just get the cream, kill all the affected cells, do another DNA test to make sure it's gone, then go back to the more infrequent schedule.
Paps would still be important, however, because HPV is responsible for something like 70% of all cervical cancers and is now the leading cause of oral cancers (thanks to smoking dropping in popularity), but that still leaves 30% of cancers that are not caused by HPV (I may have my percentages wrong, but the point is the same - some cancers are not caused by HPV). And it is our collective access to pap smears & LEEP procedures that make the mortality rate of cervical cancer so very low in this country (no thanks to the GOP defunding Planned Parenthood).
Also, do remember that even though HPV is responsible for such a high percentage of cancers, the percentage of people with HPV who *get* those cancers is very low. In other words, 80% of women will contract HPV in their lifetimes. But only a sliver of them will actually get cancer from it. The vast majority of women simply pass the virus through their system with little to no effect. It is for that sliver of women that these journal posts, and the research and the vaccines and the procedures, are so important. Being one of those women certainly doesn't make one feel good to know that they're statistically in the minority, but let's also remember that this is important to be concerned about, not to panic about. Regular checkups go a long way towards reducing and minimizing the likelihood of serious complications, but too-often checkups do not increase your chances and can actually have detrimental effects. Current recommendations are pap smears & breast exams once every 2 years if you are not in a high-risk category. I recommend annually if you have multiple partners regardless of your risk status. More frequently is not necessary unless your physician has recommended it based on your personal risk level or if you have a known exposure to an aggressive strain of HPV.
The articles I have read so far have not been very clear on the specific mechanism involved, only to say that the drug "re-activat[es] known antiviral defence systems" that HPV switch off. So this drug could, potentially, eliminate or reduce all viral infections, but not necessarily be that magical "cure for cancer" that everyone is hoping for.
The articles I have read so far have not been very clear on the specific mechanism involved, only to say that the drug "re-activat[es] known antiviral defence systems" that HPV switch off. So this drug could, potentially, eliminate or reduce all viral infections, but not necessarily be that magical "cure for cancer" that everyone is hoping for.
