Prevention and Treatment Options for Human Papillomavirus (HPV)
HPV vaccination is the primary prevention method for HPV infection and related diseases, with routine vaccination recommended for individuals aged 9-26 years, while treatment focuses on managing HPV-related lesions rather than the infection itself. 1, 2
Prevention Strategies
HPV Vaccination
Recommended Vaccination Schedule
- Primary target group: Girls and boys aged 11-12 years 2
- Vaccination can begin as early as age 9 years 2
- Catch-up vaccination recommended for:
- Standard dosing schedule: 3 doses administered at 0,2, and 6 months 2
- For individuals under 15 years: 2-dose series is sufficient (except for immunocompromised individuals who require 3 doses) 3
High-Risk Populations
Vaccination is particularly important for:
- HIV-infected individuals
- Men who have sex with men (MSM)
- Individuals with inflammatory bowel disease
- Women with precancerous cervical lesions
- Patients with immunodeficiency or on immunosuppressive treatment
- Transplant recipients
- Patients with recurrent respiratory papillomatosis 2
Contraindications and Precautions
- Do not administer to individuals with history of immediate hypersensitivity to yeast or vaccine components 2
- Defer vaccination during moderate or severe acute illness 2
- Not recommended during pregnancy; postpone remaining doses until after pregnancy 2
- Monitor for syncope (fainting) for 15 minutes after administration, especially in adolescents 2
Other Prevention Methods
- Barrier methods: Consistent and correct condom use reduces HPV infection risk by approximately 70%, though protection is incomplete as skin not covered by condoms remains vulnerable 1
- Behavioral strategies:
Screening for HPV-Related Diseases
- Regular cervical cancer screening remains essential for all women, including those who have been vaccinated 2
- Screening should follow current guidelines for Pap testing and/or HPV testing 2
- HPV vaccination does not replace the need for regular screening, as vaccines do not protect against all oncogenic HPV types 2
Treatment Options
For HPV Infection
- No specific antiviral treatment exists for HPV infection itself 2
- Treatment focuses on HPV-associated lesions rather than the infection 2
For HPV-Related Lesions
Genital Warts
Treatment options include:
- Local removal methods:
- Cryotherapy
- Electrocautery
- Laser therapy
- Surgical excision
- Topical pharmacologic agents 2
Precancerous Lesions and Cancers
- Cervical, vaginal, and vulvar precancerous lesions are treated with:
- Cryotherapy
- Laser therapy
- Loop electrosurgical excision procedure (LEEP)
- Surgical excision 2
- HPV-related cancers require standard cancer treatments (surgery, radiation, chemotherapy) based on cancer type and stage 4
Recurrent Respiratory Papillomatosis
- Typically requires multiple surgeries to remove warts and maintain an open airway 2
Emerging Therapeutic Approaches
- Therapeutic HPV vaccines targeting HPV oncoproteins E6 and E7 are under development for treating existing HPV infections and associated diseases 5, 6
- Various approaches being investigated include:
- Live-vector vaccines
- Protein and peptide-based vaccines
- Dendritic cell vaccines
- DNA-based vaccines 5
Important Clinical Considerations
- Available treatments for HPV-related lesions may reduce but likely do not eliminate infectiousness 2
- Partner notification is not recommended for HPV infection due to its high prevalence 2
- HPV infection can remain dormant for years before detection, so infection does not necessarily indicate recent acquisition or infidelity 1
- Vaccination is most effective when administered before potential exposure to HPV through sexual activity 2
- Individuals who are already sexually active or HPV-infected can still benefit from vaccination against HPV types they have not yet acquired 2
HPV prevention and management requires a comprehensive approach combining vaccination, safe sexual practices, regular screening, and appropriate treatment of HPV-related lesions to reduce morbidity and mortality from HPV-associated diseases.