HPV Infection and Gardasil Vaccine

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HPV Infection and Gardasil Vaccine

Question:

My daughter, who is almost 28, has high-risk HPV and developed high-grade dysplasia. She just had a successful LEEP. Would it help her to take the Gardasil vaccine, and should she use condoms?

Answer:

First, let me define some terms you used so other readers know what we're talking about:

• HPV means human papilloma virus.

• Dysplasia is a precancerous condition of the cervix.

• LEEP stands for loop electrosurgical excision procedure. It is done to remove a cone-shaped biopsy of the cervix, usually to evaluate the tissue for precancerous changes.

• Gardasil is a vaccine that protects sexually active women against infection with four types of HPV.

Two types of HPV, strains 16 and 18, are responsible for about 70% of viral-related cervical cancer. The other types, strains 6 and 11, are responsible for most cases of genital warts.

The vaccine is most effective if it is given prior to exposure to HPV, and this means prior to the start of sexual activity. It is currently approved by the Food and Drug Administration for use in females ages 9 to 26.

If a woman is sexual active, and even if she already has an HPV infection, the vaccine can still be given. It may protect her against the virus types she has not yet been exposed to. However, the vaccine may also be less effective at protecting these women.

Studies are under way to determine the effectiveness of Gardasil in woman over age 26. Results should be available within the year.

Because Gardasil is not 100% effective, vaccinated women should continue to follow the standard guidelines for cervical cancer screening with Pap smears. Women under age 30 should have annual Pap tests.

Condoms and other barrier methods of contraception are recommended to help decrease the spread of sexually transmitted diseases. Because HPV can infect the genitals and surrounding skin that condoms can't cover, the virus can still be spread from one person to the next even with the regular use of condoms.

Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.

Last updated:	July 20, 2009