Can HPV Vaccination Combat Genital Warts?

In mid-2007, Australia began a free quadrivalent human papillomavirus (HPV) vaccination program for schoolgirls and young women (age, $≤$ 26); by the end of 2007, about 70% of the target population had received all three doses. Now, investigators have assessed the initial effect of such immunization on the incidence of genital warts at a large sexual health clinic in Melbourne.

Overall, genital warts were diagnosed in 11% of 36,055 new patients who presented from 2004 through 2008. The proportion of young women (age, <28) with diagnoses of genital warts declined by 25% each quarter of 2008 (P<0.001). The proportion of heterosexual men diagnosed with genital warts decreased by 5% per quarter that year (P=0.031). In contrast, the proportions of older women (age, $≥$ 28), and of men who have sex with men, who were diagnosed with genital warts remained stable, as did the proportion of patients who presented with genital herpes.

Comment: The benefit of the HPV quadrivalent vaccine extends beyond preventing dysplasia and cervical cancer — a long-term goal — to reducing the burden of genital warts. These study findings support benefit of HPV immunization not only to vaccinated women but also to their male sexual partners, and, in turn, to partners' subsequent female partners. Because the vaccine currently is provided only to women, any protection of men against genital warts is indirect. Clinicians might want to provide these emerging data to their patients who are considering immunization. Discussion about the benefits of HPV vaccination is likely to continue, especially given that the FDA recently approved the quadrivalent vaccine (Gardasil) for preventing genital warts in boys and the bivalent vaccine (Cervarix) for preventing cervical cancer in girls

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