MSM May Need Greater HPV Vaccine Protection

MedicalResearch.com Interview with:
Huachun Zou PhD on behalf of all authors.

Melbourne Sexual Health Centre, Alfred Health, Carlton, VIC,
Melbourne School of Population and Global Health
University of Melbourne, Melbourne, VIC, Australia

Medical Research: What is the background for this study? What are the main findings?

Response: Anogenital human papillomavirus (HPV) infection and anal cancer are common among men who have sex with men (MSM) and preventable with the HPV vaccine. However, the optimal strategy for vaccinating MSM against HPV requires an accurate understanding of the age specific incidence of early HPV infection. In addition to understanding the optimal age at which to vaccinate young MSM, policy makers also need to know the vaccine coverage required in MSM. In this paper we aimed to provide estimates for the site specific incidence of HPV and to use this to estimate the probability of transmission per partner in a cohort of very young MSM aged 16 to 20 years. These data will assist governments in deciding what HPV vaccination strategy is likely to be the most effective in MSM.

Medical Research: What should clinicians and patients take away from your report?

Response: The rapid and early acquisition of HPV and high transmissibility suggest that the basic reproductive number for HPV among MSM will be significantly higher than among heterosexuals. The implication of this finding is that HPV vaccination coverage for boys may need to be substantially higher than the 60-70% level that is currently being achieved in Australia if the same reductions in genital warts, HPV infection and dysplasia is to be seen in MSM as is currently occurring in heterosexuals. If a sufficiently high level cannot be achieved through childhood vaccination then a supplementary program for young MSM may be need to be added to the childhood program. In the longer term these data suggest that the current childhood programs may not provide the same reduction in anal cancer in MSM that will occur for cervical cancer in women unless very high levels of coverage are achieved.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Future studies on the cost-effectiveness of age- and population-specific HPV vaccination policies and the long-term impact of the HPV vaccine are warranted.

Citation:

Site-specific human papillomavirus infection in adolescent men who have sex with men (HYPER): an observational cohort study

Dr Huachun Zou PhD,Sepehr N Tabrizi PhD,Prof Andrew E Grulich PhD,Prof Jane S Hocking PhD,Catriona S Bradshaw PhD,Alyssa M Cornall PhD,Andrea Morrow,Garrett Prestage PhD,Prof Matthew G Law PhD,Prof Suzanne M Garland MD,Marcus Y Chen PhD,Prof Christopher K Fairley PhD
The Lancet Infectious Diseases – 1 January 2015 ( Vol. 15, Issue 1, Pages 65-73 )
DOI: 10.1016/S1473-3099(14)70994-6