by Zosia Kmietowicz
Date: 15 October 2009
Source: BMJ news item: BMJ 2009;339:b2421
The number of young women presenting with new cases of genital warts in Australia has declined since the introduction of the national vaccination programme against cervical cancer, in 2007. A retrospective study (reference below) compared the proportion of new clients with genital warts attending Melbourne Sexual Health Centre (MSHC) from January 2004 to December 2008. Australia has offered free HPV vaccine, Gardasil, to 12 to 18 year old girls in schools since April 2007 and to women aged 26 and younger in general practices since July 2007. Take-up rates are approximately 70%. Gardasil targets HPV types 6, 11, 16, and 18. Types 6 and 11 are associated with the development of genital warts, and types 16 and 18 with the development of cervical cancer. The other HPV vaccine, Cervarix, which targets only HPV types 16 and 18, is used in the UK.
36,055 new clients attended the clinic altogether and genital warts were diagnosed in 3,826 (10.6%). The proportion of women under 28 years with warts diagnosed decreased by 25.1% each quarter in 2008, which was significantly different from the 1.8% increase per quarter from 2004 to 2007 (p<0.001). Women under 28 made up about 13% of clients diagnosed as having genital warts before 2008, and only 6.6% in 2008. The only other group which saw a decline in genital warts was heterosexual men, among whom new diagnoses fell by 5% each quarter in 2008 (p=0.031). The data suggest that a rapid and marked reduction in genital wart incidence may be achievable through an HPV vaccination programme targeting women, and supports some benefit being conferred to heterosexual men. These results may have implications for countries deciding between the bivalent and quadrivalent vaccines.
Fairley CK, Hocking JS, Gurrin LC, et al. Rapid decline in presentations of genital warts after the implementation of a national quadrivalent human papillomavirus vaccination programme for young women. Sexually Transmitted Infections 2009;85:499-502.
