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Suzanne MacCarthy reports how Canadian HIV researchers are marching to the front lines of the fight against cervical cancer. There are more than 100 types of HPV, and about 30 of those can infect the genital tract through skin-to-skin and sexual contact.
That’s why doctors, including Money, stress the importance for all women, HIV-positive or not, to get regular Pap tests. In 2006, another tool to help fight cervical cancer was made available to women and their doctors when Health Canada approved Gardasil — a vaccine to protect women and girls against the more common types of HPV (types 6, 11, 16 and 18). While Gardasil is considered most effective if given before any sexual activity occurs, some experts believe that the majority of women could still benefit from the vaccine, as it’s unlikely for any one woman to have been exposed to all four types of HPV that Gardasil protects against. However, researchers do not yet know how safe or effective the vaccine is in HIV-positive women.
The study will use the same standard dosing schedule and vaccine amount currently being used in HIV-negative women and girls. Penelope, who at press time was awaiting her first vaccination, says that participating in a clinical trial is a necessary step in finding valuable knowledge.
Suzanne MacCarthy is Communications and Information Coordinator at the CIHR Canadian HIV Trials Network (CTN) in Vancouver. Production of this Web site has been made possible through a financial contribution from the Public Health Agency of Canada.
Please note that some content on this website contains language, information and images related to sexuality and drug use, and may not be intended for people of all ages. Three images of a patient with an HPV-positive oropharyngeal tumor (large arrow) that has spread to a nearby lymph node (small arrow). In a new study, researchers have confirmed that infection with human papillomavirus (HPV) 16 precedes the development of some head and neck cancers. The study also reported, for the first time, an association between head and neck cancer risk and infection with HPV types other than HPV 16.
Infection in the oral cavity with cancer-causing types of HPV, especially HPV 16, is a risk factor for some types of head and neck cancer, particularly oropharyngeal cancers.

To conduct the study, the researchers analyzed data on oral HPV infection and risk of head and neck cancer in two large national prospective studies: the American Cancer Society Cancer Prevention Study II Nutrition Cohort and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. At the start of each cohort study, all participants were cancer free and provided a mouthwash sample to researchers. Mouthwash samples (containing oral cells) from the participants who developed head and neck cancer and from 396 healthy matched control individuals were analyzed for the presence of HPV DNA. Previous studies had found that, in addition to containing HPV types of the alpha genus (which includes mucosal HPV types such as HPV 16 and other cancer-causing HPV types), the mouth contains a broad range of other HPV types. HPV types 6 and 11 cause 90 percent of genital warts; types 16 and 18 are responsible for an estimated 70 percent of cases of cervical cancer, which claims the lives of more than 400 women a year in Canada. Given the possible serious consequences of HPV infection in women with HIV, it’s a question that HIV researchers and clinicians are keen to answer. In 2007, the World Health Organization (WHO) identified a knowledge gap in HPV vaccines, stating that their safety and efficiency have not yet been evaluated in Africa or in populations with a high HIV prevalence. The vaccine will be administered in three doses over the course of six months and trial participants will make a total of seven clinic visits in a 24-month period.
Her adventures in HIV have taken her from Swaziland to British Columbia, with a stop in beautiful Cape Breton, Nova Scotia, along the way. The virus can pass during any form of sexual contact — oral, vaginal or anal sex, and even finger-to-genital contact.
Previous studies have established an association between HPV-16 infection and oropharyngeal cancer, a type of head and neck cancer. In the United States, the incidence of oropharyngeal cancers caused by HPV infection has been increasing. After an average of nearly 4 years of follow up, a total of 132 participants had been diagnosed with head and neck cancers.
After adjusting for smoking history and alcohol consumption, the researchers estimated that individuals with HPV 16 in their mouthwash samples had substantially greater odds of developing oropharyngeal cancer than participants with no detectable HPV 16 in their mouthwash samples. So the researchers also investigated whether any of these were associated with head and neck cancer.

Money and a team of 40 researchers across Canada are leading the world’s first study to evaluate Gardasil in HIV-positive women and girls.
The new study is the first to do so using samples collected from participants prior to their cancer diagnoses.
They found that the presence in the mouth of several beta- and gamma-HPVs that are usually found in the skin was also associated with the development of head and neck cancer.
Please note that blog posts that are written by individuals from outside the government may be owned by the writer, and graphics may be owned by their creator. Most people will never show any signs or symptoms, which means they may unknowingly pass on the virus. CTN 236 is a five-year study recruiting 500 HIV-positive female participants at 16 sites across Canada over a two- to three-year period. So even though you or your partner might not see any genital warts, the virus can still pass between you.
In such cases, it is necessary to contact the writer, artist, or publisher to obtain permission for reuse. She also keeps her stress level down, gets plenty of rest and listens to her body — all of which can help bolster the immune system and prevent a recurrence of warts. Not only is CTN 236 breaking ground by testing the vaccine in HIV-positive women, it is also the first investigator-driven, peer-reviewed and independently funded vaccine study in which all findings of vaccine efficiency and safety will be publicly released. Condoms reduce the risk of passing the virus but do not eliminate it because the virus may be on a part of the skin not covered by the condom. The study is being funded by the Canadian Institutes of Health Research (CIHR) and supported by the CIHR Canadian HIV Trials Network (CTN).

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