Impact of HPV vaccination on anogenital warts and respiratory papillomatosis

Human papillomavirus (HPV), the most common sexually transmitted infection in the US and worldwide, can cause cancers, anogenital warts (AGW), and recurrent respiratory papillomatosis (RRP) in men, women, and children. Global incidence of AGW ranges from 160-289 cases per 100,000 person-years and peaks in young men and women in the third decade of life. RRP has an estimated incidence of 3 per 1 million person-years in children. Pre-licensure trial efficacy, modeling and time-trend ecological studies have shown a significant short-term impact of 4vHPV vaccine. In girls aged 15-19 years, a previously published meta-analysis indicated that genital warts decreased significantly by 31%; stratified analysis revealed more substantial reductions in populations with high ( \u3e /=50 %) vs. low ( \u3c 50 % ) vaccination coverage (61% vs. 14%). Longer-term monitoring will reveal whether this impact continues under 9vHPV programs, and whether current declines in AGW are mirrored by declines in RRP

Adolescent Sexuality: Updates to the Sexually Transmitted Infection Guidelines

Adolescents are at high risk for acquisition and transmission of sexually transmitted infections (STI) secondary to both cognitive and biological susceptibility. The prevention, diagnosis, and treatment of STIs are a critical part of adolescent health care. This article discusses the most common bacterial, parasitic, and viral STIs encountered in this age group with an emphasis on new guidelines for screening and management

Condylomata acuminata (anogenital warts) contain accumulations of HIV-1 target cells that may provide portals for HIV transmission

Background: Condylomata acuminata [anogenital warts (AGW)] are prevalent in HIV-infected individuals and sexually active populations at risk for HIV acquisition, and have been associated with HIV transmission. We compared AGW to control tissue for abundance, types and location of HIV-target cells, and for susceptibility to HIV infection in vitro, to provide biological evidence that AGW facilitate HIV transmission. Methods: We used immunohistology to identify HIV-target cells in AGW and control skin. We also inoculated AGW and control tissue from HIV-negative men with HIV in vitro, and assessed infection by TZM-bl and p24 assays. Results: CD1a+ dendritic cells, CD4+ T cells and macrophages were significantly more abundant in the epidermis of AGW than control tissue. These HIV target cells also often appeared in large focal accumulations in the dermis of AGW. Two out of 8 AGW vs. 0 of 8 control tissues showed robust infection with HIV in vitro. Conclusions: Compared to normal skin, AGW contain significantly higher concentrations of HIV-target cells that may be susceptible to HIV infection. Condylomata may thus promote HIV transmission, especially in the setting of typical lesion vascularity and friability. Prevention or treatment of AGW may decrease the sexual transmission of HIV