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High-risk HPV Infections Prevalent Among Homosexuals

by our Editors in Health & Body , 26 maart 2016

Dit artikel is ook in het Nederlands beschikbaar


High-risk HPV infections in the anus are very common among homosexual men, and being HIV positive is a risk factor for high-risk HPV infections. This is the result of a study conducted in Amsterdam by the Health Authority GGD Amsterdam and the Medisch Centrum Jan van Goyen in a group of 750 homosexual men. HPV is the Human Papilloma Virus, which can cause cancer in the anus, the womb and the penis.

The Medisch Centrum Jan van Goyen in a group of 750 homosexual men. HPV is the Human Papilloma Virus, which can cause cancer in the anus, the womb and the penis. The study shows that in gay men that are HIV positive, the body has more trouble getting rid of anal, high-risk HPV infections.

Most likely it is the combination of a higher risk of HPV infection and the lower chance of dealing with the infection that is responsible for frequent anal abnormalities and anal cancer in gay men that are HIV positive. There are effective vaccinations against HPV infections, but men and boys do not routinely get vaccinated against HPV infections in the Netherlands.

In this research, 750 gay men were tested every six months for a period of two years for the presence of HPV infections in the anus. That is how researches established how often new infections arose, how quickly the infections were dealt with by the immune system of the body. The reason why HIV positive people get infected with HPV and why it is harder for them to get rid of the infection is unclear. The study could not show a correlation between a compromised immune function (a low number of CD4 cells in the blood)and HPV.

HPV Vaccination

In homosexual men that are HIV positive, the risk of anal cancer is high. Vaccination against HPV can reduce the risk of high-risk infections, anal deviation and anal cancer, but it is unclear whether vaccinating older men is effective. Particularly in Australia and the US they are currently researching the screening of anal cancer.

In Amsterdam, the 2010-2013 study was conducted by a team of GGD Amsterdam, the RIVM/CIb, the Medisch Centrum Jan van Goyen, and VUmc. The research was financed by the Aids Fonds, the RIVM/CIb and the Health Authority GGD Amsterdam, led by Dr. Maarten Schim van der Loeff, epidemiologist at GGD Amsterdam and the AMC Hospital. The study results were published in the authoritative international magazine AIDS.


PreP Possibly Approved in Europe

The European Medical Agency (EMA) will study whether HIV inhibitor Truvada should be given as a preventative measure in Europe. Gilead Sciences, the pharmaceutical company that produces the medication, has submitted a request at EMA to do so. It is of the utmost importance that the EMA comes to a decision, as that would speed up the use of this new method of preventing HIV infections, “pre-exposure prophylaxis," PrEP in short, in all European member states.  In Europe, PrEP is not officially available, except in France. At the moment, a study is conducted on a selective group of men at GGD Amsterdam.

Gilead Sciences announced that by now, sufficient scientific evidence is present to support that taking HIV inhibitor Truvada on a daily basis, in combination with the use of condoms, will prevent infection with HIV. Therefore, the EMA has now been asked to approve the preventative use of Truvada. A positive review will make European countries consider reimbursing the use of PrEP.

Louise van Deth, director Aids Fonds - STOP AIDS NOW! - Soa Aids Nederland thinks this is an important step in the fight against HIV in the Netherlands: “Aids Fonds - STOP AIDS NOW! - The goal of Soa Aids Nederland is to put a stop to the HIV and AIDS epidemic.  We try to achieve this in all sorts of ways: information, education, free condoms, promoting behavioural change, and early testing and treatment.

In spite of all the efforts, there are still more than 1,000 new HIV infections in the Netherlands on a yearly basis. To reduce this number, there finally is an additional tool available, PrEP.  PrEP does not mean the end of the use of condoms: also with PrEP, only a condom can protect you against other STDs. In the fight against HIV, PrEP a very good extra tool to offer to those who run the highest risks of contracting HIV, and give them an opportunity to take responsibility in protecting themselves and their surroundings.”

As early as 2005, the EMA recognised that Truvada is effective in treating HIV infections and in preventing transference. It is the HIV inhibitor that is the most prescribed in Europe. The blue pill has very little side-effects. Scientific research now shows that people can reduce the risk of contracting HIV by 86% by taking one Truvada daily. It is necessary, however, that it is taken extremely regularly: every day or when having sexual contact. Ongoing studies, such as the study in Amsterdam, will make clear how participants want to use PrEP. In the US, the use of PrEP was already approved in 2012, and South-Africa and Kenya followed in 2015.

Van Deth: “We are convinced that PrEP is not just an effective drug in aid of individual and public health. It could save the community a lot of money. Treating someone with HIV, who needs to take medication for the rest of his or her life, is many times more expensive than prescribing PrEP during a period in which a person is sexually active and runs a high risk of contracting HIV. We want PrEP to be available and reimbursed as quickly as possible in the Netherlands.”    
 



 







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