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The Sexually Transmitted Infection (STI) Associated With Higher Cancer Risk: Know How To Prevent It
There are more than 30 different bacteria, viruses and parasites that spread through sexual contact, of which eight pathogens are associated with the greatest incidence of STIs, according to the World Health Organization (WHO). While four of them namely syphilis, gonorrhoea, chlamydia and trichomoniasis are curable, the other four are incurable in nature. These include hepatitis B, herpes simplex virus (HSV), HIV and Human Papillomavirus (HPV).
HPV in particular is extremely concerning since a large majority of cervical cancer that is more than 95% is caused by the virus. In this article, we will not only understand the link between HPV and cancer, but Dr Mridula Raghav, MS OBG, FRM ICOG, Senior Resident-Department of OBG, Kasturba Medical College, MAHE, Manipal, will list down some of the common ways to prevent it.
Also Read: HPV Vaccine: Who Needs It And How Does It Work? Clarifies Expert
What Is HPV And How Is It Linked To Cancer?HPV comprises a group of 200 known viruses that has the tendency to invade genitals, upper respiratory tract, and skin, says Dr Raghav.
According to the WHO these viruses do not cause concerns in most people, but infection with some high-risk types is common and can cause genital warts or cancer.
In fact, in 90% of the people, the body is successful in controlling the infection by itself, however, an HPV virus can cause about 5% of all cancers worldwide, with an estimated 6,25,600 women and 69,400 men getting an HPV-related cancer annually, the WHO reports.
Cervical cancer is the fourth most common cancer among women globally. The global health body notes that nearly 50% of high grade cervical pre-cancers are caused by two HPV types 16 and 18. Unfortunately, the majority of sexually active women and men will get infected at some point in their lives, and some may experience recurrent infections.
In most of the HPV cases, the virus usually clears up on its own without treatment, however, high risk subtypes cause certain changes in the cervical cells, which act as a basis of screening for cervical cancer by the PAP smear test, according to the doctor.
He notes further that it takes almost 10-20 years for HPV infected cells to become a tumour.
HPV TransmissionSince HPV is a Sexually Transmitted Infection (STI), Dr Raghav says it can spread through any intimate skin-to-skin contact, including vaginal–penile sex, penile–anal sex, penile–oral sex, vaginal–oral sex, and use of sex toys or other objects.
"It can affect anyone irrespective of gender,sex or sexual orientation.Even people who are not sexually active can get HPV infection," he says, adding, "Most people with the infection are asymptomatic and infection usually will disappear in about 6-24 months."
Also Read: Can You Still Get An HPV Vaccine If You're Sexually Active?
Preventive MeasuresTo prevent an HPV infection, it is important to first assess your risk of the virus. Common risk factors include:
The next step is to undergo regular tests to detect HPV virus in the body and signs of cancer.
Dr Raghav says, "In India, after the age of 30 years women should get themselves screened for cervical cancer by pap smear test every three years till the age of 65 years.
"Pap smear tests detect any changes in the cervical cells caused by HPV infection. It is an OPD based procedure and doesn't hurt or cause pain. Your gynaecologist will do a speculum examination and take a smear using a brush from your cervix. Reports are usually ready in a week's time. Along with Pap smear HPV DNA testing for high risk subtypes can also be performed," he advises.
In addition, while practising safe sex, using condoms and dental dams, can cut down your risk of HPV infection, vaccines can be taken by both boys and girls as early as 9 years of age.
Gardasil 9 can be taken up to the age of 45 years.
A Final WordThe best way to prevent an HPV infection is by getting vaccinated against it at an early age. Dr Raghav says, "Although vaccines don't prevent an existing infection, if you have been sexually active, you still can take the vaccine to protect against unexposed subtypes."
"People belonging to the LGBTQIA community are also recommended to get vaccinated against the virus. Cervical cancer is a preventable cancer and each and every person with a cervix should get tested and vaccinated," the doctor concludes.
Menstrual Cups Could Reduce HSV-2 Infection Risk And Improve Vaginal Health, Trial Shows
Researchers from LSTM, in collaboration with researchers in Kenya and the U.S., have been investigating options for girls and young women in low-and-middle-income countries to manage menstruation with comfort and dignity and to improve health outcomes.
Led by Penelope Phillips-Howard, Professor of Public Health Epidemiology at LSTM, the randomized trial, Cups or Cash for Girls (CCG) is the first to assess the impact of the menstrual cup on girls' incidence of HSV-2.
Two new papers from the CCG trial provide evidence that the menstrual cup may provide beneficial results to menstruators' reproductive health and is an acceptable and long-lasting solution to manage menses.
The findings of the trial, now published in eClinicalMedicine showed that girls provided with cups had a 33% reduction in HSV-2 compared to the control group. HSV-2, the virus that causes genital herpes, can triple an individual's risk of becoming infected with HIV.
Dr. Garazi Zulaika, Post-Doctoral Research Associate at LSTM and lead author on the paper said, "We were interested to know whether a long-lasting, sustainable, and hygienic menstrual solution would be used by girls and be effective in improving their schooling and sexual and reproductive health.
"Our results show that menstrual cups were well-accepted by girls' as well as protective against infections, highlighting how they can be a great option for menstrual hygiene management while also having significant health impacts."
The study involved 4,137 Kenyan schoolgirls between 16 and 18 years across 96 secondary school in western Kenya. Schools were allocated to four treatment groups: menstrual cup, conditional cash transfer, combination of cup and cash transfer, and usual menstrual practice (control). Girls were followed for three years or until they completed secondary school.
A sub-study, led by Prof Supriya Mehta, Professor of Infectious Disease Medicine at Rush University, and Adjunct Professor of Epidemiology at the University of Illinois Chicago, followed 436 girls and assessed whether menstrual cups reduced rates of bacterial vaginosis or changed the vaginal microbiome. A healthy vaginal microbiome is essential for long term vaginal health, reduces risks for infections, and is associated with improved maternal and newborn outcomes.
Recently published in PLOS Medicine, this sub-study found that girls given menstrual cups had a 24% reduction in bacterial vaginosis compared with controls. Additionally, there was a 37% relative increase in Lactobacillus crispatus, indicating cups could improve or maintain a healthy vaginal microbiome.
Elizabeth Nyothach, trial manager at the Kenya Medical Research Institute, who partnered with LSTM on the study, said, "Menstrual cups can be used for up to ten years, offer long term health benefits, reduce waste, and provide financial savings as there is no longer a need for menstruators to buy single use pads and tampons every month."
More information: Garazi Zulaika et al, Menstrual cups and cash transfer to reduce sexual and reproductive harm and school dropout in adolescent schoolgirls in western Kenya: a cluster randomised controlled trial, eClinicalMedicine (2023). DOI: 10.1016/j.Eclinm.2023.102261
Citation: Menstrual cups could reduce HSV-2 infection risk and improve vaginal health, trial shows (2023, October 17) retrieved 26 October 2023 from https://medicalxpress.Com/news/2023-10-menstrual-cups-hsv-infection-vaginal.Html
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An 'exciting' Glioblastoma Study: Boston Researchers Create Virus That Can Effectively Target The Aggressive Brain Cancer
Could a virus treatment designed by Boston researchers be the key to treating the aggressive brain cancer glioblastoma?
Brigham and Women's Hospital scientists report that they have created a cancer-attacking virus that can effectively target glioblastoma. The oncolytic virus treatment extended survival for patients with recurrent glioblastoma, especially among patients with pre-existing viral antibodies.
The virus can infect cancer cells and stimulate an anti-tumor immune response, according to the researchers.
"Almost no immunotherapies for GBM have been able to increase immune infiltration to these tumors, but the virus studied here provoked a very reactive immune response with infiltration of tumor-killing T-cells," said corresponding author E. Antonio Chiocca, chair of the BWH Department of Neurosurgery.
"That's hard to do with GBM, so our findings are exciting and give us hope for our next steps," Chiocca added.
This Phase I, first-in-human trial looked at the safety of an oncolytic herpes simplex virus called CAN-3110. The cancer-attacking virus is the same type of virus used in a therapy for the treatment of metastatic melanoma.
Overall, the trial showed the safety of CAN-3110 in 41 patients with high-grade gliomas, including 32 with recurrent GBM. The most serious adverse events were seizures in two patients.
Notably, GBM patients who had pre-existing antibodies to the HSV1 virus (66% of the patients) had a median overall survival of 14.2 months.
The researchers believe that the presence of HSV1 antibodies sparked a rapid immune response to the virus — which brought more immune cells to the tumor and increased the levels of inflammation in the tumor microenvironment.
"GBM has an aggressive effect in part because of a milieu of immunosuppressive factors surrounding the tumor, which enable the tumor's growth by preventing the immune system from entering and attacking it," Chiocca said. "This study showed that with a virus we designed, we can reshape this 'immune desert' into a pro-inflammatory environment."
Moving forward, the researchers plan to complete prospective studies to further investigate the effectiveness of the oncolytic virus in patients who do and do not have antibodies to HSV1.
After showing the safety of one viral injection, the scientists will be testing the safety and efficacy of up to six injections over four months — which, like multiple rounds of vaccination, may increase the effectiveness of the therapy.
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