The cost of managing genital warts in the UK

Lanitis, Tereza; Carroll, Stuart; O'Mahony, Colm; Charman, F.; Khalid, Javaria Mona; Griffiths, V; Brown, Ruth E.

doi:10.1258/ijsa.2011.011218

Cited by 12 publications

(11 citation statements)

References 9 publications

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“…The estimates for the unit cost for a single GWs event are highly variable, depending on the type of episode (first occurrence, recurrent or persistent GWs), the management setting and type of consultation [general practice, genitourinary medicine (GUM), hospital, etc. ], as well as the therapy used (medical treatment vs. surgery or other modalities) [ 7 , 8 ]. A recent study in Italy reported that the most frequent cause for HPV-related hospitalization was GWs [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Early Direct and Indirect Impact of Quadrivalent HPV (4HPV) Vaccine on Genital Warts: a Systematic Review

Mariani¹,

Vici²,

Suligoi³

et al. 2015

Adv Ther

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IntroductionSince 2007, many countries have implemented national human papillomavirus (HPV) vaccination programs with the quadrivalent HPV (4HPV) vaccine that has been shown to be efficacious in clinical trials involving 25,000 subjects. Two vaccine serotypes, HPV16 and 18, are responsible for cervical cancer and other HPV-related cancers, but the impact of the 4HPV vaccine on these cancers cannot be seen immediately as there is a considerable lag between infection with HPV and cancer development. The other two serotypes, HPV6 and 11, are responsible for genital warts (GWs), which develop within a few months after infection, making GWs an early clinical endpoint for the assessment of the impact of 4HPV vaccination.MethodsWe performed a systematic literature search in PubMed to identify all published studies on 4HPV vaccination, including those that assessed the impact of 4HPV vaccination programs on the incidence of GWs at a population level around the world.ResultsA total of 354 records were identified in the PubMed search. After screening and obtaining full papers for 56 publications, 16 publications presenting data on the impact or effectiveness of 4HPV vaccination on GWs were identified. These reported data on the impact or effectiveness of 4HPV in six countries [Australia (n = 6), New Zealand (n = 2), United States (n = 3), Denmark (n = 2), Germany (n = 1), and Sweden (n = 2)]. In Australia, no GWs were diagnosed in women aged <21 years who reported being vaccinated. A 92.6% reduction in GWs incidence was reported for all women in this age group, where the vaccine uptake rate (VUR) was 70% for 3 doses. The highest reductions were reported in countries with high VURs, mostly through school-based vaccination programs, although high VURs were obtained with some non-school-based programs.ConclusionThe results are coherent with the GWs incidence reduction reported in clinical trials and are an early indicator of what can be expected for the long-term clinical impact on vaccine-type HPV-related cancers.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-015-0178-4) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Early Direct and Indirect Impact of Quadrivalent HPV (4HPV) Vaccine on Genital Warts: a Systematic Review

Mariani¹,

Vici²,

Suligoi³

et al. 2015

Adv Ther

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“…Anogenital wart disease is the most common sexually transmitted disease, affecting millions worldwide every year. In 2010, approximately 190,000 new and recurrent cases were reported through GU clinics in the UK [1], with the low-risk HPV types (LR-HPV) 6 and 11 predominating in the pathogenesis of the common anogenital wart, or condyloma acuminatum [2]. The licensing of the prophylactic quadrivalent vaccine Gardasil (Merck) in 2007, which conveys protection against HPV types 6 and 11 in addition to the high-risk types HPV 16 and 18, has now raised the real prospect of reducing the disease burden of anogenital warts in society.…”

Section: Introductionmentioning

confidence: 99%

“…The UK has recently selected the quadrivalent HPV vaccine as part of its immunisation programme for 2012. The annual cost of wart disease diagnoses and treatments to the NHS in the UK is thought to be as high as £52.4 million [1]. …”

Section: Introductionmentioning

confidence: 99%

Detection of specific HPV subtypes responsible for the pathogenesis of condylomata acuminata

Hawkins

Winder

Ball

et al. 2013

Virol J

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BackgroundThe low-risk human papillomavirus types 6 and 11 are responsible for approximately 90% of anogenital wart cases, with approximately 190,000 new and recurrent cases reported in the UK in 2010. The UK has recently selected the quadrivalent HPV vaccine, which conveys protection against both HPV6 and HPV 11, as part of its immunisation programme for 2012 and it is expected that this will reduce disease burden in the UK. The aims of the study were to evaluate current strategies used for the monitoring of HPV infection in genital warts and to assess the suitability of laser-capture microdissection (LCM) as a technique to improve the understanding of the natural history of HPV types associated with genital wart lesions.MethodsDNA and RNA were extracted from whole wart, surface swabs and LCM sections from 23 patients. HPV types present were determined using the Linear Array HPV Genotyping Test (Roche), with HPV DNA viral load and mRNA expression investigated using qPCR and qRT-PCR, respectively.ResultsResults indicated that swabbing the surface of warts does not accurately reflect potential causative HPV types present within a wart lesion, multiple HPV types being present on the surface of the wart that are absent in the lower layers of tissue isolated by LCM. Although it was shown that HPV DNA viral load does not directly correlate with HPV mRNA load, the presence of both DNA and mRNA from a single HPV type suggested a causative role in lesion development in 8/12 (66.6%) of patients analysed, with dual infections seen in 4/12 (33.3%) cases. HPV 6 and HPV 11 were present in more than 90% of the lesions examined.ConclusionsSurface swabbing of warts does not necessarily reflect the causative HPV types. HPV type specific DNA and mRNA loads do not correlate. HPV 6 and 11 were likely to be causally involved in over 90% of the lesions. Dual infections were also found, and further studies are required to determine the biological and clinical nature of dual/multiple infections and to establish the relationship of multiple HPV types within a single lesion.

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“…Treatment has a significant morbidity and can be frustrating, and recurrences are common. This causes psychosocial distress to patients and results in substantial financial costs [6, 7]. GWs result from persistent infection with low-risk HPV genotypes, predominantly 6 and 11, although other low-risk types were not evaluated in the former study [8, 9].…”

mentioning

confidence: 99%

Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation

Szarewski

Skinner

Garland

et al. 2013

Journal of Infectious Diseases

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Background. Public Health England has reported a decrease of up to 20.8% in new diagnoses of external genital warts (GWs) among women aged <19 years since the national vaccination program with the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine began in 2008. A post hoc analysis of the phase III PATRICIA (PApilloma TRIal against Cancer In young Adults) trial (NCT00122681) was performed to ascertain whether protection against low-risk HPV types was apparent.Methods. Vaccine efficacy (VE) at 48 months was assessed against 6-month persistent infection (6MPI) with low-risk HPV types in the total vaccinated cohort (TVC) and in the TVC naive (for 25 HPV types tested) populations.Results. In the TVC naive cohort, VE against 6MPI (95% confidence interval) was 34.5% (11.3 to 51.8) for HPV-6/11, 34.9% (9.1 to 53.7) for HPV-6, 30.3% (−45.0 to 67.5) for HPV-11, and 49.5% (21.0 to 68.3) for HPV-74.Conclusions. The HPV-16/18 AS04-adjuvanted vaccine appears to have moderate efficacy against persistent infections with a number of low-risk HPV types (HPV-6/11/74), which are responsible for the majority of external GWs, and recently, antibody and cell-mediated immune response to HPV-6/11 have been observed. These findings may help to explain the decrease in external GW diagnoses seen in England.

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The cost of managing genital warts in the UK

Cited by 12 publications

References 9 publications

Early Direct and Indirect Impact of Quadrivalent HPV (4HPV) Vaccine on Genital Warts: a Systematic Review

Early Direct and Indirect Impact of Quadrivalent HPV (4HPV) Vaccine on Genital Warts: a Systematic Review

Detection of specific HPV subtypes responsible for the pathogenesis of condylomata acuminata

Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation

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