“As a healthcare professional, a colleague asks your opinion as to which HPV strains should be covered in a new treatment. Based on your reading from the Sarid and Gao 2011 article, what would your recommendation be, and when should the treatment be administered? What evidence supports your opinion? Keep in mind a cost/benefit analysis, as the cost of developing a vaccine for each strain can get very pricey! (You should not indicate “all of them” in your answer, unless you have strong supportive evidence):”
According to Sarid and Gao’s (2011) article, I would recommend treatment for HPV strains: 16, 18, 31, 45, 33, 35, 39, 51 52, 56, 58 and 59. Although this is a lot of strains, some are considered high risk and the others have been associated with cervical cancer at some point in time. Although it may begin to get pricey, it’s stated in the article that HPV causes almost ALL cases of cervical cancer. Therefore, if there’s treatments/vaccines that can prevent all these different strains from being transmitted, it’s wroth the money. Especially because it is known already what the detrimental effects are. Although this is many strains, it is not all the strains that may be associated with carcinogenic effects. The reason I did not include those is because there is still a lot of associations and work that goes into determining if something indeed has a negative effect. What I think about most regarding preventative treatments is if we eradicate certain strains, will these other strains that we’re unsure of take over and cause similar issues? Some even as extreme as cancer? This is where it gets foggy in knowing what is best for creating vaccines and treatments.
For timeline, I would recommend these vaccines get administered before sexual activity even occurs. If they are treatments for people already infected with the virus, my recommendation would be to get the treatment ASAP. Viruses can live dormant for decades before they cause tumors.
Reference:
Sarid R, Gao S-J. 2011. Viruses and human cancer: from detection to causality. Cancer Lett 305:218-227.