What can surveillance of genital warts tell us?
Christopher K. Fairley A B E and Basil Donovan C DA Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Vic. 3053, Australia.
B School of Population Health, University of Melbourne, Carlton, Vic. 3053, Australia.
C Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW 2000, Australia.
D National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2010, Australia.
E Corresponding author. Email: cfairley@unimelb.edu.au
Sexual Health 7(3) 325-327 https://doi.org/10.1071/SH09145
Submitted: 14 December 2009 Accepted: 12 March 2010 Published: 19 August 2010
Abstract
In this Review, we describe the recent epidemiology of genital warts and postulate what the future may hold as a result of the introduction of the quadrivalent human papillomavirus (HPV) vaccine. HPV types 6 or 11 are responsible for most cases and they develop in about two-thirds of women a few months after HPV 6 or 11 infections are first detected by polymerase chain reaction. Surveillance data, cohort studies and cross-sectional surveys suggest that the annual incidence of genital warts exceeds 1% and serological studies suggest cumulative risk up to 40 years of age for HPV 6 or 11 is over 25%. The quadrivalent HPV vaccine is highly effective against genital warts and Australian surveillance data in the 2 years after the introduction of the vaccine have shown large declines in younger women and to a lesser degree heterosexual men. No significant changes in older women or men who have sex with men were seen. Given the success of Australia’s catch-up program it will not be long before we know if the basic reproductive number for genital warts holds the prospect of elimination. However, if genital warts stabilise at a lower, but not very low, rate we will know that elimination will not be possible without vaccination of males.
Additional keywords: epidemiology, HPV vaccine.
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