HPV and Cervical Cancer, Taking a New Direction
Apr 7, 2014 - 12:07:25 AM
Over my career, my research has focused on the integration of nutritional supplements with Western medicine to improve women's health. I feel this is an innovative approach to address many unmet healthcare needs, like HPV infection.
HPV, human papilloma virus, often goes completely undiagnosed, and yet is the most common sexually transmitted virus in the US. The association between cancer and HPV is now center stage as a focus of cancer prevention. Up to 70% of sexually active adults will acquire HPV at some point in their lives. According to the CDC, about 79 million Americans are currently infected. A new study in the Journal of Infectious Diseases found that at least one partner had HPV in 67% of young Canadians in new heterosexual relationships, with both partners already infected in 49% of those couples. The rate of HPV was 52% among couples in which both partners said they always used condoms for previous sexual intercourse. (1)
No method of avoiding HPV infection is 100% effective except total sexual abstinence -- including abstinence from manual and oral sex, because it can be transmitted with any skin-to-skin contact. Most HPV infections have no obvious symptoms and eventually the immune system fights off the infection. However, often the HPV infection is dormant and goes undetected for an extended period of time until events such as stress or decreased immune function triggers the pathway to cancer.
Human papillomavirus DNA has been detected in 99.7% of cervical cancer biopsies, the largest causative relationship of any cancer. (2) Other types of cancer are also HPV related, including: 95% of anal cancer; 60% of head and neck cancer; 65% of vaginal cancer; 50% of vulvar cancer; and 35% of penile cancer.
Searching for better treatments
Although the HPV vaccine is useful in preventing HPV infections, it has little benefit for treating patients already infected with HPV. Current topical treatments usually work to relieve symptoms and remove tissue that has been invaded with cancer cells, but may increase the risk for early delivery during pregnancy. A number of research studies evaluating oral and topical administration of antiretroviral medications are ongoing for the treatment of HPV infection. Since these prescription medications have potential for many side effects and require patient monitoring, this approach will require testing for HPV infection prior to treatment.
Our research is evaluating the nutritional supplement approach, seeking to improve the immune response to eradicate the HPV infection. We hope to find a nutritional supplement that will eradicate HPV that could be used without requiring HPV testing in under developed countries where HPV-related cancers are so common and so deadly.
The first supplement my team has been evaluating is AHCC (Active Hexose Correlated Compound) because we have already done extensive studies looking at safety with other medications, and safety in humans in phase I studies have already been completed.
Recently, we presented encouraging results at the Society of Gynecological Oncology 45th Annual Meeting on Women's Cancer in Tampa. We found that this common, well-tolerated nutritional supplement killed the HPV virus in vitro, eliminated the HPV infection in mice, and decreased their rate of tumor growth.
AHCC is a nutritional supplement, an extract prepared from Japanese medicinal mushrooms that has been suggested to have many health benefits including both immune boosting and anti-tumor effects. A number of clinical studies evaluating AHCC have shown it to help patients with cancer, hepatitis, liver disease, as well as viral and bacterial infections.
After evaluating the safety of AHCC and learning about potential anti-viral effects, I was intrigued to evaluate if it might help in the treatment of HPV infections. It was a particularly inviting option because AHCC is already widely used by healthy individuals looking to improve their immune function.
Our current research is an encouraging step in the right direction, but there is more to be done. First we must complete the pilot study of AHCC in HPV+ women that is currently ongoing and open for enrollment at University of Texas Health Science Center Medical School at Houston Women's Center, to define the duration the supplement needs to be taken to eradicate HPV. Then we will conduct a multi-institutional, randomized, placebo-controlled study to confirm the potential for AHCC to eradicate HPV infections in Humans. ###
Dr. Judith A. Smith is Associate Professor, Department of Obstetrics, Gynecology and Reproductive Sciences at The University of Texas Health Science Center at Houston Medical School. Her research focus is on drug development for gynecologic cancers and women's health conditions with a specific focus on integration of nutritional supplements and herbs with traditional Western medicine.
(1.) Determinants of prevalent human papillomavirus in recently-formed heterosexual partnerships: A dyadic-level analysis. Ann N. Burchell, Allita Rodrigues, Veronika Moravan, Pierre-Paul Tellier, James Hanley, François Coutlée and Eduardo L. Franco
The Journal of Infectious Diseases, doi: 10.1093/infdis/jiu200,
First published online: March 27, 2014
(2.) Clinical Perspectives on the Role of the Human Papillomavirus Vaccine in the Prevention of Cancer, Justin M. Julius, Pharm.D., Lois Ramondeta, M.D., Katherine A. Tipton, Pharm.D., Lincy S. Lal, Pharm.D., Ph.D., Karen Schneider, M.D., Judith A. Smith, Pharm.D., FCCP, FISOPP
Pharmacotherapy. 2011;31(3):280-297 http://onlinelibrary.wiley.com/doi/10.1592/phco.31.3.280/abstract;jsessionid=28484FCF040C2FE4843FABE7C391950A.f03t01