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HPV freak out!
Jun 2, 2008

Dear Dr. Bob: first of all I really appreciate your sense of humour you sprinkle in your responses - you rock!

I'm a 42 year old male who nearly "checked out" in July 06, undectable CD4 count, viral load of 265K, 2 hospitilizations, a blood transfusion, and 3 AIDS defining illnesses including an HPV diagnosis requiring 2 "back porch" surgeries. OMG horrible horrible horrible, I wouldn't wish that recovery on my worst enemy!!! My CD4 has now climbed to over 300 and I remain undetectable - please let people know there is hope!!!!

My question relates to HPV. I have read recent articles about the increasing prevalence of HPV and it's strong correlation to various deadly cancers and I wonder what is being studied regarding finding a cure for this "background bastard". I know it's too late for a vaccination for me so my doc and I basically just watch to make sure no symptoms surface of a serious HPV problem. Is there anything I can do to reduce the chances of my HPV infection developing into something that frankly to me is worse than dealing with HIV? Thanks in advance Dr. B!!!

Response from Dr. Frascino

Hi,

Thanks for your question and for writing in to share your remarkable story. I don't have to "let people know there is hope," because your own words and story do that far more effectively than I ever could. Congratulations on your remarkable turnaround. BRAVO!

As for HPV, yeah, it can indeed be a real pain in the ass. As you probably already know, only certain strains of HPV are prone to subsequently evolve into cancer. Have you had your HPV typed to see if you have any of these worrisome subtypes?

Guardasil, the HPV vaccine, covers a number of these potential cancer-inducing subtypes. What we don't yet know is whether the vaccine would be effective in providing protection to folks with HPV, but who do not have the dangerous subtypes. We also don't now how effective the vaccine is in HIVers. Studies to answer these questions are underway. What we do know is that the vaccine appears to be quite safe for both men and women (as well as boys and girls). Our group, the Frascino Medical Group, has been vaccinating men, HIV positive or negative, who request it and demonstrate by anal pap smears that they do not already have the HPV subtypes contained in the vaccine. You might discuss this potential strategy with your HIV specialist, realizing that we do not yet have the scientific studies to prove this is an effective preventative intervention under these circumstances.

Good luck.

Dr. Bob



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