No one dreams of walking into his or her doctor's office and hearing the words, "You have an STD," followed by, "There is no cure."
But for the many many people around the world who have been diagnosed with human papillomavirus, or HPV, this scenario is all too real. HPV is indeed incurable, and it strikes nearly every sexually active human at some point in his or her lifetime. Right now, according to the Centers for Disease Control and Prevention, 79 million Americans have the virus and doctors report roughly 14 million new cases every year in this country.
The reason we aren't in an all-out panic is because most strains of HPV will clear the body on their own—meaning, for most people, the only real consequence is the stigma of having an STD.
However, HPV still poses a major health threat, since certain strains can lead to serious symptoms such as genital warts or life-threatening illnesses such as cancer of the cervix, vulva, vagina, penis, anus, or throat. In fact, doctors estimate that 99% of cervical cancers are caused by HPV strains, and more than 270,000 women die of HPV-related cervical cancer every year worldwide.
Of course, an easy and effective way to prevent HPV is to get vaccinated against the virus. But the HPV vaccine has sparked controversy since its introduction in 2006, largely because the CDC recommends that doctors administer it on boys and girls ages 11 to 12—before they become sexually active—which makes some parents and prudish critics uncomfortable.
This hesitation is reflected in recent CDC reports, which estimate that only 60% of girls and 42% of boys ages 13 to 17 in the U.S. have been vaccinated.
And yet, low as those numbers may be considering the vaccine promises to prevent cancer, they are still first-world numbers. In other parts of the globe, HPV vaccines are both costly and hard to acquire. Which is one reason why 85% of deaths related to cervical cancers occur in the developing world, according to the World Heath Organization.
But what if instead of relying on a preventative vaccine, we also had an honest-to-goodness cure for HPV? As it turns out, an HIV drug that's been on the market since 2006 may hold the key to fighting the virus—and warding off its associated cancers.
British scientists Ian and Lynne Hampson, a husband-and-wife team who are both molecular virologists at the University of Manchester, recently published results from a phase 1 clinical trial in the peer-reviewed journal PLoS One—which suggest that a cure is looking more promising than ever.
The trial was conducted in 2013, in Kenya, where cervical cancer is five times more prevalent than in the U.K. Cervical cancer is also the most prevalent cancer among women in Kenya.
For their research, the Hampsons recruited hundreds of female patients from Kenyatta National Hospital's Family Planning and Gynecology clinics to undergo free cervical smears, as well as HIV and HPV testing. Twenty-three women who tested negative for HIV but positive for the types of "high risk" HPV strains associated with pre-cancer of the cervix were identified and admitted to the trial. These women already showed signs of having pre-cancerous cells in their cervix.
These 23 women were then given Lopimune, a combination of the anti-viral HIV drugs lopinavir and ritonavir, for two weeks. Lopimune is normally taken orally for HIV, but in the Kenyan trial, the doctors had the participants administer it directly to their cervix using a pessary (a small device inserted into the vagina). This was done twice daily.
According to the PLoS One study, participants experienced no major side effects from the medication. At worst, some women experienced slight nausea. Over half the women reported missing at least one dose—some saying it was difficult to remember to take or carry around—and one woman said she missed five consecutive doses.
Despite not having 100% of participants take the proper amount of medicine, the results were still remarkable. Twelve weeks after the trial began, the researchers found that HPV infection levels had declined in 19 of the 23 women. Not only that, but in 12 of the 23 women (52%), no virus could be detected at all.
But the most striking result was that approximately 64% of the women now had no detectable pre-cancerous cells in their cervix, and a further 18% also showed their disease had regressed to low-grade. This means that the Lopimune treatment produced approximately an 80% overall improvement in the disease within three months.
The Hampsons and their colleagues also conducted a one-year follow-up on 17 of the women, and 82% were HPV negative. Thanks to the efficacy seen with high-risk infections in Kenyan women, the researchers now plan to forge ahead into phase II of clinical trials. For reference, most drugs in the U.K. are considered "pre-market" at stage III. From there, the drug is considered ready to be considered for approval.
Given the drug's preliminary success, I reached out to the pharmaceutical company that makes the drug stateside, the Chicago-based Abbvie. (In this country, the drug is known as Kaletra.) I was curious if Abbvie had any plans to do clinical trials of their own—but I was told that, as of now, they do not.
So what can we expect in the future then?
At present, there is no cure for HPV. For women with pre-cancerous HPV, this is especially troubling. The current recommended form of treatment for cervical dysplasia (precancerous cells in the cervix) is surgery, which involves cutting out the abnormal tissues. While highly effective, the surgery comes with its own set of risks such hemorrhage, prolonged vaginal discharge, and infection, which can be problematic in low-income countries. Not to mention, even if surgery is successful, it's not a cure and cervical dysplasia can reoccur.
If Lopimune continues to be successful at actually resolving HPV in upcoming trials, it could—with a big emphasis on could—provide a safe, effective, non-surgical treatment for HPV infection and all grades of dysplasia. Not to mention, it’s self-applied and much cheaper than surgical options.
“At the very least, it could be used as a first-line treatment, prior to surgery," Ian Hampson told me. "At best, it could revolutionize the management of this disease in poorer nations where more than 85% of cervical cancer is found."
Hampson added, "These countries cannot afford national cervical screening or surgery, and since it is non-destructive and safe, the above treatment could be given on the basis of a simple, self-sampled, and cheap HPV test, which could also be used [to see if it was effective] several months later."
While more testing is certainly required, if the treatment does eventually prove effective, a cure for HPV could help save millions of men and women who might die from HPV-related cancer over the next several decades.
Taryn Hillin is Fusion's love and sex writer, with a large focus on the science of relationships. She also loves dogs, Bourbon barrel-aged beers and popcorn — not necessarily in that order.