If a colleague were to ask my opinion on which HPV strains should be covered in a prospective treatment, I would include HPV strains 16, 18, 31, and 45. These strains are responsible for roughly eighty percent of cervical cancer in women (1). While other strains of HPV are known to be carcinogenic to the human body, treatments are expensive to develop, and the addition of strains to a therapeutic would mean a larger development bill. Strains 16, 18, 31, and 45 are responsible for a majority of the cases of cervical cancer we see, so including these 4 strains in a treatment would create the most considerable benefit for the least cost.

This treatment should be administered upon the first detection of the virus, whether by positive test or by the first detection of genital warts. While this treatment would not cure all strains of HPV, we know that time is of the essence when it comes to treating oncoviruses like HPV. Oncoviruses block the activity of tumor-suppressing genes like p53 and pRB and dysregulate the cell’s ability to become apoptotic in the event of cancerous activity (2). While HPV-infected cells become cancerous at a low frequency, the chances of an infected cell becoming cancerous increase as more time passes. Treatment with this drug would not cure every individual because it does not cover every strain of HPV. However, it would cure those individuals at the highest risk of developing cervical cancer from their HPV infection.

Citations

1. Sarid R, Gao SJ. Viruses and human cancer: from detection to causality. Cancer Lett. 2011;305(2):218-227. doi:10.1016/j.canlet.2010.09.011

2. Krump NA, You J. Molecular mechanisms of viral oncogenesis in humans. Nat Rev Microbiol. 2018;16(11):684-698. doi:10.1038/s41579-018-0064-6