IZINDABA

HPV: Hope in 15 years for unvaccinated women

The deadly cervical cancer-causing human papillomavirus (HPV) could be eliminated in South Africa (SA) within 15 years if ground-breaking new 'test-and-treat' technology for women can be successfully introduced to supplement nationwide vaccination of primary schoolgirls.

This was said last month by Prof. Lynette Denny, Head of the Department of Obstetrics and Gynaecology at the University of Cape Town's Faculty of Health Sciences and Principal Specialist at Groote Schuur Hospital. Creator of the 'test-and-treat' HPV-detecting technology, which uses the GeneXpert machine (currently diagnosing tuberculosis and rifampicin resistance), Denny was asked what overall impact this would have when added to the current HPV vaccination being offered at all primary schools. Dr Yogan Pillay, Deputy Director-General of Strategic Health Programmes in the National Department of Health (NDoH), said that 659 330 grade 4 girls aged 9 years and older completed the required two doses of HPV vaccination at schools across the country in 2014/2015. The goal is eventually to cover all 18 000 primary schools.

Cancer of the cervix is the most common cancer among women in SA, with 6 000 new cases diagnosed annually, half of whom eventually die and most of whom are black. The vaccine cannot help the millions of already infected women, so the 1-hour 'test-and-treat' intervention, the outcome of Denny's life's work so far, will help reduce this suffering via early detection and highly successful treatment. There are currently 250 GeneXpert machines in the country, which can take cartridges from 32 analysts, one of which is high-risk HPV. Denny said there is a 'bit more scientific work to do to make it slightly more accurate - we don't want to waste resources as we're already over-treating a small proportion of women'. In 5 years her team would be ready to 'go with infrastructure for point-of-care screen and treat' to prevent cervical cancer. 'I reckon we'll pick up 90% of existing disease - and if we can combine it with the HPV vaccine we'll drastically reduce if not eliminate it within the next 10 - 15 years,' she added.

Chris Bateman

chrisb@hmpg.co.za