V503 | Shim Clinic, Singapore

V503 | Shim Clinic, Singapore: HPV (Human Papillomavirus) Nonavalent (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58) Recombinant vaccine jab/shot/injection, to vaccinate against HPV types 6, 11, 16, 18, 31, 33, 45, 52, & 58, to immunise against cervical/penile/anal/mouth/throat cancer & genital warts clinic, Singapore. Private and confidential service. Definitions, references, and latest news.

Description

Table of Contents

• HPV (human papillomavirus)
• Genital warts
  • Genital Warts Treatment / Genital Warts Removal
• Cervical Cancer
• HPV vaccine / Cervical Cancer Vaccine
  • Gardasil®
  • Cervarix®
  • V503
• HPV test

• 2007 October 12th - Broad Spectrum HPV (Human Papillomavirus) Vaccine Study in 16-to 26-Year-Old Women (V503-001)
• 2009 July 21st - A Study of V503 in Preadolescents and Adolescents (V503-002)
• 2010 May 11th - The Phase III trial is ongoing and Merck anticipates filing a Biologics License Application (BLA) in 2012
• 2010 July - Merck is recruiting for Phase III clinical trials of a nine-valent vaccine

• Gardasil® [HPV (Human Papillomavirus) Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant]
• Cervarix® [HPV (Human Papillomavirus) Bivalent (Types 16 and 18) Vaccine, Recombinant]
• V503 [HPV (Human Papillomavirus) Nonavalent (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58) Vaccine, Recombinant]

• 2006 June 8th - US FDA approves use in females aged 9 to 26 years
• 2006 - Singapore HSA approval
• 2008 September 12th - US FDA approves use to prevent vulvar and vaginal cancer
• 2009 October 16th - US FDA approves use to prevent genital warts in males aged 9 to 26 years
• 2010 December 22nd - US FDA approves use to prevent anal cancer in males and females aged 9 to 26 years
• 2010 December 22nd - Singapore HSA approves use to prevent genital warts in males aged 9 to 26 years
• 2011 April 5th - US FDA approves use in women 27 through 45 years of age
• 2011 December 20th Singapore HSA approves use to prevent anal cancer in males and females aged 9 to 26 years

• Gardasil.com
• Gardasil® @ US FDA

• 2007 - Singapore HSA approval
• 2009 October 16th - US FDA approves use in females aged 10 to 25 years
• 2011 July 19th - US FDA approves use in females as young as 9 years of age
• 2011 August 3rd - Singapore HSA approves use for the prevention of persistent infection, premalignant cervical lesions and cervical cancer

• Cervarix.com
• Cervarix® @ US FDA

Vaccine	Against	Disease	Age	D o s e s	Dose schedule	Price per dose (SG$)
Havrix™ 1440 Adult Hepatitis A vaccine	Hepatitis A virus	Hepatitis A	≥19y	2	m 0 & 6-12	$90/=
Engerix™-B 20 μg Hepatitis B vaccine	Hepatitis B virus	Hepatitis B	11-15y	2	m 0, & 6	$50/=
			≥20y	3	m 0, 1, & 6
				4	m 0, 1, 2, & 12 or d 0, 7, 21 & m 12
Twinrix®	Hepatitis A virus Hepatitis B virus	Hepatitis A Hepatitis B	1-15y	2	m 0, 6-12	$120/=
			≥16y	3	m 0, 1, 6
				4	d 0, 7, 21 & m 12
Gardasil® - HPV vaccine	HPV types 6, 11, 16 and 18	Genital warts Cervical cancer	9-26y	3	m 0, 2, & 6 or m 0, 1, & 4	$195/=
Cervarix® - HPV vaccine	HPV types 16 and 18 (31, 33, and 45)	Genital warts Cervical cancer	10-25y	3	m 0, 1, & 6 m 0, 1, & 5 m 0, 2½, 12	$195/=
V503 - HPV vaccine	HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58	Genital warts Cervical cancer		3	m 0, 2, & 6 or m 0, 1, & 4	$???/=

HPV test for men/women.

• Digene® High-Risk HPV DNA Test
  • QIAGEN - digene HC2 High-Risk HPV DNA Test - For detection of human papillomavirus infections using hybrid capture 2 technology
  • Detects 13 high-risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68.
  • Unable to differentiate which types are positive.
  • Cost is SG$200/=
• Digene® HPV DNA Test
  • QIAGEN - digene HC2 HPV DNA Test - For detection of human papillomavirus infections
  • Detects 13 high-risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. And 5 low-risk types: 6, 11, 42, 43, and 44.
  • Unable to differentiate which types are positive.
  • Not available in Singapore. Unlikely to be available in future.
• Hybribio®
  • HPV GenoArray Test Kit
  • Detects 15 high-risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, and 68. And 6 low-risk HPV types: 6, 11, 42, 43, 44, CP8304
  • Able to differentiate which types are positive.
  • May be available in Singapore soon.
• Cobas® HPV Test
  • Cobas® HPV Test
  • Detects 14 high-risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68
  • The test specifically identifies (types) HPV 16 and HPV 18, while concurrently detecting the rest of the high risk types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68)
  • Cost is SG$200/=
• LINEAR ARRAY® HPV Genotyping Test
  • LINEAR ARRAY® HPV Genotyping Test
  • Identifies 37 high-risk HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 73 (MM9), 82 (MM4) low-risk HPV genotypes 6, 11, 26, 40, 42, 53, 54, 55, 61, 62, 64, 67, 69, 70, 71, 72, 81, 83 (MM7), 84 (MM8), IS39, and CP6108
• INNO-LiPA HPV Genotyping Extra
  • INNO-LiPA HPV Genotyping Extra
  • Identifies 15 high-risk HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, 82) 3 probable high-risk HPV genotypes (26, 53, 66) 7 low-risk HPV genotypes (6, 11, 40, 43, 44, 54, 70) and some additional types (69, 71, 74).
• PapilloCheck®
  • PapilloCheck®
  • Identifies 24 hiv-risk HPV types 16 18 31 33 35 39 45 51 52 53 56 58 59 66 68 70 73 82 and low-risk HPV types 6 11 40 42 43 44

HPV (human papillomavirus) There are nearly 200 known types of HPV. They cause

• 100% of genital warts
• 100% of cervical cancers in females,
• 90% of anal cancers in males & females
• 40% of external genitalia cancers
  • penile cancers in males,
  • vulvar cancers in females,
  • vaginal cancers in females,
• 12% of oropharyngeal cancers (mouth and throat cancers)
• 3% of oral cancers

• HPV types 1 and 2 cause plantar warts
• HPV types 3 and 10 cause flat warts
• HPV types 6 and 11 (preventable with Gardasil® vaccination) cause 90% of genital warts
• HPV types 16 and 18 (preventable with Gardasil® or Cervarix® vaccination) cause 70% of cervical cancers in females
• HPV types 16, 18, 31, 33, 45, 52, and 58 (preventable with V503 vaccination) cause 90% of cervical cancers in females. It may be available by 2013.

• Human_papillomavirus | 2can Support Portal | EBI

HPV	1 6	1 8	3 1	3 3	3 5	3 9	4 5	5 1	5 2	5 6	5 8	5 9	6 8	7 0	7 3	8 2	2 6	5 3	6 6	6	1 1	4 0	4 2	4 3	4 4	5 4	5 5	6 1	6 2	6 4	6 7	6 9	7 1	7 2	8 1	8 3	8 4	C P 6 1 0 8	I S 0 3 9	7 4
Risk	H	H	H	H	H	H	H	H	H	H	H	H	H	H	H	H	I	I	I	L	L	L	L	L	L	L	L	L	L	L	L	L	L	L	L	L	L	L	L	U
Cervarix	+	+	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
Gardasil	+	+	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	+	+	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
V503	+	+	+	+	-	-	+	-	+	-	+	-	-	-	-	-	-	-	-	+	+	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
DigeneHR	+	+	+	+	+	+	+	+	+	+	+	+	+	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
CobasHPV	+	+	+	+	+	+	+	+	+	+	+	+	+	-	-	-	-	-	+	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
Digene	+	+	+	+	+	+	+	+	+	+	+	+	+	-	-	-	-	-	-	+	+	-	+	+	+	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
HybriBio	+	+	+	+	+	+	+	+	+	+	+	+	+	-	-	-	-	+	+	+	+	-	+	+	+	-	-	-	-	-	-	-	-	-	+	-	-	-	-	-
PapilloCheck	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	-	+	+	+	+	+	+	+	+	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
InnoLiPA	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	-	+	+	+	-	-	-	-	-	+	+	-	-	-	-	-	-	+
LinearArray	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	+	-	-	+	+	+	+	+	+	+	+	+	+	+	+	+	+	-

Legend: 71 (CP 8061), 81 (CP 8304), 82/MM4, 82/IS039, 83 (MM7), 84 (MM8)

References

• Human-papilloma

• 100% of cervical cancers is caused by HPV (human papillomavirus).
• 70% of cervical cancers is caused by HPV types 16 & 18. Which may be prevented by vaccination with Gardasil® or Cervarix®.
• 90% cervical cancers is caused by HPV types 16, 18, 31, 33, 45, 52, and 58. Which may be prevented by vaccination with V503. It may be available by 2013.

Genital warts appear within 3 months after sexual contact with an infected person.

Genital warts:

• are usually soft, pink cauliflower-like growths or flesh-coloured bumps on the sex organs
• may also be hard and smooth
• occur alone or in groups
• tend to recur after treatment
• increase the risk of cervical cancer in women.

A person with genital warts can infect others through sexual contact.

Genital warts treatment is usually by cryosurgery with liquid nitrogen. Genital warts removal may also be done by curettage.

Prevention is possible with a HPV vaccine like Gardasil®, which covers types 6 and 11, as they cause 90% of genital warts.

References

• V503 - Wikipedia, the free encyclopedia
• V503: Definition from Answers.com
• V503 - definition of V503 in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia.

Gender Differences Among Low Income Women in Their Intent to Vaccinate Their Sons and Daughters Against Human Papillomavirus Infection
Tue, 15 May 2012 21:43:57 +0100 | Journal of Pediatric and Adolescent Gynecology
Conclusion: Educational interventions are needed to address the importance to mothers of vaccinating both their sons and daughters against HPV. (Source: Journal of Pediatric and Adolescent Gynecology)

Recurrent Respiratory Papillomatosis
Tue, 15 May 2012 18:55:47 +0100 | Otolaryngologic clinics of North America
Recurrent respiratory papillomatosis (RRP) is a rare, benign disease with no known cure. RRP is caused by infection of the upper aerodigestive tract with the human papillomavirus (HPV). Passage through the birth canal is thought to be the initial transmission event, but infection may occur in utero. HPV vaccines have helped to provide protection from cervical cancer; however, their role in the prevention of RRP is undetermined. Clinical presentation of initial symptoms of RRP may be subtle. RRP course varies, and current management focuses on surgical debulking of papillomatous lesions with or without concurrent adjuvant therapy. (Source: Otolaryngologic clinics of North America)

Perspectives on Decision Making About Human Papillomavirus Vaccination Among 11- to 12-Year-Old Girls and Their Mothers
Tue, 15 May 2012 04:00:00 +0100 | Clinical Pediatrics
Conclusions. This study provides novel insights into perspectives on decision making about HPV vaccination among mothers and 11- to12-year-old daughters, which can be used in interventions to improve vaccination rates. (Source: Clinical Pediatrics)

Prevalence of human papillomavirus types in cervical lesions from women in rural Western India
Mon, 14 May 2012 04:00:00 +0100 | Journal of Medical Virology
In this study, the HPV type distribution and the frequency of p16INK4a immunoexpression have been determined in 125 cases of inflammatory lesions or grade 1 cervical intraepithelial neoplasia, 74 cases of grade 2, 72 cases of grade 3, and 113 cervical cancer cases diagnosed among women from rural Solapur and Osmanabad districts, Maharashtra. The overall prevalence of high‐risk HPV was 37.6% in inflammatory lesions or grade 1 cervical intraepithelial neoplasia, 63.5% in grade 2, 97.2% in grade 3 and 92% in cervical cancer cases. HPV 16 and HPV 18 were detected in 80.6% of grade 3 cervical intraepithelial neoplasia and 86.5% of cervical cancer cases. 94.7% of the cervical cancer and 84.4% of the high grade lesions with a strong and full thickness staining for p16INK4a were positive for HPV...

Advertisements promoting human papillomavirus vaccine for adolescent boys: does source matter?
Sat, 12 May 2012 04:00:00 +0100 | Sexually Transmitted Infections
Conclusions Parents were more accurate in identifying drug company advertisements, primarily because they tended to assume any advertisement was from a drug company. Public health organisations may need to take special measures to ensure their messages are not perceived as sponsored by drug companies. (Source: Sexually Transmitted Infections)

Reminder Stamp Boosts HPV Vaccination (CME/CE)
Fri, 11 May 2012 17:30:00 +0100 | MedPage Today Infectious Disease
SAN DIEGO (MedPage Today) -- Rubber stamping a patient's chart with a reminder about the human papillomavirus vaccine was associated with a greater than four-fold increase in vaccination rates at one institution. (Source: MedPage Today Infectious Disease)

HPV vaccine completion rate more than halved since its introduction
Thu, 10 May 2012 23:26:53 +0100 | MedWire News - Pediatrics
The proportion of insured girls and young women completing the human papillomavirus vaccine series has dropped significantly since the vaccine was approved in 2006, US study data show. (Source: MedWire News - Pediatrics)

Here Is How We Know Gardasil Has Not Killed 100 People
Thu, 10 May 2012 17:58:19 +0100 | Forbes.com Healthcare News
Forbes commenters keep saying Gardasil has caused 100 deaths. Here is why they are wrong. (Source: Forbes.com Healthcare News)

The cost of managing genital warts in the UK
Thu, 10 May 2012 04:00:00 +0100 | International Journal of STD and ----
This study estimated the 2010 UK costs based on secondary genitourinary (GU) medicine clinic data from the Health Protection Agency (HPA) and primary care data from the Health Improvement Network database. Extrapolating data to 2010 resulted in 173,077 GU medicine clinic and 16,782 primary care GW episodes. Using treatment patterns obtained from key opinion leaders and tariffs from National Health Service Payment by Results (NHS PbR), the national costs were estimated at £52.4 million: £276 per treated GW episode. (Source: International Journal of STD and ----)

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