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Women sought for study
of sex-virus infections

By Helen Altonn
Star-Bulletin

The University of Hawaii Cancer Research Center hopes to recruit 4,000 volunteers for a study designed to find the cause of one of the most common sexually transmitted diseases among Hawaii women.

The disease is papillomavirus, or HPV, a group of more than 80 types of viruses that cause warts, or papillomas, that are benign or noncancerous tumors.

Of those, more than 30 types can infect the genital tract, causing cervical cancer and cervical disease leading to cancer, according to the Cancer Information Service of Hawaii.

Often undetected, the virus can be spread by sexual intercourse despite use of condoms.

Dr. Marc Goodman, associate Cancer Research Center researcher, is chief investigator for the five-year study, funded by the National Cancer Institute. He's collaborating with Queen's Health System, Kapiolani Health and Kaiser Permanente.

Of the 30 types of HPV that can infect the genital tract, at least 10 are capable of causing cervical cancer, said Brenda Hernandez, Cancer Research Center research coordinator.

"Our intention is to find out if a woman is infected in the first place, then follow them over a period of time to see if they maintain that infection."

There is no cure for HPV but infections can be cleared with treatment before cervical problems develop. Preliminary research shows it seems to be a transient infection in many women, Hernandez said. "Most women through their own immune system or other mechanism are able to clear the virus readily."

Others seem to be at very high risk and, once infected, have difficulty shedding the infection, she said. Those who retain a persistent infection for a long time are at great risk for cervical cancer, she said.

She said the study will examine effects of diet on the ability to clear the virus, based on findings in an earlier study by Goodman.

He conducted tests of women with abnormal and normal pap smears that suggested nutrients may affect how long a woman has an infection, she said.

A dietary survey and analysis will be included in the study, with free testing for the virus and free Pap smears.

Participants will be monitored through six visits over three years and paid $15 per visit.

A Pap smear, including collection of cells for HPV testing, will be done at each visit and a blood sample be taken to measure nutrients.

Women 18 years or older who aren't pregnant and haven't had a hysterectomy are eligible to participate.

Testing sites will be at the Cancer Research Center, the Clinical Research Center-Kapiolani Health and Kaiser's Honolulu Clinic.

Hali Robinett and Tammy Ho, among the first to sign up, said the study will help them and other women remain healthy.

"As a working mother, my participating in the study allows me to do something to safeguard my own health and add knowledge that will help my daughter in the future," said Robinett.

Hernandez said it isn't known exactly how many Hawaii women are infected with the virus. But in preliminary research, she said, at least 20 percent of women with normal and abnormal Pap smears had HPV cervical infection.

"This current study will help us to determine why most women infected with HPV never develop any problems while a small number of women go on to develop cervical cancer," she said.

Momi Ann Breault, Kapiolani Health research nurse coordinator, said, "This study will offer tests that all women need, but most insurers will not cover. The results of our study can change that situation."

A new test collected when a Pap smear is done now detects the DNA of the virus in cervical cells and tissues.

The test, approved by the Food and Drug Administration, can indicate the presence of HPV before there are visible cell changes and identify the type of HPV present as low or high risk.

Researchers want to see if use of the test can enhance results of a Pap smear, Hernandez said, noting few doctors do routine HPV testing. Most rely on Pap smears, she said.

Women interested in participating in the study should call 1-800-4-CANCER for more information.