HPV and Cervical Cancer
HPV (human papillomavirus) is the name for a group of more than 100 viruses associated with the development of papillomas, or warts. More than 30 types can be passed person-to-person through sexual contact. In most cases, infection with HPV doesn’t cause any symptoms, so people aren’t aware they have acquired the virus.

HPV can be classified into two groups – low-risk and high-risk. Low risk types are those that cause warts, most notably HPV-6 and HPV-11. High-risk types of HPV are associated with an increased risk for cancer. Of special importance are HPV-16 and HPV-18, which are linked to 70 percent of all cervical cancers.

According to the CDC, about 20 million Americans are currently infected with HPV. Roughly 6.2 million new cases occur each year. In most people, the infection clears from the body in one to two years. Those who develop persistent HPV infections are most at risk for developing cervical cancer. Researchers say, the longer a person has persistent HPV, the greater the risk for developing cervical cancer. The American Cancer Society estimates 11,270 cases of cervical cancer will be diagnosed in the U.S. this year and 4,070 women will die from the disease.

Green Tea for HPV
Green tea contains a group of chemicals, called catechins. Some of the main catechins are epigallocatechin-3-gallate (EGCG), epigallocatechin (EGC), epicatechin-3-gallate and epicatechin. Catechins are antioxidants. They halt the oxidative damage to healthy cells and may aid in the fight against cancer and other diseases.

Scientists have found a way to extract these healthy chemicals from green tea leaves and put them into a product, called Polyphenon E® (also referred to as green tea extract). Sherry Chow, Ph.D., Researcher with the Arizona Cancer Center in Tucson, AZ, says the amount of catechins in Polyphenon E is highly concentrated – roughly the equivalent of 8 to 16 cups of green tea.

In 2006, the FDA approved an ointment with Polyphenon E, called VEREGEN®, for the treatment of genital warts. Now researchers are trying to see if an oral form of the compound can help women with persistent HPV clear the viral infection.

The Phase II study aims to enroll 176 women. Some will receive the oral green tea extract and others will receive a placebo. The investigators will test the effects of both treatments on levels of HPV and low-grade changes to cervical cells (called CIN 1). The women with CIN 1will all be monitored for any toxic effects of the treatment.

The study is still ongoing, so researchers don’t have results yet. Currently, the study is only taking place at the University of Arizona. However, investigators are looking to expand to sites in North Carolina and California. Polyphenon E is also being investigated as a treatment for lung cancer, breast cancer, Barrett’s esophagus and multiple sclerosis.

AUDIENCE INQUIRY
For information about the trial, go to http://clinicaltrials.gov. Then type the trial identification number in the search box: NCT00303823.

For information on Polyphenon E®, http://www.polyphenon-pharma.com

For information on HPV or cervical cancer:
American Cancer Society, http://www.cancer.org
American Social Health Association, http://www.asha.org
Centers for Disease Control and Prevention, http://www.cdc.gov/std/HPV
National Cancer Institute, http://www.cancer.gov

BIBLIOGRAPHY
Castle, Philip, et al., “Short Term Persistence of Human Papillomavirus and Risk of Cervical Precancer and Cancer,” BMJ, July 28, 2009, Vol. 399, p. b2599.

Koshiol, Jill, et al., “Persistent Human Papillomavirus Infection and Cervical Neoplasia,” American Journal of Epidemiology, July 15, 2008, Vol. 168, No. 2, pp. 123-137.

Rodriguez, Ana Cecilia, et al., “Rapid Clearance of Human Papillomavirus and Implications for Clinical Focus on Persistent Infections,” Journal of the National Cancer Institute, April 2, 2008, Vol. 100, No. 7, pp. 513-517.

Stockfleth, E., et al., “Topical Polyphenol E in the Treatment of External Genital and Perianal Warts,” British Journal of Dermatology, June 2008, Vol. 158, No. 6, pp. 1329-1338.

Zhang, Qunzhou, et al., “Green Tea Extract and (-)-epidallocatechin-3-gallate Inhibit Hypoxia- and Serum-Induced HIF-1 alpha Protein Accumulation and VEGF Expression in Human Cervical Carcinoma and Hepatoma Cells,” Molecular Cancer Therapy, May 2006, Vol. 5, No. 5, pp. 1227-1238.