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FRIDAY, May 18 (HealthDay News) -- Amid the controversy around mandated vaccination of young girls against the human papillomavirus (HPV), some experts are beginning to wonder whether the shot should also be given to boys.

While males cannot get HPV-linked cervical cancer, they make up half of the equation when it comes to spreading the sexually transmitted virus. And a new study released last week shows that the virus is also a leading cause of throat cancer, which affects both sexes.

"This is a viral infectious process, and the majority of the time it is passed through heterosexual contact. And I think it's important to consider boys as equal players in that process," said Dr. Michael Bookman, director of medical gynecologic oncology at Fox Chase Cancer Center in Philadelphia.

"Boys are not as prone to [HPV-linked] cancer as girls, but they are obviously involved in the transmission, and there is some risk of cancer in boys, as well," he added.

No one is debating the effectiveness of the vaccine, called Gardasil. The shot is targeted against the four strains (out of 15) of HPV that are thought to trigger 70 percent of cervical cancers.

Since its approval for use in girls and women between the ages of 9 and 26 by the U.S. Food and Drug Administration last June, several states have moved to mandate Gardasil's inclusion into routine school vaccination programs. That's because vaccinating before the onset of sexual activity is most effective in preventing HPV infection.

Those efforts have met with strong opposition, however. Some conservative groups worry the vaccine will encourage sex among young people, while other critics view the mandates as an intrusion on parental rights. Most state measures do give parents the right to opt out of the program, however.

So far, those debates have centered on young girls. But, in more rare instances, boys and men can fall prey to HPV as well. Reporting last week in the New England Journal of Medicine, a team of researchers at Johns Hopkins University confirmed that infection with HPV via oral sex is by far the leading cause of throat cancer, which strikes 11,000 American men and women each year. HPV is also a major cause of anal cancer and genital warts, both of which affect either sex.

The threat of throat cancer is especially troubling, Bookman said, because doctors traditionally only look for these malignancies in long-time smokers and drinkers. "Head and neck exams are more associated with smoking and alcohol and less associated with HPV, although that's changing," he said.

And while girls and women typically see a gynecologist for their Pap smear to look for cervical cancer, "how many boys and men are going to go to a doctor and ask them to look at their throat? It's just not that common," Bookman said.

Debbie Saslow is director of breast and gynecological cancers at the American Cancer Society. She agreed that HPV also poses a threat to males, but she's not yet convinced that Gardasil would help protect them.

"We have been considering vaccination for boys since day one, but the problem is that there is just no data yet -- everything is holding until we get data that the vaccine actually works in boys," she said.

Gardasil's maker, Merck & Co., is largely responsible for pulling that data together. However, according to Bookman, "they took a more conservative stance when they approached the FDA for licensure, registration and vaccine recommendations -- their safety data base was stronger for girls than boys."

Saslow also is doubtful whether Gardasil -- which costs $360 per three-shot regimen -- would prove to be cost-effective if provided to boys as well, at least in terms of preventing the biggest threat, cervical cancer.

"It may be cost-effective to vaccinate boys if not that many girls get vaccinated," she said. "But if most of the female population ends up getting vaccinated, then vaccinating boys won't add very much."

But what about the vaccine's cost-effectiveness in preventing anal and throat cancers, plus genital warts, among boys? Saslow said that since Gardasil has not yet been proven to be effective in boys, or to be effective against cancers outside the cervix, those points remain up in the air. "We still have all these questions that we need to look at," she said.

Another expert, Dr. Robert Frenck, a professor of pediatrics at Cincinnati Children's Hospital, was equally noncommittal. Frenck, who sits on the American Academy of Pediatrics' committee on infectious diseases, said his group is "in the process of developing the recommendations for HPV vaccine use." He said the AAP recommendations would focus only on the vaccine's "currently [FDA] licensed usage," which is exclusively for females.

Still, Bookman believes that, should Gardasil prove effective in boys, widening its use to both sexes "is the correct way to try and do things."

"What about everything that we know about controlling any other type of infectious process? Where we wouldn't discriminate on the basis of sex, we would vaccinate universally," he said. "Yes, in women cervical cancer is a more serious risk statistically than other cancers in men. But I think that the best way of controlling it with a vaccine is to use it broadly."

More information

Learn more about HPV and cervical cancer at the U.S. Centers for Disease Control and Prevention.

THURSDAY, May 17 (HealthDay News) -- Women at high risk for the pregnancy complication preeclampsia can lower their odds by 10 percent by taking daily aspirin, a new study suggests.

Preeclampsia is a potentially fatal obstetric complication that can lead to sudden high blood pressure and irregular blood flow. This can activate platelets and the clotting system, which in turn slows blood flow.

The use of aspirin may help counter this effect, according to a report in the May 16 online issue of The Lancet.

"Preeclampsia complicates between about 2 and 8 percent of all pregnancies, and is associated with approximately 10 to 15 percent of the half-million maternal deaths [worldwide] that occur each year," said lead researcher Lisa Askie, a research fellow in the School of Public Health at the University of Sydney, Australia.

Although the benefits of antiplatelet therapy such as daily aspirin are modest, they are important if given to women at risk of preeclampsia, Askie said. "They could potentially result in many thousands less women who experience a bad pregnancy outcome. Hence, particularly for women at high risk of preeclampsia, a more widespread use of antiplatelet agents may be worthwhile," she said.

In the study, Askie and colleagues in the Perinatal Antiplatelet Review of International Studies (PARIS) group looked at the results of 31 preeclampsia prevention trials that included almost 33,000 women and their babies. Women who took aspirin in these trials typically took between 50 milligrams to 150 milligrams of the drug per day.

The researchers found the risks of developing preeclampsia dropped 10 percent among women taking aspirin or other antiplatelet medications. In addition, these women also had a lower risk of delivering before 34 weeks and of having other pregnancy problems.

Moreover, aspirin had no significant effect on the risk of death of the fetus or baby. It didn't boost the risk of bleeding for either mothers or their infants, nor did it raise risks for underweight newborns.

Askie's team said no particular group of women was more or less likely to benefit from aspirin.

"Women at risk of preeclampsia should discuss the potential benefits and harms of this treatment with their doctor," Askie advised.

But one expert was less than impressed with the findings.

"The results of this study were, to a large extent, disappointing," said Dr. James Roberts, the director of the Magee-Womens Research Institute at the University of Pittsburgh, and author of an accompanying editorial.

Roberts had hoped the study would have shown a larger protective effect -- especially in the women who are at the greatest risk for the problem. "It's difficult to determine if it's more beneficial in any subset of women or at what dose," he said.

"In very high-risk women, the use of aspirin is justified," Roberts said. Women who are at the highest risk for preeclampsia are those who have high blood pressure and have also suffered preeclampsia in previous pregnancies. This group "are almost certain to develop it," he said.

Women at risk because of high blood pressure, pre-pregnancy diabetes or preeclampsia in one previous pregnancy have about a 20 percent risk of developing preeclampsia, Roberts noted.

"For these women, you would have to treat 50 with aspirin to prevent one case of preeclampsia," Roberts said. "For a woman, whether benefits outweigh the risks is a decision that she has to work out with her doctor," he said.

More information

To learn more about preeclampsia, visit the U.S. National Library of Medicine.

THURSDAY, April 12 (HealthDay News) -- Newer antibiotics called cephalosporins should become the sole drug treatment for the sexually transmitted disease gonorrhea.

The reason: The bacterial infection is becoming increasingly resistant to treatment with the standard family of antibiotics called fluoroquinolones that includes Cipro, the U.S. Centers for Disease Control and Prevention said Thursday.

Since the early 1990s, fluoroquinolones have been the standard treatment for gonorrhea.

An article published in Friday's edition of the CDC's Morbidity and Mortality Weekly Report says that preliminary 2006 data show that fluoroquinolone-resistant gonorrhea is now widespread among both heterosexual and gay men in the United States.

A survey of 26 cities found that fluoroquinolone-resistant disease accounted for 6.7 percent of gonorrhea cases among heterosexual men, compared with about 0.6 percent of cases in 2001. Among gay men, drug-resistant strains accounted for 38 percent of gonorrhea cases in the first half of 2006.

The recognized threshold for changing treatment recommendations is when 5 percent of cases are drug-resistant, the CDC said.

Along with switching to cephalosporins to treat gonorrhea, the CDC recommends increased monitoring for cephalosporin-resistant gonorrhea and accelerated research into new treatments for the disease.

"Gonorrhea has now joined the list of other superbugs for which treatment options have become dangerously few. To make a bad problem even worse, we're also seeing a decline in the development of new antibiotics to treat these infections," Dr. Henry Masur, president of the Infectious Disease Society of America, told the Associated Press.

According to the U.S. National Institutes of Health, gonorrhea is the second most commonly reported bacterial sexually transmitted infection in the United States, following chlamydia. In 2004, there were 330,132 gonorrhea cases reported to the CDC. The highest rates of gonorrhea are found in African-Americans, 15 to 24 years of age, and women, the NIH said.

Gonorrhea can spread into the uterus and fallopian tubes, resulting in pelvic inflammatory disease (PID). PID affects more than 1 million American women every year and can cause tubal (ectopic) pregnancy and infertility in as many as 10 percent of infected women. Some researchers also think gonorrhea adds to the risk of HIV infection, according to the NIH.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about gonorrhea.

THURSDAY, March 15 (HealthDay News) -- Researchers report that they've found more evidence of how the AIDS virus escapes the immune system.

While the findings could help in the development of an HIV vaccine, they suggest that it will be far from simple to figure out how the virus will react in specific people.

"There aren't just easy, predictable patterns," said study co-author Bette Korber, a laboratory fellow at Los Alamos National Laboratory, in New Mexico. "The virus is changing in response to our immune system, but it's not always changing in one direction."

At issue is the AIDS virus's ability to evolve as it learns about the weaponry that the human immune system tries to throw at it. "In the human population, we all have different immune response teams," Korber said. "We inherit them from our parents -- half of our response is from Mom, half from Dad. The question is: Are those responses really predictable? If I know your (genetic profile), could I predict how the virus would escape from you?"

Korber and her colleagues decided to try to find out. In their study, they statistically analyzed how the AIDS virus mutates into new forms and "escapes" from the immune system. Their findings appear in the March 16 issue of Science.

The researchers found that the immune system is important in pushing the virus to mutate in response to it, but the genetic heritage of the virus itself also plays a major role. All this combines to make it difficult to predict what the virus will do when it needs to mutate to get away from the immune system, Korber said.

According to her, this suggests that a successful HIV vaccine would have to cover a wide number of "escape routes" that the virus might take in the body.

Scientists have long been trying to develop a vaccine against HIV, but the disease has turned out to be extremely stubborn. Among other things, the virus' ability to mutate into new forms has made it difficult to develop a vaccine that can keep up with all the changes. Other types of germs don't adjust so rapidly to the immune system.

In an accompanying commentary, two British scientists speculate that it may be possible to design a "complex" vaccine that would anticipate mutations in the AIDS virus.

Another alternative would be to develop a vaccine that would focus on killing parts of the virus that don't mutate as rapidly, they said. In February, researchers at the U.S. National Institute of Allergy and Infectious Diseases announced in the journal Nature that they had found this type of non-mutating "site of vulnerability" on the surface of HIV, renewing hopes for an effective vaccine.

Ultimately, Korber is hopeful about the possible effects of her research, as well. It may bring scientists "one tiny nudge closer to a vaccine," she said.

More information

Learn more about HIV vaccine research from the Centers for Disease Control & Prevention.