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This Week in JAMA: Apr 13, 2011

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In JAMA this week, researchers in Seattle and Vietnam present findings from a study of immunogenicity and reactogenicity of alternative schedules of the quadrivalent HPV vaccine in Vietnam. Although the HPV vaccine can reduce morbidity and mortality of cervical cancer, the three-dose schedule over six months is often a barrier to introduction and dissemination of the vaccine in low-resource countries, the authors write. The team assessed four different schedules for vaccine delivery in 903 adolescent girls, and found that administration of the vaccine on both standard and alternative schedules was immunogenic and well-tolerated. "The use of two alternative dosing schedules (at 0, 3, and 9 months and at 0, 6, and 12 months) compared with a standard schedule (at 0, 2, and 6 months) did not result in inferior antibody concentrations," the authors write.

Also in JAMA this week, NCI and CDC researchers present findings from a trial of the proportions of certain cancers in the US in people with AIDS from 1980 to 2007. They found that in that time period, an estimated 81.6 percent of Kaposi sarcoma cases, 6 percent of diffuse large B-cell lymphomas, 19.9 percent of Burkitt lymphomas, 27.1 percent of central nervous system lymphomas, and 0.42 percent of cervical cancers in the US occurred in people with AIDS, peaking in the 1990s and then declining starting in 2001. "In the United States, the estimated proportions of AIDS-defining malignancies that occurred among persons with AIDS were substantial, particularly for Kaposi sarcoma and some non-Hodgkin lymphomas," the authors write. "The HIV epidemic has likely contributed to the overall numbers of these cancers in the United States."

And finally in JAMA this week, Princeton's Richard Stein says there is an epigenetic link between infectious diseases and cancer. The idea that certain viruses, like hepatitis B and HPV, are causally linked to cancer is starting to gain acceptance in oncology, and more than 20 percent of cancers have been causally linked to human pathogens since the relationship was discovered in 1911, Stein says. "Why an infection is sometimes controlled and on other occasions progresses to malignant tumors is still a mystery, but epigenetic changes increasingly emerge as having a causative role," he adds.

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