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Genital Warts — SCE Infectious Diseases MCQ

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EasySTIsGenital WartsSCE Infectious Diseases

A 25-year-old woman with HIV on ART develops genital warts (condylomata acuminata). She is HPV-vaccinated (bivalent vaccine — Cervarix — covering HPV 16 and 18 only). Why did she still develop genital warts?

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Correct answer: E — Genital warts are caused by HPV 6 and 11 (low-risk types), which are NOT covered by the bivalent vaccine

Genital warts are caused by low-risk HPV types 6 and 11 (~90% of cases). The bivalent vaccine (Cervarix) only covers high-risk types 16 and 18 (cervical cancer prevention) and does NOT protect against HPV 6/11. The quadrivalent (Gardasil) and nonavalent (Gardasil 9) vaccines include HPV 6 and 11 and do protect against genital warts. The UK switched from Cervarix to Gardasil 9 in 2023. This patient received the older bivalent vaccine. Treatment of warts is with topical Podophyllotoxin, Imiquimod, or cryotherapy.

Reference: BASHH 2019 – Anogenital warts; UKHSA 2024 – Green Book Ch 18a: HPV