Association of Varying Number of Doses of Quadrivalent Human Papillomavirus Vaccine With Incidence of Condyloma

Herweijer, Eva; Levál, Amy; Ploner, Alexander; Eloranta, Sandra; Simard, Julia F.; Dillner, Joakim; Netterlid, Eva; Sparén, Pär; Arnheim-Dahlström, Lisen

doi:10.1001/jama.2014.95

Cited by 83 publications

(86 citation statements)

References 33 publications

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“…27 An open cohort of 1,045,165 girls and young women aged 10 to 24 y were followed up for a mean duration of 3.8 y Two doses of the vaccine were associated with significant reduction in the risk of genital warts especially in women receiving the first dose of the vaccine below the age of 17 y The incidence rate ratio (IRR) for genital warts among the recipients of 3 doses below 17 y of age was 0.18 (95% CI, 0.15-0.22) compared to unvaccinated women. Two doses were associated with an IRR of 0.29 (95% CI, 0.21-0.40), and even a single dose was associated with an IRR of 0.31 (95% CI, 0.20-0.49).…”

Section: Efficacy Of Less Than 3 Doses To Prevent Genital Wartsmentioning

confidence: 99%

Less than 3 doses of the HPV vaccine – Review of efficacy against virological and disease end points

Basu

Bhatla

Ngoma

et al. 2016

Human Vaccines & Immunotherapeutics

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World Health Organization (WHO) recommended 2 doses of the Human Papillomavirus (HPV) vaccine for girls below 15 y on the basis of the immune-bridging studies demonstrating non-inferior immune response of 2 doses in the adolescent girls compared to 3 doses in the young adult women in whom the efficacy against disease is established. The biological nature of the antigens (virus-like particles) constituting the HPV vaccine is responsible for the vigorous antibody response that may make the third dose redundant. The protection offered by 2 doses has been demonstrated in non-randomized clinical trials to be comparable to that offered by 3 doses against incident and persistent infections of vaccine targeted HPV types. However, results emerging from the ecological and nested case-control studies embedded in the population based screening programs of different countries indicate reduced efficacy of 2 doses against virological and disease end points. Some recent studies observed the protective effect of single dose of the vaccine against incident and persistent infections of the vaccine targeted HPV types to be similar to 3 doses in spite of immunological inferiority. The sample size, duration of follow-ups and number of events were limited in these studies. Longer follow ups of the less than 3 doses cohorts in the ongoing studies as well as appropriately designed and ethically justifiable randomized studies are needed to establish the protection offered by the alternative schedules at least beyond 10 y of vaccination.

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Section: Efficacy Of Less Than 3 Doses To Prevent Genital Wartsmentioning

confidence: 99%

Less than 3 doses of the HPV vaccine – Review of efficacy against virological and disease end points

Basu

Bhatla

Ngoma

et al. 2016

Human Vaccines & Immunotherapeutics

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“…12 This is the basis of the highly effective HPV vaccines that are directed against the L1 proteins of the most common genital HPV types. 13,14 Programmed death ligand 1 (PD L1) is a protein that is capable of strongly modulating the adaptive arm of the immune system. 15,16 PD L1 can bind to its ligands that include PD 1 and CD80 that, in turn, can reduce both the proliferation and activity of the cytotoxic CD8 T cells response to both viral or cancer associated antigens.…”

mentioning

confidence: 99%

Enhanced expression of PD L1 in cervical intraepithelial neoplasia and cervical cancers

et al. 2015

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Programmed death ligand 1 (PD L1) expression can reduce the immune response in both infectious diseases and cancers. We thus examined PD L1 expression in cervical intraepithelial neoplasias (CINs) and cancers since they each reflect infection by human papillomavirus (HPV). PD L1 protein was not evident by immunohistochemistry in histologically normal cervical epithelia (0/55) even when adjacent to CIN or cancer. PD L1 expression was much increased in CINs (20/21 = 95%) and cervical squamous cell cancer (56/70 = 80%) and localized to the dysplastic/neoplastic squamous cells and mononuclear cells, respectively. There was also a significant increase (each Po0.001) in PD L1 detection in mononuclear cells when comparing cervical squamous cell cancers to endometrial (22/115 = 19%) and ovarian adenocarcinomas (5/40 = 13%). Co-expression analyses showed that the primary inflammatory cell that contained PD L1 was the CD8+ lymphocyte that strongly concentrated around the dysplastic CIN cells and nests of invasive squamous cancer cells. These data show that PD L1 is a solid biomarker of productive HPV infection of the cervix and that it is significantly upregulated in both the carcinoma and surrounding inflammatory cells in cervical cancer when compared with other gynecologic malignancies. This suggests that anti-PD L1 therapy may have a role in the treatment of cervical cancer.

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“…15 Although the main goal of HPV vaccination is to prevent cervical cancer, the quadrivalent vaccine also prevents genital condyloma, a clinical outcome which typically develops earlier than cervical cancer. A cohort of over one million females aged 10-24 years living in Sweden (where subsidized and free vaccination programs for girls were in place) were followed between 2006 and 2010 for the incidence of condyloma.…”

Section: Number Of Doses and Vaccine Efficacymentioning

confidence: 99%

HPV Update: Vaccination, Screening, and Associated Disease

et al. 2016

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Human papillomavirus (HPV) infection is the causative agent in cervical cancer, and is associated with numerous other genital cancers, including vulvar, vaginal, and anal cancer. Primary prevention with HPV vaccination is safe and efficacious, and a recently approved HPV vaccine will provide even more extensive protection against several oncogenic HPV strains. Screening strategies for HPV are rapidly evolving, reflecting the essential role that HPV infection plays in cervical cancer. This article highlights new evidence regarding the efficacy of the recently approved 9-valent HPV (9vHPV) vaccine and the use of primary high-risk HPV testing in cervical cancer screening. We consider the utility of urinary HPV testing in routine clinical practice and review current guidelines regarding anal HPV screening.

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Association of Varying Number of Doses of Quadrivalent Human Papillomavirus Vaccine With Incidence of Condyloma

Cited by 83 publications

References 33 publications

Less than 3 doses of the HPV vaccine – Review of efficacy against virological and disease end points

Less than 3 doses of the HPV vaccine – Review of efficacy against virological and disease end points

Enhanced expression of PD L1 in cervical intraepithelial neoplasia and cervical cancers

HPV Update: Vaccination, Screening, and Associated Disease

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