HPV Vaccination: The Position Paper of the Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV)

Abstract

<jats:p>Human papillomavirus (HPV) related cervical cancer represents an issue of public health priority. The World Health Organization recommended the introduction of HPV vaccination in all national public programs. In Europe, vaccines against HPV have been available since 2006. In Italy, vaccination is recommended and has been freely offered to all young girls aged 11 years since 2008. Three prophylactic HPV vaccines are available against high- and low-risk genotypes. The quadrivalent vaccine contains protein antigens for HPV 6, 11, 16, and 18. The bivalent vaccine includes antigens for HPV 16 and 18. The nonavalent vaccine was introduced in 2014, and it targets HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. Clinical trials demonstrated the effectiveness of the three vaccines in healthy young women. Likewise, all vaccines showed an excellent safety profile. The bivalent vaccine provides two doses in subjects aged between 9 and 14 years and three doses in subjects over 14 years of age. The quadrivalent vaccine provides two doses in individuals from 9 to 13 years and three doses in individuals aged 14 years and over. The nonavalent vaccine schedule provides two doses in individuals from 9 to 14 years of age and three doses in individuals aged 15 years and over at the time of the first administration. Preliminary results suggest that the HPV vaccine is effective in the prevention of cervical squamous intraepithelial lesions even after local treatment. Given these outcomes, in general, it is imperative to expand the vaccinated target population. Some interventions to improve the HPV vaccine’s uptake include patient reminders, physicians-focused interventions, school-based vaccinations programs, and social marketing strategies. The Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV) is committed to supporting vaccination programs for children and adolescents with a catch-up program for young adults. The SICPCV also helps clinical and information initiatives in developing countries to decrease the incidence of cervico-vaginal and vulvar pathology.</jats:p>

Surgical Treatment of Vulvar HSIL: Adjuvant HPV Vaccine Reduces Recurrent Disease

“…In order to reduce disease relapse, adjuvant vaccination in HPV related disease is an upcoming issue [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]; this clinical topic is analysed by a very recent review investigating about the use of prophylactic vaccines in patients treated for HPV related pathologies [ 37 ].…”

Simultaneous Detection and Viral DNA Load Quantification of Different Human Papillomavirus Types in Clinical Specimens by the High Analytical Droplet Digital PCR Method

“…In our preliminary investigation, GP5 + GP6 + were tested in ddPCR on: (i) three HR-HPVs, including HPV16 and HPV18, which are considered the most common oncogenic HR-HPVs; (ii) HPV45, which has been frequently found in cervical carcinomas and others malignancies of the anogenital/upper-respiratory tract (Gheit, 2019); (iii) one LR-HPV, HPV11, which has been related to benign genital warts or condylomata acuminata (Gheit, 2019). Notably, HPV16/18/45/11 are all targeted by both quadrivalent and non-avalent vaccines (Ciavattini et al, 2020).…”

Potential Effects of Human Papillomavirus Type Substitution, Superinfection Exclusion and Latency on the Efficacy of the Current L1 Prophylactic Vaccines

“…However, for >15 years, there has been considerable debate on the ability of Cervarix and Gardasil to protect both HPV-positive and -negative women from HPV-associated cervical cancer. For example, it is well known that HPV-negative women vaccinated with either the bivalent or quadrivalent vaccines can still develop CIN lesions positive for HPV types not covered by these products although it is anticipated that the more recently introduced Gardasil 9 should improve this [ 29 , 30 ]. Furthermore, there is also evidence of some cross-protection against other non-vaccine high-risk types for both Cervarix and Gardasil [ 31 , 32 , 33 ].…”