HPV vaccines – A review of the first decade

Abstract

Pre-adolescent girls (9-15years) have the option of receiving a two dose HPV vaccine series at either a six month or one year interval to provide protection from HPV 16, the most prevalent type associated with cervical cancers, as well as several other less prevalent types. This series of vaccinations is highly likely to protect her from HPV infection until she enters the routine screening program, whether that be primary HPV testing or a combination of HPV testing and cytology. The two dose program has been recommended by the World Health Organization (WHO) since 2015. For women 15years and older, the three dose vaccine schedule is still recommended. The past ten years of Gardasil use has provided evidence of reduced HPV 16/18 infections in countries where there has been high coverage. Gardasil9 has replaced Gardasil. Gardasil9 has the same rapid anti-HPV 18 and HPV45 titer loss as Gardasil did. Cervarix remains equivalent to Gardasil9 in the prevention of HPV infections and precancers of any HPV type; Cervarix also has demonstrated sustained high antibody titers for at least 10years. One dose of Cervarix provides protection against HPV 16/18 infection with robust antibody titers well above natural infection titers. This may offer the easiest and most cost effective vaccination program over time, especially in low and lower middle income countries. Cervical cancer screening must continue to control cancer incidence over the upcoming decades. Future studies of prophylactic HPV vaccines, as defined by the WHO, must demonstrate protection against six month type specific persistent infections, not actual cervical cancer precursor disease endpoints, such as cervical intraepithelial neoplasia grade 3 (CIN 3) or adenocarcinoma in situ (AIS). This simplifies and makes less expensive future comparative studies between existing and new generic vaccines.

A Targeted LC‐MS Strategy for Low‐Abundant HLA Class‐I‐Presented Peptide Detection Identifies Novel Human Papillomavirus T‐Cell Epitopes

“…The vast majority of cervical cancer is caused by HPV16 and HPV18 (60 and 15% of cases, respectively) 6, 7. The likelihood to get infected with a high‐risk HPV type and consequently develop cancer was reduced after prophylactic vaccines became available for immunization of adolescents in 2006 8. However, these vaccines have no therapeutic effects in already infected individuals.…”

Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women

“…Cervical cancer is unique among common cancers in that it can be almost totally eradicated. High risk Human Papilloma Virus (HPV) is the primary causative agent of virtually all cases, and since 2006, there are very effective HPV prophylactic vaccines . In addition, it has been reconfirmed recently that all true cervical intraepithelial neoplasia grade 3 lesions (CIN3) can be linked to HPV while 95–98% of CIN3 will test HR‐HPV positive with a validated HPV test .…”

Gynecologic cancers and solid organ transplantation

“…67,68 There is evidence that adherence to recommended cervical cancer screening guidelines can be low in transplant recipients. 67,68 There is evidence that adherence to recommended cervical cancer screening guidelines can be low in transplant recipients.…”