Reduced Prevalence of Vulvar HPV16/18 Infection Among Women Who Received the HPV16/18 Bivalent Vaccine: A Nested Analysis Within the Costa Rica Vaccine Trial

Kuhs, Krystle A. Lang; González, Paula; Rodríguez, Ana Cecilia; Doorn, Leen–Jan van; Schiffman, Mark; Struijk, Linda; Chen, Sabrina; Quint, Wim; Lowy, Douglas R.; Porras, Carolina; DelVecchio, Corey; Jiménez, Silvia; Safaeian, Mahboobeh; Schiller, John T.; Wacholder, Sholom; Herrero, Rolando; Hildesheim, Allan; Kreimer, Aimée R.

doi:10.1093/infdis/jiu357

Cited by 17 publications

(5 citation statements)

References 26 publications

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“…Non-cervical disease endpoints were planned for regulatory evidence only for Gardasil and Gardasil9. The WHO vaginal/vulvar endpoints are VaIN 2/3 and VIN 2/3 disease for which Gardasil has [56], and efficacy against oral HPV 16/18 infection was 93% (95% CI: 63, 100) [55] four years after vaccination. In the full analysis approximating the intent to treat population, the efficacy against anal HPV 16/18 infection was 62% (95% CI: 47, 73) four years after vaccination; and efficacy against anal non-vaccine related HPV 31/33/45 infections was 49% (95% CI: 30, 64) [57].…”

Section: Efficacy Against Non-cervical Endpointsmentioning

confidence: 99%

HPV vaccines – A review of the first decade

Harper

DeMars

2017

Gynecologic Oncology

343

249

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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.

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Section: Efficacy Against Non-cervical Endpointsmentioning

confidence: 99%

HPV vaccines – A review of the first decade

Harper

DeMars

2017

Gynecologic Oncology

343

249

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“…More importantly, this subtype may be largely preventable. Results of clinical trials in other gynecological cancers suggest that the incidence of HPV-18 infection and resultant cancers, “will decrease at several anatomical sites in women who receive the prophylactic HPV vaccines before exposure to the virus” 16 .…”

Section: Discussionmentioning

confidence: 99%

In North America, Some Ovarian Cancers Express the Oncogenes of Preventable Human Papillomavirus HPV-18

Roos

Orlando

Fagerstrom

et al. 2015

Sci Rep

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Some researchers in other regions have recommended human papillomavirus (HPV) vaccination to reduce risk of ovarian cancer, but not in North America, where evidence has previously suggested no role for HPV in ovarian cancer. Here we use a large sample of ovarian cancer transcriptomes (RNA-Seq) from The Cancer Genome Atlas (TCGA) database to address whether HPV is involved with ovarian cancer in North America. We estimate that a known high-risk type of HPV (type 18) is present and active in 1.5% of cases of ovarian epithelial cancers in the US and Canada. Our detection methods were verified by negative and positive controls, and our sequence matches indicated high validity, leading to strong confidence in our conclusions. Our results indicate that previous reports of zero prevalence of HPV in North American cases of ovarian cancer should not be considered conclusive. This is important because currently used vaccines protect against the HPV-18 that is active in ovarian tumors and, therefore, may reduce risk in North America of cancers of the ovaries as well as of the cervix and several other organ sites.

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“…Non-cervical protection was demonstrated in the Costa Rican vaccine trial, which showed an 84% reduction in anal infections of HPV16/18 in young women four years after vaccination ( Kreimer et al., 2011 ). In vaccine trials involving about 1,000 women, HPV16/18 vulvar infections were reduced by 50% ( Lang Kuhs et al., 2014 ). Although the bivalent vaccines have less protection for two HPV types than the quadrivalent vaccines, they have a better preventive effect on advanced lesions.…”

Section: Research Progress Of Hpv Prophylactic Vaccinesmentioning

confidence: 99%

Prophylactic and Therapeutic HPV Vaccines: Current Scenario and Perspectives

Ma²,

Zhang³

et al. 2022

Front. Cell. Infect. Microbiol.

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Persistent human papillomavirus (HPV) infection is recognized as the main cause of cervical cancer and other malignant cancers. Although early detection and treatment can be achieved by effective HPV screening methods and surgical procedures, the disease load has not been adequately mitigated yet, especially in the underdeveloped areas. Vaccine, being regarded as a more effective solution, is expected to prevent virus infection and the consequent diseases in the phases of both prevention and treatment. Currently, there are three licensed prophylactic vaccines for L1-VLPs, namely bivalent, quadrivalent and nonavalent vaccine. About 90% of HPV infections have been effectively prevented with the implementation of vaccines worldwide. However, no significant therapeutic effect has been observed on the already existed infections and lesions. Therapeutic vaccine designed for oncoprotein E6/E7 activates cellular immunity rather than focuses on neutralizing antibodies, which is considered as an ideal immune method to eliminate infection. In this review, we elaborate on the classification, mechanism, and clinical effects of HPV vaccines for disease prevention and treatment, in order to make improvements to the current situation of HPV vaccines by provoking new ideas.

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Reduced Prevalence of Vulvar HPV16/18 Infection Among Women Who Received the HPV16/18 Bivalent Vaccine: A Nested Analysis Within the Costa Rica Vaccine Trial

Abstract: NCT00128661.

Cited by 17 publications

References 26 publications

HPV vaccines – A review of the first decade

HPV vaccines – A review of the first decade

In North America, Some Ovarian Cancers Express the Oncogenes of Preventable Human Papillomavirus HPV-18

Prophylactic and Therapeutic HPV Vaccines: Current Scenario and Perspectives

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