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The Impact of Quadrivalent Human Papillomavirus (HPV; Types 6, 11, 16, and 18) L1 Virus-Like Particle Vaccine on Infection and Disease Due to Oncogenic Nonvaccine HPV Types in Sexually Active Women Aged 16-26 Years
- Wheeler, Cosette M. (author)
- Kjaer, Susanne K. (author)
- Sigurdsson, Kristjan (author)
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- Iversen, Ole-Erik (author)
- Hernandez-Avila, Mauricio (author)
- Perez, Gonzalo (author)
- Brown, Darron R. (author)
- Koutsky, Laura A. (author)
- Tay, Eng Hseon (author)
- Garcia, Patricia (author)
- Ault, Kevin A. (author)
- Garland, Suzanne M. (author)
- Leodolter, Sepp (author)
- Tang, Grace W. K. (author)
- Ferris, Daron G. (author)
- Paavonen, Jorma (author)
- Steben, Marc (author)
- Bosch, F. Xavier (author)
- Joura, Elmar A. (author)
- Kurman, Robert J. (author)
- Majewski, Slawomir (author)
- Munoz, Nubia (author)
- Myers, Evan R. (author)
- Villa, Luisa L. (author)
- Taddeo, Frank J. (author)
- Roberts, Christine (author)
- Tadesse, Amha (author)
- Bryan, Janine (author)
- Lupinacci, Lisa C. (author)
- Giacoletti, Katherine E. D. (author)
- James, Margaret (author)
- Vuocolo, Scott (author)
- Hesley, Teresa M. (author)
- Barr, Eliav (author)
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- (creator_code:org_t)
- Oxford University Press (OUP), 2009
- 2009
- English.
- In: Journal Of Infectious Diseases. - : Oxford University Press (OUP). - 0022-1899 .- 1537-6613. ; 199:7, s. 936-944
- Conference paper (peer-reviewed)
Abstract
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- Background. We evaluated the impact of a quadrivalent human papillomavirus (HPV) vaccine on infection and cervical disease related to 10 nonvaccine HPV types (31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) associated with >20% of cervical cancers. The population evaluated included HPV-naive women and women with preexisting HPV infection and/or HPV-related disease at enrollment. Methods. Phase 3 efficacy studies enrolled 17,622 women aged 16-26 years. Subjects underwent cervicovaginal sampling and Pap testing on day 1 and then at 6-12-month intervals for up to 4 years. HPV typing was performed on samples from enrollment and follow-up visits, including samples obtained for diagnosis or treatment of HPV-related disease. All subjects who received >= 1 dose and returned for follow-up were included. Results. Vaccination reduced the rate of HPV-31/33/45/52/58 infection by 17.7% (95% confidence interval [CI], 5.1% to 28.7%) and of cervical intraepithelial neoplasia (CIN) 1-3 or adenocarcinoma in situ (AIS) by 18.8% (95% CI, 7.4% to 28.9%). Vaccination also reduced the rate of HPV-31/58/59-related CIN1-3/AIS by 26.0% (95% CI, 6.7% to 41.4%), 28.1% (95% CI, 5.3% to 45.6%), and 37.6% (95% CI, 6.0% to 59.1%), respectively. Although a modest reduction in HPV-31/33/45/52/58-related CIN2 or worse was observed, the estimated reduction was not statistically significant. Conclusions. These cross-protection results complement the vaccine's prophylactic efficacy against disease associated with HPV-6, -11, -16, and - 18. Long-term monitoring of vaccinated populations are needed to fully ascertain the population-based impact and public health significance of these findings.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
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- Brown, Darron R.
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- Garcia, Patricia
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- Ferris, Daron G.
- Paavonen, Jorma
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