Prophylactic efficacy of a quadrivalent human papillomavirus (HPV) vaccine in women with virological evidence of HPV infection

Research output: Contribution to journalArticle

Abstract

Background. A quadrivalent (types 6, 11, 16, and 18) human papillomavirus (HPV) L1 virus-like-particle (VLP) vaccine has been shown to be 95%-100% effective in preventing cervical and genital disease related to HPV-6,-11,-16, and-18 in 16-26-year-old women naive for HPV vaccine types. Because most women in the general population are sexually active, some will have already been infected with >= 1 HPV vaccine types at the time vaccination is offered. Here, we assessed whether such infected women are protected against disease caused by the remaining HPV vaccine types. Methods. Two randomized, placebo-controlled trials of the quadrivalent (types 6, 11, 16, and 18) HPV vaccine enrolled 17,622 women without consideration of baseline HPV status. Among women infected with 1-3 HPV vaccine types at enrollment, efficacy against genital disease related to the HPV vaccine type or types for which subjects were naive was assessed. Results. Vaccination was 100% effective (95% confidence interval [CI], 79%-100%) in preventing incident cervical intraepithelial neoplasia 2 or 3 or cervical adenocarcinoma in situ caused by the HPV type or types for which the women were negative at enrollment. Efficacy for preventing vulvar or vaginal HPV-related lesions was 94% (95% CI, 81%-99%). Conclusions. Among women positive for 1-3 HPV vaccine types before vaccination, the quadrivalent HPV vaccine protected against neoplasia caused by the remaining types. These results support vaccination of the general population without prescreening.

Details

Authors
  • Luisa L. Villa
  • Gonzalo Perez
  • Susanne Krueger Kjaer
  • Jorma Paavonen
  • Matti Lehtinen
  • Nubia Munoz
  • Kristjan Sigurdsson
  • Mauricio Hernandez-Avila
  • Ole Eric Iversen
  • Steinar Thoresen
  • Patricia J. Garcia
  • Slawomir Majewski
  • Eng Hseon Tay
  • F. Xavier Bosch
  • Joakim Dillner
  • Sven-Eric Olsson
  • Kevin A. Ault
  • Darron R. Brown
  • Daron G. Ferris
  • Laura A. Koutsky
  • And 14 others
  • Robert J. Kurman
  • Evan R. Myers
  • Eliav Barr
  • John Boslego
  • Janine Bryan
  • Mark T. Esser
  • Teresa M. Hesley
  • Micki Nelson
  • Radha Railkar
  • Margaret James
  • Carlos Sattler
  • Frank J. Taddeo
  • Annemarie R. Thornton
  • Scott C. Vuocolo
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Infectious Medicine
Original languageEnglish
Pages (from-to)1438-1446
JournalJournal of Infectious Diseases
Volume196
Issue number10
Publication statusPublished - 2007
Publication categoryResearch
Peer-reviewedYes