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 Generally HPV-Naive Women Aged 16-26 Years

Research output: Chapter in Book/Report/Conference proceedingPaper in conference proceeding


Background. Human papillomavirus (HPV)-6/11/16/18 vaccine reduces the risk of HPV-6/11/16/18-related cervical intraepithelial neoplasia (CIN) 1-3 or adenocarcinoma in situ (AIS). Here, its impact on CIN1-3/AIS associated with nonvaccine oncogenic HPV types was evaluated. Methods. We enrolled 17,622 women aged 16-26 years. All underwent cervicovaginal sampling and Pap testing at regular intervals for up to 4 years. HPV genotying was performed for biopsy samples, and histological diagnoses were determined by a pathology panel. Analyses were conducted among subjects who were negative for 14 HPV types on day 1. Prespecified analyses included infection of >= 6 months' duration and CIN1-3/AIS due to the 2 and 5 most common HPV types in cervical cancer after HPV types 16 and 18, as well as all tested nonvaccine types. Results. Vaccination reduced the incidence of HPV-31/45 infection by 40.3% (95% confidence interval [CI], 13.9% to 59.0%) and of CIN1-3/AIS by 43.6% (95% CI, 12.9% to 64.1%), respectively. The reduction in HPV-31/33/45/52/58 infection and CIN1-3/AIS was 25.0% (95% CI, 5.0% to 40.9%) and 29.2% (95% CI, 8.3% to 45.5%), respectively. Efficacy for CIN2-3/AIS associated with the 10 nonvaccine HPV types was 32.5% (95% CI, 6.0% to 51.9%). Reductions were most notable for HPV-31. Conclusions. HPV-6/11/16/18 vaccine reduced the risk of CIN2-3/AIS associated with nonvaccine types responsible for similar to 20% of cervical cancers. The clinical benefit of cross-protection is not expected to be fully additive to the efficacy already observed against HPV-6/11/16/18-related disease, because women may have >1 CIN lesion, each associated with a different HPV type.


  • Darron R. Brown
  • Susanne K. Kjaer
  • Kristjan Sigurdsson
  • Ole-Erik Iversen
  • Mauricio Hernandez-Avila
  • Cosette M. Wheeler
  • Gonzalo Perez
  • Laura A. Koutsky
  • Eng Hseon Tay
  • Patricia Garcia
  • Kevin A. Ault
  • Suzanne M. Garland
  • Sepp Leodolter
  • Sven-Eric Olsson
  • Grace W. K. Tang
  • Daron G. Ferris
  • Jorma Paavonen
  • Marc Steben
  • F. Xavier Bosch
  • Joakim Dillner
  • And 16 others
  • Elmar A. Joura
  • Robert J. Kurman
  • Slawomir Majewski
  • Nubia Munoz
  • Evan R. Myers
  • Luisa L. Villa
  • Frank J. Taddeo
  • Christine Roberts
  • Amha Tadesse
  • Janine Bryan
  • Lisa C. Lupinacci
  • Katherine E. D. Giacoletti
  • Heather L. Sings
  • Margaret James
  • Teresa M. Hesley
  • Eliav Barra
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Infectious Medicine
Original languageEnglish
Title of host publicationJournal Of Infectious Diseases
PublisherUniversity of Chicago Press
Publication statusPublished - 2009
Publication categoryResearch
Event24th International Papillomavirus Conference and Clinical Workshop - Beijing, PEOPLES R CHINA
Duration: 2007 Nov 32007 Nov 9

Publication series

ISSN (Print)0022-1899


Conference24th International Papillomavirus Conference and Clinical Workshop