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

Villa, Luisa L. ; Perez, Gonzalo ; Kjaer, Susanne Krueger ; Paavonen, Jorma ; Lehtinen, Matti ; Munoz, Nubia ; Sigurdsson, Kristjan ; Hernandez-Avila, Mauricio ; Iversen, Ole Eric and Thoresen, Steinar , et al. (2007) In Journal of Infectious Diseases 196(10). p.1438-1446
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... (More)
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. (Less)
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@article{c0f2b2b7-2f15-4dbf-9928-2b4bd278c00c,
  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.}},
  author       = {{Villa, Luisa L. and Perez, Gonzalo and Kjaer, Susanne Krueger and Paavonen, Jorma and Lehtinen, Matti and Munoz, Nubia and Sigurdsson, Kristjan and Hernandez-Avila, Mauricio and Iversen, Ole Eric and Thoresen, Steinar and Garcia, Patricia J. and Majewski, Slawomir and Tay, Eng Hseon and Bosch, F. Xavier and Dillner, Joakim and Olsson, Sven-Eric and Ault, Kevin A. and Brown, Darron R. and Ferris, Daron G. and Koutsky, Laura A. and Kurman, Robert J. and Myers, Evan R. and Barr, Eliav and Boslego, John and Bryan, Janine and Esser, Mark T. and Hesley, Teresa M. and Nelson, Micki and Railkar, Radha and James, Margaret and Sattler, Carlos and Taddeo, Frank J. and Thornton, Annemarie R. and Vuocolo, Scott C.}},
  issn         = {{1537-6613}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1438--1446}},
  publisher    = {{Oxford University Press}},
  series       = {{Journal of Infectious Diseases}},
  title        = {{Prophylactic efficacy of a quadrivalent human papillomavirus (HPV) vaccine in women with virological evidence of HPV infection}},
  url          = {{http://dx.doi.org/10.1086/522864}},
  doi          = {{10.1086/522864}},
  volume       = {{196}},
  year         = {{2007}},
}