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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 Generally HPV-Naive Women Aged 16-26 Years

Brown, Darron R.; Kjaer, Susanne K.; Sigurdsson, Kristjan; Iversen, Ole-Erik; Hernandez-Avila, Mauricio; Wheeler, Cosette M.; Perez, Gonzalo; Koutsky, Laura A.; Tay, Eng Hseon and Garcia, Patricia, et al. (2009) 24th International Papillomavirus Conference and Clinical Workshop In Journal Of Infectious Diseases 199(7). p.926-935
Abstract
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... (More)
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. (Less)
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Journal Of Infectious Diseases
volume
199
issue
7
pages
926 - 935
publisher
University of Chicago Press
conference name
24th International Papillomavirus Conference and Clinical Workshop
external identifiers
  • wos:000264056600003
  • scopus:65549109389
ISSN
0022-1899
DOI
10.1086/597307
language
English
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1ca62aba-0c4a-46c1-baca-2cab4b0edac0 (old id 1404704)
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2009-06-15 09:45:44
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2017-12-10 04:21:13
@inproceedings{1ca62aba-0c4a-46c1-baca-2cab4b0edac0,
  abstract     = {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.},
  author       = {Brown, Darron R. and Kjaer, Susanne K. and Sigurdsson, Kristjan and Iversen, Ole-Erik and Hernandez-Avila, Mauricio and Wheeler, Cosette M. and Perez, Gonzalo and Koutsky, Laura A. and Tay, Eng Hseon and Garcia, Patricia and Ault, Kevin A. and Garland, Suzanne M. and Leodolter, Sepp and Olsson, Sven-Eric and Tang, Grace W. K. and Ferris, Daron G. and Paavonen, Jorma and Steben, Marc and Bosch, F. Xavier and Dillner, Joakim and Joura, Elmar A. and Kurman, Robert J. and Majewski, Slawomir and Munoz, Nubia and Myers, Evan R. and Villa, Luisa L. and Taddeo, Frank J. and Roberts, Christine and Tadesse, Amha and Bryan, Janine and Lupinacci, Lisa C. and Giacoletti, Katherine E. D. and Sings, Heather L. and James, Margaret and Hesley, Teresa M. and Barra, Eliav},
  booktitle    = {Journal Of Infectious Diseases},
  issn         = {0022-1899},
  language     = {eng},
  number       = {7},
  pages        = {926--935},
  publisher    = {University of Chicago Press},
  title        = {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},
  url          = {http://dx.doi.org/10.1086/597307},
  volume       = {199},
  year         = {2009},
}