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

Luisa L. Villa, Gonzalo Perez, Susanne Krüger Kjær, Jorma Paavonen, Matti Lehtinen, Nubia Muñoz, Kristján Sigurdsson, Mauricio Hernandez-Avila, Ole Eric Iversen, Steinar Thoresen, Patricia J. García, Slawomir Majewski, Hseon Tay Eng, F. Xavier Bosch, Joakim Dillner, Sven Eric Olsson, Kevin A. Ault, Darron R. Brown, Daron Gale Ferris, Laura A. KoutskyRobert 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

Research output: Contribution to journalArticlepeer-review

119 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1438-1446
Number of pages9
JournalJournal of Infectious Diseases
Issue number10
StatePublished - Nov 15 2007

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases


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