TY - JOUR
T1 - Prophylactic efficacy of a quadrivalent human papillomavirus (HPV) vaccine in women with virological evidence of HPV Infection
AU - Villa, Luisa L.
AU - Perez, Gonzalo
AU - Kjær, Susanne Krüger
AU - Paavonen, Jorma
AU - Lehtinen, Matti
AU - Muñoz, Nubia
AU - Sigurdsson, Kristján
AU - Hernandez-Avila, Mauricio
AU - Iversen, Ole Eric
AU - Thoresen, Steinar
AU - García, Patricia J.
AU - Majewski, Slawomir
AU - Eng, Hseon Tay
AU - Bosch, F. Xavier
AU - Dillner, Joakim
AU - Olsson, Sven Eric
AU - Ault, Kevin A.
AU - Brown, Darron R.
AU - Ferris, Daron Gale
AU - Koutsky, Laura A.
AU - Kurman, Robert J.
AU - Myers, Evan R.
AU - Barr, Eliav
AU - Boslego, John
AU - Bryan, Janine
AU - Esser, Mark T.
AU - Hesley, Teresa M.
AU - Nelson, Micki
AU - Railkar, Radha
AU - James, Margaret
AU - Sattler, Carlos
AU - Taddeo, Frank J.
AU - Thornton, Annemarie R.
AU - Vuocolo, Scott C.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/11/15
Y1 - 2007/11/15
N2 - 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.
AB - 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.
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U2 - 10.1086/522864
DO - 10.1086/522864
M3 - Article
C2 - 18008221
AN - SCOPUS:38049008823
SN - 0022-1899
VL - 196
SP - 1438
EP - 1446
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 10
ER -