Early Direct and Indirect Impact of Quadrivalent HPV (4HPV) Vaccine on Genital Warts: a Systematic Review

Overview

Journal Adv Ther

Date 2015 Jan 27

PMID 25620536

Citations 16

Authors

Luciano Mariani

Patrizia Vici

Barbara Suligoi

Giovanni Checcucci-Lisi

Rosybel Drury

Affiliations

Soon will be listed here.

Abstract

Introduction: Since 2007, many countries have implemented national human papillomavirus (HPV) vaccination programs with the quadrivalent HPV (4HPV) vaccine that has been shown to be efficacious in clinical trials involving 25,000 subjects. Two vaccine serotypes, HPV16 and 18, are responsible for cervical cancer and other HPV-related cancers, but the impact of the 4HPV vaccine on these cancers cannot be seen immediately as there is a considerable lag between infection with HPV and cancer development. The other two serotypes, HPV6 and 11, are responsible for genital warts (GWs), which develop within a few months after infection, making GWs an early clinical endpoint for the assessment of the impact of 4HPV vaccination.

Methods: We performed a systematic literature search in PubMed to identify all published studies on 4HPV vaccination, including those that assessed the impact of 4HPV vaccination programs on the incidence of GWs at a population level around the world.

Results: A total of 354 records were identified in the PubMed search. After screening and obtaining full papers for 56 publications, 16 publications presenting data on the impact or effectiveness of 4HPV vaccination on GWs were identified. These reported data on the impact or effectiveness of 4HPV in six countries [Australia (n = 6), New Zealand (n = 2), United States (n = 3), Denmark (n = 2), Germany (n = 1), and Sweden (n = 2)]. In Australia, no GWs were diagnosed in women aged <21 years who reported being vaccinated. A 92.6% reduction in GWs incidence was reported for all women in this age group, where the vaccine uptake rate (VUR) was 70% for 3 doses. The highest reductions were reported in countries with high VURs, mostly through school-based vaccination programs, although high VURs were obtained with some non-school-based programs.

Conclusion: The results are coherent with the GWs incidence reduction reported in clinical trials and are an early indicator of what can be expected for the long-term clinical impact on vaccine-type HPV-related cancers.

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References

Gertig D, Brotherton J, Budd A, Drennan K, Chappell G, Saville A . Impact of a population-based HPV vaccination program on cervical abnormalities: a data linkage study. BMC Med. 2013; 11:227. PMC: 4015688. DOI: 10.1186/1741-7015-11-227. View

Baldo V, Cocchio S, Buja A, Baldovin T, Furlan P, Bertoncello C . Hospitalization for diseases attributable to human papillomavirus in the Veneto Region (North-East Italy). BMC Infect Dis. 2013; 13:462. PMC: 3851564. DOI: 10.1186/1471-2334-13-462. View

Baldur-Felskov B, Dehlendorff C, Munk C, Kjaer S . Early impact of human papillomavirus vaccination on cervical neoplasia--nationwide follow-up of young Danish women. J Natl Cancer Inst. 2014; 106(3):djt460. DOI: 10.1093/jnci/djt460. View

Baio G, Capone A, Marcellusi A, Mennini F, Favato G . Economic burden of human papillomavirus-related diseases in Italy. PLoS One. 2012; 7(11):e49699. PMC: 3504125. DOI: 10.1371/journal.pone.0049699. View

Desai S, Wetten S, Woodhall S, Peters L, Hughes G, Soldan K . Genital warts and cost of care in England. Sex Transm Infect. 2011; 87(6):464-8. PMC: 3253068. DOI: 10.1136/sti.2010.048421. View

Merckx M, Broeck D, Benoy I, Depuydt C, Weyers S, Arbyn M . Early effects of human papillomavirus vaccination in Belgium. Eur J Cancer Prev. 2014; 24(4):340-2. DOI: 10.1097/CEJ.0000000000000067. View

Harrison C, Britt H, Garland S, Conway L, Stein A, Pirotta M . Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study. PLoS One. 2014; 9(9):e105967. PMC: 4152193. DOI: 10.1371/journal.pone.0105967. View

Wilson N, Morgan J, Baker M . Evidence for effectiveness of a national HPV vaccination programme: national prescription data from New Zealand. Sex Transm Infect. 2014; 90(2):103. DOI: 10.1136/sextrans-2013-051037. View

Dasbach E, Insinga R, Elbasha E . The epidemiological and economic impact of a quadrivalent human papillomavirus vaccine (6/11/16/18) in the UK. BJOG. 2008; 115(8):947-56. DOI: 10.1111/j.1471-0528.2008.01743.x. View

10.

Hariri S, Markowitz L, Dunne E, Unger E . Population impact of HPV vaccines: summary of early evidence. J Adolesc Health. 2013; 53(6):679-82. PMC: 7499050. DOI: 10.1016/j.jadohealth.2013.09.018. View

11.

Clarke E, Board C, Patel N, Atkinson L, Tulloch H, Patel R . Why are anogenital warts diagnoses decreasing in the U.K.: bivalent human papillomavirus (HPV) vaccine cross-protection or failure to examine?. Sex Transm Infect. 2014; 90(8):587. DOI: 10.1136/sextrans-2013-051480. View

12.

Blomberg M, Dehlendorff C, Munk C, Kjaer S . Strongly decreased risk of genital warts after vaccination against human papillomavirus: nationwide follow-up of vaccinated and unvaccinated girls in Denmark. Clin Infect Dis. 2013; 57(7):929-34. DOI: 10.1093/cid/cit436. View

13.

Markowitz L, Dunne E, Saraiya M, Lawson H, Chesson H, Unger E . Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007; 56(RR-2):1-24. View

14.

Munoz N, Kjaer S, Sigurdsson K, Iversen O, Hernandez-Avila M, Wheeler C . Impact of human papillomavirus (HPV)-6/11/16/18 vaccine on all HPV-associated genital diseases in young women. J Natl Cancer Inst. 2010; 102(5):325-39. DOI: 10.1093/jnci/djp534. View

15.

. Adult vaccination coverage--United States, 2010. MMWR Morb Mortal Wkly Rep. 2012; 61(4):66-72. View

16.

Smith M, Liu B, McIntyre P, Menzies R, Dey A, Canfell K . Fall in genital warts diagnoses in the general and indigenous Australian population following implementation of a national human papillomavirus vaccination program: analysis of routinely collected national hospital data. J Infect Dis. 2014; 211(1):91-9. DOI: 10.1093/infdis/jiu370. View

17.

Kavanagh K, Pollock K, Potts A, Love J, Cuschieri K, Cubie H . Introduction and sustained high coverage of the HPV bivalent vaccine leads to a reduction in prevalence of HPV 16/18 and closely related HPV types. Br J Cancer. 2014; 110(11):2804-11. PMC: 4037824. DOI: 10.1038/bjc.2014.198. View

18.

Szarewski A, Skinner S, Garland S, Romanowski B, Schwarz T, Apter D . Efficacy of the HPV-16/18 AS04-adjuvanted vaccine against low-risk HPV types (PATRICIA randomized trial): an unexpected observation. J Infect Dis. 2013; 208(9):1391-6. PMC: 3789574. DOI: 10.1093/infdis/jit360. View

19.

Wiley D, Douglas J, Beutner K, Cox T, Fife K, Moscicki A . External genital warts: diagnosis, treatment, and prevention. Clin Infect Dis. 2002; 35(Suppl 2):S210-24. DOI: 10.1086/342109. View

20.

Baandrup L, Blomberg M, Dehlendorff C, Sand C, Andersen K, Kjaer S . Significant decrease in the incidence of genital warts in young Danish women after implementation of a national human papillomavirus vaccination program. Sex Transm Dis. 2013; 40(2):130-5. DOI: 10.1097/OLQ.0b013e31827bd66b. View