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INTRODUCTION: HPV is a major cause of anogenital, oropharyngeal and penile cancers. Currently, there are three safe and effective HPV vaccines, however introducing them in the Middle East is slow for various social, cultural and religious reasons. METHODS: At the women health center of the AUBMC, HPV vaccination was offered to women and their daughters since 2007. We will present a retrospective review of a prospectively collected database on 563 Lebanese females who received these vaccines. RESULTS: From 2007 to 2017, a total of 563 females were HPV vaccinated. (379 (67%) had Gardasil and 183 (33%) had Cervarix; P=0.00). Their average age was 25.64±5.86(12.16-51.12). hundred 449 (87%) completed 3 doses and 67 (13%) took only 2 doses. The 3 doses completion was highest between 2007-2013 [329/449 (72%)] while the 2 doses completion was more common from 2013-2017 [47/57 (70%)]. 2/175 (1.13%) of those who received Gardasil had subsequent abnormal Pap smears (mostly LSIL) after an average of 33 months, while 5/91 (5.5%) of those who received Cervarix had abnormal Pap smears [ASCUS: 3/91 (3.3%); HSIL: 2/91 (2.2%,) after an average of 5 months and 1 month respectively]. The average abnormal cytology rates at AUBMC is 1.9-2.2% during that period of time. CONCLUSION: We report successful introduction and continuation of HPV vaccine into our private patient Middle-Eastern population. Longer follow-up is needed to assess the proper impact on genital warts, pre-cancerous genital lesions and genital and other cancers.

National cervical cancer screening (NCS) programs are mostly lacking in the Middle East. Consequently, most cervical cancers are diagnosed late and are associated with high mortality. Most of these countries practice more or less limited opportunistic screening, which often lacks quality assurance and follow-up care. Lebanon is no exception. 1 A few countries have just started, within a National Cancer Control Plan, to implement NCS programs using either visual inspection with acetic acid (Morocco) or HPV screening (Turkey).Moreover, most Middle Eastern countries lack NCS guidelines, as well as resources for the management of abnormal screening. The

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cardiovascular risk factors of the lymphopenic group : hypertension( 29% vs10% ) graft artery stenosis (17% vs 0%) and acute coronary syndrome (11%vs 0%). Conclusions: In conclusion, our study demonstrates that late lymphopenia is associated with a greater risk of malignancies and infections compared with non-lymphopenic patients, This study should prompt clinicians to evaluate thymic function in patients who have undergone long-term dialysis treatment and doing Further investigation of risk factors for persistent post-transplant lymphopenia to improve longterm outcome