Cross-protective efficacy of HPV-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by non-vaccine oncogenic HPV types: 4-year end-of-study analysis of the randomised, double-blind PATRICIA trial

The Road Ahead for Cervical Cancer Prevention and Control

“…Finally, epidemiology studies investigating the potential for hpv type replacement (that is, the scenario in which other hpv types take over the niches vacated by the eradication of vaccine target types) have so far provided no strong evidence of natural type competition, which is considered a requirement for type replacement to occur in vaccinated populations 60 . Meanwhile, evidence of cross-type protection (primarily for phylogenetically related types 31, 33, and 45) suggests that the benefit of vaccination might ultimately be greater than expected 61,62 .…”

Burden of Cervical, Anal, and Oral HPV in an Inner-City Pre-vaccine Adolescent Population

“…This highlights the importance of early vaccination, although vaccinating sexually active adolescents may still provide a benefit, either against other HPV types targeted by the vaccine (e.g., for HPV16 among those HPV-DNA positive for HPV18 only and vice versa, which still include the majority of adolescents tested), or for phylogenetically related alpha-9 and -7 HPV types (e.g., HPV31 and 45) that may benefit from cross-protection. 12,13 This study shows only moderate concordance in detection of HPV vaccine high-risk (HPV16 and 18) and related types (HPV31 and 45) between cervical and extra-cervical sites. Although the implications of prevalent anal or oral HPV infections on vaccine efficacy are unknown, this suggests post-vaccine surveillance studies of cervical, anal, and oral HPV in real-world settings and high-risk populations are warranted.…”

“…The majority of subjects (82 %) had had at least three sexual partners at the time of enrollment, and 53 % had four or more partners. The overall median age at first vaginal intercourse was 14 years (range [12][13][14][15][16][17][18][19], and history of sexually transmitted infections (STIs; 47 %) was high, including for Chlamydia (33 %). Over a third of cervical Paps collected at enrollment showed atypical cells of undetermined significance (ASCUS; 23 %) or presence of squamous intraepithelial lesions (LSIL 15 %/HSIL 1 %).…”

Role of HPV Vaccination in Fighting Cervical Cancer

“…The bivalent and quadrivalent vaccines are also known to have cross reactivity against some types. HPV 16 is phylogenetically related to HPV strains 31, 33,52 and 58 and HPV 18 is related to HPV strains 45 (15,16) , so these vaccines do actually give some protection against these strains. However, being protected against 6, 11, 16, 18, 31, 33, 45, 52 and 58 are still not even half of the 40 known types or even 20 of the low-risk and high-risk types.…”

“…The support of government funding to make HPV vaccines as national health program is crucial, although, in reality, it is a difficult decision (31) . Cost is one of the major barriers in reducing cervical cancer, in the USA a survey was done in 2008 found that only 12% among female adolescents aged [11][12][13][14][15][16][17] To who had no health insurance received HPV vaccination (32) . This shows that public is not willing to pay to get vaccinated.…”