Indication of prophylactic vaccines as a tool for secondary prevention in HPV-linked disease

Pieralli, Annalisa; Bianchi, Claudia; Auzzi, Noemi; Fallani, Maria Grazia; Bussani, Cecilia; Fambrini, Massimiliano; Cariti, Giuseppe; Scarselli, Gianfranco; Ghelardi, Alessandro

doi:10.1007/s00404-018-4926-y

Cited by 39 publications

(53 citation statements)

References 20 publications

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“…Of these studies, 39 were excluded, according to our inclusion/exclusion criteria, as they evaluated other therapies than conization/LEEP or provided no adjuvant HPV vaccination. Eleven studies fulfilled the predefined inclusion criteria and were eligible for inclusion in the final meta-analysis [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. In total, the studies comprised 21,310 patients: 4039 (19%) received adjuvant HPV vaccination while 17,271 (81%) surgery alone.…”

Section: Resultsmentioning

confidence: 99%

“…All studies were published between 2012 and 2020. The study designs included: three prospective non-randomized studies [ 41 , 44 , 46 ], one randomized controlled trial [ 42 ], four retrospective studies [ 38 , 43 , 45 , 47 ], and three post-hoc pooled analyses of randomized clinical trials [ 37 , 39 , 40 ]. The women included in the studies were between the years of 15 and 89.…”

Section: Resultsmentioning

confidence: 99%

“…The median follow-up time across the studies ranged from 2 to 5 years. HPV vaccination was administered after surgical treatment in nine studies [ 37 , 38 , 39 , 40 , 41 , 42 , 45 , 46 , 47 ], while either shortly before or after surgery in the other two studies [ 43 , 44 ]. The type of vaccine used was quadrivalent (against HPV 6/11/16/18 genotypes) in four studies [ 37 , 38 , 41 , 42 ] and bivalent (against HPV 16/18 genotypes) in two [ 39 , 40 ], whereas the other five studies [ 43 , 44 , 45 , 46 , 47 ] used both vaccines.…”

Section: Resultsmentioning

confidence: 99%

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Adjuvant HPV Vaccination to Prevent Recurrent Cervical Dysplasia after Surgical Treatment: A Meta-Analysis

et al. 2021

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Objective: The aim of this meta-analysis was to discuss evidence supporting the efficacy of adjuvant human papillomavirus (HPV) vaccination in reducing the risk of recurrent cervical intraepithelial neoplasia (CIN) 2 or greater after surgical treatment. Methods: A systematic literature search was performed for studies reporting the impact of HPV vaccination on reducing the risk of recurrence of CIN 2+ after surgical excision. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI). Results: Eleven studies met the inclusion criteria and were selected for analysis. In total, 21,310 patients were included: 4039 (19%) received peri-operational adjuvant HPV vaccination while 17,271 (81%) received surgery alone. The recurrence of CIN 2+ after treatment was significantly lower in the vaccinated compared with the unvaccinated group (OR 0.35; 95% CI 0.21–0.56; p < 0.0001). The recurrence of CIN 1+ after treatment was significantly lower in the vaccinated compared with the unvaccinated group (OR 0.51; 95% CI 0.31–0.83; p = 0.006). A non-significant trend of reduction rate of HPV persistence was observed in the vaccinated compared with the unvaccinated cohorts (OR was 0.84; 95% CI 0.61–1.15; p = 0.28). Conclusions: HPV vaccination, in adjuvant setting, is associated with a reduced risk of recurrent CIN 1+ and CIN 2+ after surgical treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Adjuvant HPV Vaccination to Prevent Recurrent Cervical Dysplasia after Surgical Treatment: A Meta-Analysis

et al. 2021

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“…31 This alleged crossreactivity between HPV types covered and not covered by the vaccines may be based on the homology and similar structure of the T-helper cells (CD4 receptor), which are conserved due to a cross-linking function within the L1 virus-like particle. 32 In other HPV-related diseases such as head and neck cancers, 33 cervical diseases, 4,19,34 and recurrent respiratory papillomatosis, 35 the vaccination has been demonstrated as a promising and seemingly safe strategy of secondary prevention.…”

Section: Discussionmentioning

confidence: 99%

Could the human papillomavirus vaccine prevent recurrence of ano-genital warts?: a systematic review and meta-analysis

Husein‐ElAhmed¹

2020

Int J STD AIDS

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Human papillomavirus (HPV) is the most prevalent sexually transmitted infection worldwide and ano-genital warts (AGWs) are highly infectious. This virus is transmitted through sexual, anal, or oral contact as well as skin-to-skin contacts. Treatment for this condition has significant morbidity and it can be frustrating in certain cases. The HPV vaccination has been demonstrated as a promising strategy of secondary prevention in HPV-related diseases such as head and neck cancers, cervical diseases, and recurrent respiratory papillomatosis. Regarding AGWs, it is unclear whether vaccination can provide analogous clinical benefit. The aim of this work is to systematically review the literature regarding HPV vaccination for secondary disease prevention after treatment of AGWs. From October to December 2018, a systematic search for clinical trials was conducted in five databases: PubMed, MEDLINE, EMBASE, Cochrane, and clinicaltrials.gov using a combination of the following descriptors: ‘gardasil’ OR ‘cervarix’ OR ‘nine-valent’ OR ‘9-valent’ OR ‘vaccine’ AND ‘recurrence’ OR ‘relapse’ AND ‘hpv’ OR ‘papillomavirus’ AND ‘warts’ OR ‘condyloma.’ Data were synthetized and entered in the Review Manager software (RevMan 5.3.5) to perform the meta-analysis. The search yielded 824 potentially relevant studies. Two studies fulfilled the eligibility criteria involving 656 participants. The meta-analysis estimated the rate of recurrence of AGWs was similar between the vaccine group and the control group. The overall effect estimate was 1.02 (0.75–1.38). This is the first meta-analysis exploring the effect of HPV vaccine in preventing the relapse of AGWs. These results suggest that HPV vaccination does not provide secondary benefit in patients with previous AGWs. However, these results cannot be generalized due to the scarce number of RCTs currently available in the literature. The outcomes from future randomized controlled trials (RCTs) are warranted to further clarify the precise effect of the vaccine.

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“…Although the minimum antibody titer required for protection is not defined, recent studies (Safaeian et al, 2010;Castellsagué et al, 2014) have shown that anti-HPV antibodies acquired by natural infection provide protection if naturally acquired titers are high. Vaccination is not effective in patients with prevalent HPV infection, but the possible therapeutic benefit of the licensed HPV vaccines in reducing recurrent lesions in previously infected persons has been studied (Ghelardi et al, 2018;Pieralli et al, 2018;Stankiewicz Karita et al, 2019). The antibodies evoked by HPV vaccination during the follow-up post treatment for HPV-linked disease is recommended to reduce the risk of reactivation/ re-infection or a new HPV infection, without adverse events or adverse reactions (Ghelardi et al, 2018;Pieralli et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Cross-Protective IgG and IgA Antibodies against Oncogenic and Non-Oncogenic HPV Genotypes

Costa

Giraldo

Cobucci

et al. 2020

Asian Pac J Cancer Prev

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Objective: The aim of the study was to describe the course of IgG/IgA immune response in women immunized with bivalent vaccine and in women non-vaccinated with HPV infection, as well as evaluating the cross-protection against non-vaccine HPV types. Methods: Serum and cervical mucus samples were collected from infected and vaccinated women for HPV detection/genotyping and for detection of IgG/IgA anti-HPV/VLP (Virus-like Particles) by ELISA. Results: The median absorbance detected in serum samples for anti-HPV-IgG antibodies was higher in vaccinated women when compared to HPV infected women (p <0.01), however, the median absorbance in cervical mucus samples for anti-HPV-IgA was higher in infected women when compared to vaccinated women (p<0.01). Additionally, our analyses also provided additional evidence for cross-protective efficacy of the HPV-16/18 vaccine against HPV-82,-6,-11,-13,-61,-72 and-74. Conclusion: The IgG antibodies were significantly more detected in the serum of vaccinated women, while the IgA was found in greater quantities in cervical samples from those infected by the virus. In addition, there is evidence that the bivalent vaccine provides cross-protection against other non-oncogenic viral subtypes.

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Indication of prophylactic vaccines as a tool for secondary prevention in HPV-linked disease

Cited by 39 publications

References 20 publications

Adjuvant HPV Vaccination to Prevent Recurrent Cervical Dysplasia after Surgical Treatment: A Meta-Analysis

Adjuvant HPV Vaccination to Prevent Recurrent Cervical Dysplasia after Surgical Treatment: A Meta-Analysis

Could the human papillomavirus vaccine prevent recurrence of ano-genital warts?: a systematic review and meta-analysis

Cross-Protective IgG and IgA Antibodies against Oncogenic and Non-Oncogenic HPV Genotypes

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