The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis

Abstract

Background: The quadrivalent human papillomavirus (HPV) vaccine has been assumed to give protection against genital warts (GW) as well as cervical cancer. Our main question was whether HPV vaccine has any effects on the prevention of GW reported in randomised controlled clinical trials (RCTs) and time-trend analyses. Methods: This meta-analysis was performed according to the PRISMA guidelines using the PICO format. We searched in three electronic databases (PubMed, Embase, Cochrane Trials), and assessed heterogeneity using the Q-test and Isquared statistics, meta-regression was also performed. Odds ratios (OR) and their confidence intervals (CI) were calculated. The sensitivity was tested by leave-one-out method. We evaluated the presence of publication bias using the funnel plot graph and the Copas selection model. The strength of evidence was assessed using the GRADE approach. Results: Eight RCTs (per-protocol populations) and eight time-trend ecological studies were included in this meta-analysis. A significant reduction (pooled OR = 0.03, 95% CI: 0.01-0.09; I-squared = 53.6%) of GW in young women was recorded in RCTs, and in time-trend analyses both in young women (pooled OR = 0.36, CI 95% = 0.26-0.51; I-squared = 98.2%), and in young men (pooled OR = 0.69, 95% CI = 0.61-0.78; I-squared = 92.7%). In subgroup analysis, a significant reduction of the number of GW events was observed especially in women under 21 years (pooled OR = 0.33, 95% CI = 0.17-0.63). Leave-one-out analysis showed that similar results could be obtained after excluding one study, meta-regression did not show significant difference. Conclusions: Prophylactic, quadrivalent HPV vaccination can prevent GW in healthy women and men, therefore, it should be included in routine immunization programme.

Human Papillomavirus Vaccine Efficacy and Effectiveness against Cancer

“…Most vaccinations given in 2014 were the quadrivalent type, which targets oncogenic HPV types 6/11/16/18. The quadrivalent HPV vaccine shows excellent efficacy against genital warts in young women (pooled OR = 0.36; 95% CI = 0.26 to 0.51) and young male (pooled OR = 0.69; 95% CI = 0.61 to 0.78) [50]. The vaccine efficacy in an unrestricted susceptible population (USP) (negative polymerase chain reaction (PCR) and serologic testing at enrollment) was 100% (95% CI = 94% to100%) against the four HPV subtypes 3 years after vaccination.…”

Human Papillomavirus associated prevention: knowledge, attitudes, and perceived risks among men who have sex with men and transgender women in Pakistan: a qualitative study

“…The Advisory Committee on Immunization Practices recommends vaccinating all MSM up through age of 26 years due to the increased risk of anal cancer in this key population [21] A recent meta-analysis [22] has reported the average HPV vaccine acceptability among MSM of 63% with the highest from China (97%) [23] and the lowest from Australia (30%) [24], however an increasing trend of vaccine uptake is being reported by others over time [25]. Studies have reported decline in HPV associated anogenital warts among MSM since the introduction of HPV vaccination program [26,27]. Furthermore, anal Papanicolaou (Pap) screening for the precancerous HPV anal lesions as a secondary prevention may have greater utility in preventing future anal cancer [28][29][30][31] and indeed is a cost-effective method for anal cancer prevention among MSM [32,33].…”

Ten-Year Trend in Emergency Department Visits for Sexually Transmitted Infections among Adolescents: A Retrospective Cross-Sectional Study in Italy

“…In contrast and coherently to what was reported in other countries, Genital Warts, caused by the papillomavirus, showed a slight decrease over time [ 30 ]. This is a reduction that could most likely be a direct and visible effect of the mass HPV vaccination strategy adopted in our country along with many other countries in Europe [ 40 , 41 , 42 , 43 , 44 , 45 ], which deserves further investigation.…”