a Sydney University Discipline of Paediatrics and Child Health , The Children's Hospital at Westmead , Sydney , NSW , Australia.
b Vaccine Trials Group, Telethon Kids Institute , University of Western Australia , Perth , Australia.
Expert Rev Vaccines. 2016;15(3):367-87. doi: 10.1586/14760584.2016.1124763.
Vaccines are available against human papillomavirus (HPV), the causal agent of cervical and other cancers. Efficacy data from the HPV-16/18 AS04-adjuvanted vaccine clinical trial program were reviewed. Six randomized, controlled phase II/III trials evaluating cervical endpoints enrolled women from diverse populations and geographical locations. The program analyzed extensively the cohorts most relevant from a public health perspective: the total vaccinated cohort (TVC), approximating a general population including those with existing or previous HPV infection, and TVC-naïve, approximating a population of young women before sexual debut. Results show that the vaccine reduces HPV-16/18 infection and associated cervical endpoints in women regardless of age, location, or sexual experience. It provides cross-protection against some non-vaccine oncogenic HPV types and types causing genital warts, and may be effective against vulvar, oral, and anal HPV infection. Early epidemiology data following its introduction suggest a decline in the prevalence of vaccine and some non-vaccine HPV types.
疫苗可预防人乳头瘤病毒(HPV),该病毒是宫颈癌和其他癌症的致病因子。本文对 HPV-16/18 AS04 佐剂疫苗临床试验项目的疗效数据进行了回顾。六项随机对照的 II/III 期临床试验评估了宫颈终点,入组了来自不同人群和地理位置的女性。该项目从公共卫生的角度对最相关的队列进行了广泛分析:总接种人群(TVC),近似于包括现有或既往 HPV 感染人群的一般人群,以及 TVC-初免人群,近似于年轻女性首次性行为前的人群。结果表明,无论年龄、地点或性经验如何,疫苗均可降低 HPV-16/18 感染和相关的宫颈终点事件。它对一些非疫苗致癌 HPV 型和引起生殖器疣的 HPV 型提供交叉保护,并且可能对外阴、口腔和肛门 HPV 感染有效。在引入疫苗后早期的流行病学数据表明,疫苗和一些非疫苗 HPV 型的流行率有所下降。