The Impact of Quadrivalent Human Papillomavirus (HPV; Types 6, 11, 16, and 18) L1 Virus-Like Particle Vaccine on Infection and Disease Due to Oncogenic Nonvaccine HPV Types in Generally HPV-Naive Women Aged 16-26 Years

被引：429

作者：

Brown, Darron R. ^{[1
]}

Kjaer, Susanne K. ^{[2
]}

Sigurdsson, Kristjan ^{[3
]}

Iversen, Ole-Erik ^{[4
,5
]}

Hernandez-Avila, Mauricio ^{[6
]}

Wheeler, Cosette M. ^{[7
,8
]}

Perez, Gonzalo ^{[9
]}

Koutsky, Laura A. ^{[10
]}

Tay, Eng Hseon ^{[11
]}

Garcia, Patricia ^{[12
]}

Ault, Kevin A. ^{[13
]}

Garland, Suzanne M. ^{[14
,15
]}

Leodolter, Sepp ^{[16
]}

Olsson, Sven-Eric ^{[17
]}

Tang, Grace W. K. ^{[18
]}

Ferris, Daron G. ^{[19
]}

Paavonen, Jorma ^{[20
]}

Steben, Marc ^{[21
]}

Bosch, F. Xavier ^{[22
]}

Dillner, Joakim ^{[23
]}

Joura, Elmar A. ^{[16
]}

Kurman, Robert J. ^{[24
,25
]}

Majewski, Slawomir ^{[26
]}

Munoz, Nubia ^{[27
]}

Myers, Evan R. ^{[28
]}

Villa, Luisa L. ^{[29
]}

Taddeo, Frank J. ^{[30
]}

Roberts, Christine ^{[30
]}

Tadesse, Amha ^{[30
]}

Bryan, Janine ^{[30
]}

Lupinacci, Lisa C. ^{[30
]}

Giacoletti, Katherine E. D. ^{[30
]}

Sings, Heather L. ^{[30
]}

James, Margaret ^{[30
]}

Hesley, Teresa M. ^{[30
]}

Barra, Eliav ^{[30
]}

机构：

[1] Indiana Univ, Sch Med, Indianapolis, IN 46202 USA

[2] Rigshosp, Danish Canc Soc, Dept Virus Hormones & Canc, Inst Canc Epidemiol, DK-2100 Copenhagen, Denmark

[3] Natl Canc Detect Clin, Reykjavik, Iceland

[4] Univ Bergen, Dept Clin Med, Bergen, Norway

[5] Haukeland Hosp, Dept Obstet & Gynecol, N-5021 Bergen, Norway

[6] Inst Publ Hlth, Cuernavaca, Morelos, Mexico

[7] Univ New Mexico, Dept Mol Genet & Microbiol, Albuquerque, NM 87131 USA

[8] Univ New Mexico, Dept Obstet & Gynecol, Albuquerque, NM 87131 USA

[9] Univ Rosario, Bogota, Colombia

[10] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

[11] KK Womens & Childrens Hosp, Singapore, Singapore

[12] Univ Peruana Cayetano Heredia, Epidemiol HIV & STD Unit, Lima, Peru

[13] Emory Univ, Sch Med, Dept Gynecol & Obstet, Atlanta, GA 30322 USA

[14] Univ Melbourne, Microbiol & Infect Dis Dept, Royal Womens Hosp, Melbourne, Vic, Australia

[15] Univ Melbourne, Dept Obstet & Gynecol, Melbourne, Vic, Australia

[16] Med Univ Vienna, Dept Gynecol & Obstet, Vienna, Austria

[17] Karolinska Inst, Danderyd Hosp, Stockholm, Sweden

[18] Univ Hong Kong, Dept Obstet & Gynecol, Hong Kong, Hong Kong, Peoples R China

[19] Med Coll Georgia, Dept Family Med & Obstet & Gynecol, Augusta, GA 30912 USA

[20] Univ Cent Hosp, Dept Obstet & Gynecol, Helsinki, Finland

[21] Inst Natl Sante Publ Quebec, Direct Risques Biol Environm & Occupat, Montreal, PQ, Canada

[22] IDIBELL, Inst Catala Oncol, Barcelona, Spain

[23] Lund Univ, Dept Med Microbiol, Lund, Sweden

[24] Johns Hopkins Univ, Sch Med, Dept Gynecol & Obstet, Baltimore, MD USA

[25] Johns Hopkins Univ, Sch Med, Dept Pathol & Oncol, Baltimore, MD USA

[26] Warsaw Med Univ, Dept Dermatol & Venereol, Ctr Diagnost & Treatment Sexually Transmitted Dis, Warsaw, Poland

[27] Natl Canc Inst, Bogota, Colombia

[28] Duke Univ, Med Ctr, Dept Obstet & Gynecol, Durham, NC USA

[29] Ludwig Inst Canc Res, Dept Virol, Sao Paulo, Brazil

[30] Merck Res Labs, West Point, PA USA

来源：

JOURNAL OF INFECTIOUS DISEASES | 2009年 / 199卷 / 07期

关键词：

GRADE CERVICAL LESIONS; DOUBLE-BLIND; YOUNG-WOMEN; EFFICACY; CANCER; CLASSIFICATION;

D O I：

10.1086/597307

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Human papillomavirus (HPV)-6/11/16/18 vaccine reduces the risk of HPV-6/11/16/18-related cervical intraepithelial neoplasia (CIN) 1-3 or adenocarcinoma in situ (AIS). Here, its impact on CIN1-3/AIS associated with nonvaccine oncogenic HPV types was evaluated. Methods. We enrolled 17,622 women aged 16-26 years. All underwent cervicovaginal sampling and Pap testing at regular intervals for up to 4 years. HPV genotying was performed for biopsy samples, and histological diagnoses were determined by a pathology panel. Analyses were conducted among subjects who were negative for 14 HPV types on day 1. Prespecified analyses included infection of >= 6 months' duration and CIN1-3/AIS due to the 2 and 5 most common HPV types in cervical cancer after HPV types 16 and 18, as well as all tested nonvaccine types. Results. Vaccination reduced the incidence of HPV-31/45 infection by 40.3% (95% confidence interval [CI], 13.9% to 59.0%) and of CIN1-3/AIS by 43.6% (95% CI, 12.9% to 64.1%), respectively. The reduction in HPV-31/33/45/52/58 infection and CIN1-3/AIS was 25.0% (95% CI, 5.0% to 40.9%) and 29.2% (95% CI, 8.3% to 45.5%), respectively. Efficacy for CIN2-3/AIS associated with the 10 nonvaccine HPV types was 32.5% (95% CI, 6.0% to 51.9%). Reductions were most notable for HPV-31. Conclusions. HPV-6/11/16/18 vaccine reduced the risk of CIN2-3/AIS associated with nonvaccine types responsible for similar to 20% of cervical cancers. The clinical benefit of cross-protection is not expected to be fully additive to the efficacy already observed against HPV-6/11/16/18-related disease, because women may have >1 CIN lesion, each associated with a different HPV type.

引用

页码：926 / 935

页数：10

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