Bartolozzi G, Bona G, Ciofi M, De Martino M, Di Pietro P, Duse M, Esposito S, Gasparini R, Mariani L, Marostica G, Paravati F, Plebani A, Principi N, Zuccotti G V, Tovo P A
Dipartimento di Pediatria, Università degli Studi di Firenze, Firenze.
Minerva Pediatr. 2007 Jun;59(3):165-82.
Genital human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide. Spontaneous clearance of HPV infection occurs in most cases, but chronic infection with high risk genotypes is associated with the development of cervical cancer. In particular, HPV 16 and 18 are responsible for 70% of cancers of the cervix and, in variable proportions, for cancers of the vagina, vulva, anus, penis and oropharinx. Low risk HPV genotypes, such as HPV 6 and 11, cause genital warts. Two prophylactic vaccines using virus like particles (VLPs) of L1 capside protein of HPV 16 and 18 have been developed. Of these, one also containing VLPs of HPV 6 and 11, has been approved by FDA, EMEA and AIFA for use in 9-26 year-old females. Large scale studies have shown that these vaccines are safe, well tolerated, elicits high levels of neutralizing antibodies, prevent chronic HPV infections due to genotypes present in the vaccine, and associated cervical lesions (and genital wars for the quadrivalent vaccine). To be effective the vaccines should be given prior to sexual debut. In Italy, the vaccination will be offered to 12 year-old girls. This article is the result of a targeted Consensus Conference by a panel of experts, which reviews the cornerstones of HPV infection, its association with cervical cancer, the advances in prophylactic vaccines, and the primary role of the paediatrician for the optimal adoption of this new preventive strategy.
生殖器人乳头瘤病毒（HPV）感染是全球最常见的性传播感染。大多数情况下HPV感染可自发清除，但高危基因型的慢性感染与宫颈癌的发生有关。特别是，HPV 16和18型导致了70%的宫颈癌，在不同比例上，还导致阴道癌、外阴癌、肛门癌、阴茎癌和口咽癌。低危HPV基因型，如HPV 6和11型，可引起生殖器疣。已研发出两种使用HPV 16和18型L1衣壳蛋白病毒样颗粒（VLP）的预防性疫苗。其中一种还含有HPV 6和11型VLP，已获美国食品药品监督管理局（FDA）、欧洲药品管理局（EMEA）和意大利药品管理局（AIFA）批准，用于9至26岁女性。大规模研究表明，这些疫苗安全、耐受性良好，能引发高水平的中和抗体，预防因疫苗中所含基因型导致的慢性HPV感染及相关宫颈病变（四价疫苗还可预防生殖器疣）。为确保疫苗有效，应在首次性行为之前接种。在意大利，将为12岁女孩提供疫苗接种。本文是一个专家小组有针对性的共识会议的成果，该会议回顾了HPV感染的基础、其与宫颈癌的关联、预防性疫苗的进展以及儿科医生在最佳采用这一新预防策略方面的主要作用。
