Muñoz Nubia, Jacquard Anne-Carole
Instituto Nacional de Cancerologia, Bogotá, Colombia.
Presse Med. 2008 Oct;37(10):1377-90. doi: 10.1016/j.lpm.2008.04.008. Epub 2008 Sep 10.
Genital human papillomavirus (HPV) infection is one of the most common sexually transmitted infections worldwide. Two HPV vaccines are now available in many countries: (i) the first vaccine is quadrivalent and indicated in the prevention of CIN 2/3, cervical cancers, VIN 2/3, VaIN 2/3 and genital warts associated with the HPV types 6, 11, 16 and 18, (ii) the second vaccine is bivalent and indicated in the prevention of CIN 2+ and cervical cancers associated with the HPV types 16 and 18.
To critically review all epidemiological aspects of the HPV infection and its relation with preneoplasic lesions of the cervix and cervical cancer to assist the relevant public health authorities to make plans for the introduction of HPV vaccines that have been recently commercialized.
Only articles published in English in peer reviewed journals have been selected in Date base PubMed (National Library of Medicine - National Institutes of Health) with Keywords HPV, risk factor, cervical cancer, CIN2/3, incidence, prevalence, transmission, prevention, genital cancer, HPV vaccines, screening. A critical review of most papers published during the last 10 years was made. The topics covered included: diseases caused by HPV, prevalence, incidence and transmission of HPV, risk factors for the acquisition of HPV, natural history of HPV infection, risk factors determining the progression from HPV to cancer, protective factors blocking the progression from infection to cancer (screening) and primary prevention of HPV by vaccines and other methods. The information was interpreted and summarized.
It was concluded that HPV infection is one of the most common sexually transmitted infections, that it is the necessary cause of cervical cancer and the cause of other genital cancers and cancers of the upper aerodigestive tract. Fortunately most infections regress, but those infections that persist are the ones leading to cancer. Primary prevention by the introduction of prophylactic vaccines is the ideal means of preventing cervical cancer and other cancers associated to HPV.
This review is to my knowledge, the most comprehensive and up-to date review to be published in French on HPV epidemiology and related diseases. It will be of great value to educate medical and paramedical personnel on HPV infection and associated diseases and it will be of great help to public health authorities and decision makers when they have to evaluate the convenience of introducing HPV vaccination in a given population.
生殖器人乳头瘤病毒（HPV）感染是全球最常见的性传播感染之一。目前许多国家有两种HPV疫苗：（i）第一种疫苗是四价的，用于预防与HPV 6、11、16和18型相关的CIN 2/3、宫颈癌、VIN 2/3、VaIN 2/3和尖锐湿疣；（ii）第二种疫苗是二价的，用于预防与HPV 16和18型相关的CIN 2+和宫颈癌。
批判性地综述HPV感染的所有流行病学方面及其与宫颈前体病变和宫颈癌的关系，以协助相关公共卫生当局制定引入最近已商业化的HPV疫苗的计划。
仅在数据库PubMed（国立医学图书馆 - 国立卫生研究院）中选择发表于同行评审期刊的英文文章，关键词为HPV、危险因素、宫颈癌、CIN2/3、发病率、患病率、传播、预防、生殖器癌、HPV疫苗、筛查。对过去10年发表的大多数论文进行了批判性综述。涵盖的主题包括：HPV引起的疾病、HPV的患病率、发病率和传播、感染HPV的危险因素、HPV感染的自然史、决定从HPV进展为癌症的危险因素、阻止从感染进展为癌症的保护因素（筛查）以及通过疫苗和其他方法对HPV的一级预防。对信息进行了解释和总结。
得出的结论是，HPV感染是最常见的性传播感染之一，是宫颈癌以及其他生殖器癌和上呼吸道消化道癌症的必要病因。幸运的是，大多数感染会消退，但持续存在的感染会导致癌症。引入预防性疫苗进行一级预防是预防宫颈癌和其他与HPV相关癌症的理想手段。
据我所知，本综述是法语发表的关于HPV流行病学及相关疾病的最全面和最新的综述。它对于教育医护和准医护人员了解HPV感染及相关疾病具有重要价值，并且在公共卫生当局和决策者必须评估在特定人群中引入HPV疫苗的便利性时将提供极大帮助。
