Bornstein Jacob
Department of Obstetrics and Gynecology, Western Galilee Hospital-Nahariya, and Rappaport Faculty of Medicine, Hatechnion University, Haifa, Israel.
Obstet Gynecol Surv. 2009 May;64(5):345-50. doi: 10.1097/OGX.0b013e31819f992e.
This review presents an unbiased comparison between the two vaccines available against human papillomavirus (HPV). We conducted a PUBMED and Google search for the years 1998 to October 2008 using the terms: cervical cancer vaccine, HPV vaccine, Gardasil, and Cervarix; and also reviewed abstracts from international meetings. Both vaccines are intended to protect against cervical cancer and high-grade CIN caused by HPV 16 and HPV 18. Only the quadrivalent vaccine is designed to prevent condylomata acuminata and low-grade CIN caused by HPV 6 and HPV 11. It has been approved by the FDA for women aged 9 to 26 years against vulvar and vaginal cancer, and against cervical cancer and precancer. The adjuvant of the bivalent vaccine more significantly accelerates an immune reaction. Both vaccines demonstrate cross-protection, although against different HPV types. The bivalent vaccine is registered for above age 26 in Australia and Israel, and the quadrivalent vaccine in the Philippines and Ecuador. Time will verify claims and reveal differences. In the meantime, both vaccines are safe and effective for their approved indications and, recommendations should be based on individual patient characteristics.
Obstetricians & Gynecologists, Family Physicians.
After completion of this article, the reader should be able to describe the viral targets of the two HPV vaccines, explain the potential benefits of HPV vaccination to patients, and compare the data regarding the two HPV vaccines.
本综述对两种可用于预防人乳头瘤病毒（HPV）的疫苗进行了客观比较。我们在1998年至2008年10月期间利用“宫颈癌疫苗”“HPV疫苗”“加德西”和“希瑞适”等关键词在PUBMED和谷歌上进行了检索，并查阅了国际会议的摘要。两种疫苗均旨在预防由HPV 16和HPV 18引起的宫颈癌和高级别宫颈上皮内瘤变（CIN）。只有四价疫苗设计用于预防由HPV 6和HPV 11引起的尖锐湿 疣和低级别CIN。它已获美国食品药品监督管理局（FDA）批准用于9至26岁女性预防外阴癌和阴道癌、宫颈癌及癌前病变。二价疫苗的佐剂能更显著地加速免疫反应。两种疫苗均显示出交叉保护作用，尽管针对的是不同的HPV类型。二价疫苗在澳大利亚和以色列已获批用于26岁以上人群，四价疫苗在菲律宾和厄瓜多尔已获批。时间将验证各种说法并揭示差异。与此同时，两种疫苗对于其获批的适应症都是安全有效的，建议应基于个体患者特征。
妇产科医生、家庭医生。
阅读本文后，读者应能够描述两种HPV疫苗的病毒靶点，向患者解释HPV疫苗接种的潜在益处，并比较两种HPV疫苗的数据。
