Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), NOIDA, Uttar Pradesh, India.
Indian J Med Res. 2009 Sep;130(3):327-33.
Cervical cancer is the second-most common cancer in women worldwide causing most cancer related deaths in women in developing countries including India. The most predominant etiological factor for cervical cancer is persistent infection of certain high-risk types of human papillomaviruses (HR-HPVs), while low-risk types are associated with benign cervical lesions and genital warts. In India, the most common (98%) oncogenic types are HPV types 16 and 18 with HPV 16 exclusively (80-90%) prevalent. Two recently developed virus-like particle (VLP) based prophylactic HPV vaccines, quadrivalent Gardasil (HPV 16/18/6/11) and Cervarix (HPV 16/18) offer great promise. Several other therapeutic vaccines are also in clinical trials and are yet to establish their efficacy. The use of already developed VLP vaccines in resource-poor regions is limited by several factors, most importantly the high cost of the vaccine. Therefore efforts are being made in India to develop cost-effective second-generation vaccines. Besides cost, there are several socio-cultural and ethical issues involved with the implementation of already developed vaccines including the acceptability of HPV vaccination by preadolescent girls and their parents in India.
宫颈癌是全球范围内女性第二大常见癌症，也是发展中国家（包括印度）女性癌症相关死亡的主要原因。宫颈癌最主要的病因是某些高危型人乳头瘤病毒（HR-HPV）的持续感染，而低危型 HPV 则与良性宫颈病变和生殖器疣有关。在印度，最常见的（98%）致癌型 HPV 是 HPV 16 和 18 型，其中 HPV 16 型（80-90%）更为常见。最近开发的两种基于病毒样颗粒（VLP）的预防性 HPV 疫苗，四价加德西（HPV 16/18/6/11）和佳达修（HPV 16/18），前景广阔。还有其他几种治疗性疫苗也正在临床试验中，尚未确定其疗效。由于多种因素的限制，包括疫苗的高成本，已开发的 VLP 疫苗在资源匮乏地区的使用受到限制。因此，印度正在努力开发具有成本效益的第二代疫苗。除了成本之外，实施已开发疫苗还涉及到一些社会文化和伦理问题，包括 HPV 疫苗在印度青春期前女孩及其父母中的可接受性。
