Department of Gynaecology and Obstetrics, Comprehensive Cancer Centre, Medical University of Vienna, Austria.
Department of Gynaecology and Obstetrics, Comprehensive Cancer Centre, Medical University of Vienna, Austria.
Clin Microbiol Infect. 2016 Dec 1;22 Suppl 5:S125-S127. doi: 10.1016/j.cmi.2016.12.017.
Since 2006, three vaccines against infections and disease caused by human papillomavirus (HPV) became available in Europe-in 2006 a quadrivalent HPV 6/11/16/18 vaccine, in 2007 a bivalent HPV 16/18 vaccine and in 2015 a nonavalent HPV 6/11/16/18/31/33/45/52/58 vaccine. HPV 16 and 18 are the most oncogenic HPV strains, causing about 70% of cervical and other HPV-related cancers, HPV 6 and 11 cause 85% of all genital warts. The additional types of the polyvalent vaccine account for about 20% of invasive cervical cancer and >35% of pre-cancer. The potential differences between these vaccines caused some debate. All three vaccines give a robust and long-lasting protection against the strains in the various vaccines. The promise of cross-protection against other types (i.e. HPV 31/33/45) and hence a broader cancer protection was not fulfilled because these observations were confounded by the vaccine efficacy against the vaccine types. Furthermore, cross-protection was not consistent over various studies, not durable and not consistently seen in the real world experience. The protection against disease caused by oncogenic HPV strains was not compromised by the protection against low-risk types causing genital warts. The most effective cancer protection to date can be expected by the nonavalent vaccine, data indicate a 97% efficacy against cervical and vulvovaginal pre-cancer caused by these nine HPV types.
自 2006 年以来，三种针对人乳头瘤病毒（HPV）感染和疾病的疫苗已在欧洲上市——2006 年上市的是四价 HPV 6/11/16/18 疫苗，2007 年上市的是二价 HPV 16/18 疫苗，2015 年上市的是九价 HPV 6/11/16/18/31/33/45/52/58 疫苗。HPV 16 和 18 是最具致癌性的 HPV 株，导致约 70%的宫颈癌和其他 HPV 相关癌症，HPV 6 和 11 导致 85%的生殖器疣。多价疫苗的其他类型占侵袭性宫颈癌的约 20%和 >35%的癌前病变。这些疫苗之间的潜在差异引起了一些争论。所有三种疫苗都能针对各种疫苗中的菌株提供强大而持久的保护。针对其他类型（即 HPV 31/33/45）的交叉保护作用，从而提供更广泛的癌症保护作用的承诺并没有实现，因为这些观察结果受到疫苗对疫苗类型的功效的影响。此外，交叉保护作用在不同的研究中不一致，也不持久，在现实世界的经验中也不一致。针对致癌 HPV 株的保护作用不会因针对导致生殖器疣的低危型的保护作用而受到影响。迄今为止，九价疫苗可提供最有效的癌症保护作用，数据表明该疫苗对这九种 HPV 类型引起的宫颈癌和外阴阴道癌前病变的有效率为 97%。
