Lee Lai-Yang, Garland Suzanne M
Department of Microbiology and Infectious Diseases, Royal Women's Hospital, Parkville, Victoria, Australia.
Department of Microbiology, Royal Children's Hospital, Parkville, Victoria, Australia.
F1000Res. 2017 Jun 12;6:866. doi: 10.12688/f1000research.10691.1. eCollection 2017.
We currently have the knowledge and experience to prevent much of human papillomavirus (HPV)-related disease burden globally. In many countries where prophylactic HPV vaccination programs have been adopted as highly effective public health programs with good vaccine coverage, we are already seeing, in real-world settings, reduction of vaccine-related HPV-type infections, genital warts and cervical pre-cancers with potential reductions in vulvar, vaginal and anal pre-cancers. Moreover, we are seeing a change in cervical screening paradigms, as HPV-based screening programs now have strong evidence to support their use as more sensitive ways to detect underlying cervical abnormalities, as compared with conventional cervical cytology. This article describes the impact of prophylactic vaccination on these outcomes and in settings where these vaccines have been implemented in national immunisation programs. Given the successes seen to date and the availability of essential tools, there has been a global push to ensure that every woman has access to effective cervical screening and every girl has the opportunity for primary prevention through vaccination. A gender-neutral approach by offering vaccination to young boys has also been adopted by some countries and is worthy of consideration given that HPV-related cancers also affect males. Furthermore, vaccination of young boys has the advantage of reducing the risk of HPV transmission to sexual partners, lowering the infectious pool of HPV in the general population and ultimately HPV-related diseases for both genders. Therefore, it is appropriate that all countries consider and promote national guidelines and programs to prevent HPV-related diseases.
目前，我们具备相关知识和经验，能够在全球范围内预防大部分与人类乳头瘤病毒（HPV）相关的疾病负担。在许多已将预防性HPV疫苗接种计划作为高效公共卫生计划并实现了良好疫苗覆盖率的国家，在现实环境中，我们已经看到与疫苗相关的HPV型感染、尖锐湿疣和宫颈癌前病变有所减少，外阴、阴道和肛门癌前病变也可能随之减少。此外，我们还看到了宫颈筛查模式的转变，因为与传统宫颈细胞学检查相比，基于HPV的筛查计划现在有强有力的证据支持其作为检测潜在宫颈异常更敏感方法的应用。本文描述了预防性疫苗接种对这些结果的影响，以及在国家免疫计划中实施这些疫苗的情况。鉴于迄今所取得的成功以及必要工具的可得性，全球范围内一直在推动确保每个女性都能获得有效的宫颈筛查，每个女孩都有机会通过接种疫苗进行一级预防。一些国家还采取了向年轻男孩提供疫苗接种的性别中立方法，鉴于HPV相关癌症也会影响男性，这种方法值得考虑。此外，对年轻男孩进行疫苗接种具有降低HPV传播给性伴侣的风险、减少普通人群中HPV的感染源以及最终降低两性HPV相关疾病风险的优势。因此，所有国家都应考虑并推广预防HPV相关疾病的国家指南和计划。
