a Department of Public Health and Infectious Diseases , Sapienza University of Rome , Rome , Italy.
Hum Vaccin Immunother. 2018 May 4;14(5):1266-1274. doi: 10.1080/21645515.2017.1423155. Epub 2018 Jan 30.
The vaccination against Humanpapilloma Virus (HPV) is an effective strategy to prevent high-risk HPV infection and subsequent cervical carcinogenesis. Although the safety profile has been ascertained, the relation with the development of central nervous system (CNS) autoimmune disorders (AD) appears still controversial. Multiple Sclerosis (MS) is the most common cause of chronic neurological impairment in young people, typically striking females. The main purpose of this review was to assess the association between HPV vaccination and MS.
The systematic review of the literature was carried out using 5 search engines: MEDLINE, SCOPUS, ISI WEB OF KNOWLEDGE, GOOGLE SCHOLAR and ClinicalTrial.gov. The web search was updated on January 2017. PRISMA checklist was adopted to address the content of the systematic review. The measures of outcome were reported as relative risk (RR) in cohort studies and odds ratio (OR) in case-control studies.
The systematic review identified 5 observational studies, 9 reviews, and 1 randomized clinical trials (RCT) pooled analysis. The RR of MS onset detected by cohort studies ranged from 1.54 (95%CI, 0.04-8.59) to 1.37 (95%CI, 0.74-3.20). Concerning case-control studies, the OR spanned from 0.3, (95%CI 0.1-0.9) to 1.60 (95%CI = 0.79-3.25) for the group exposed to HPV vaccination. No result was significant.
This review showed no significant association between HPV vaccination and MS. The low statistical power of the studies agreed with the low incidence of MS disease among general population. In order to overcome the shortcoming the research may be extended to the entire pattern of CNS ADs.
人乳头瘤病毒（HPV）疫苗接种是预防高危型 HPV 感染和随后宫颈癌发生的有效策略。尽管安全性已得到证实，但与中枢神经系统（CNS）自身免疫性疾病（AD）的发展之间的关系似乎仍存在争议。多发性硬化症（MS）是年轻人中最常见的慢性神经功能障碍原因，通常影响女性。本综述的主要目的是评估 HPV 疫苗接种与 MS 之间的关系。
使用 5 个搜索引擎（MEDLINE、SCOPUS、ISI WEB OF KNOWLEDGE、GOOGLE SCHOLAR 和 ClinicalTrials.gov）进行文献系统评价。网络搜索于 2017 年 1 月更新。采用 PRISMA 清单解决系统评价的内容。结果的测量指标在队列研究中报告为相对风险（RR），在病例对照研究中报告为比值比（OR）。
系统评价确定了 5 项观察性研究、9 项综述和 1 项随机临床试验（RCT）荟萃分析。队列研究中 MS 发病的 RR 范围从 1.54（95%CI，0.04-8.59）到 1.37（95%CI，0.74-3.20）。关于病例对照研究，暴露于 HPV 疫苗组的 OR 从 0.3（95%CI，0.1-0.9）到 1.60（95%CI = 0.79-3.25）不等。没有结果是显著的。
本综述显示 HPV 疫苗接种与 MS 之间没有显著关联。研究的低统计效能与普通人群中 MS 疾病的低发病率相符。为了克服这一缺点，研究可能会扩展到整个中枢神经系统 AD 模式。
