Toh Zheng Quan, Kosasih Jennie, Russell Fiona M, Garland Suzanne M, Mulholland Edward K, Licciardi Paul V
Infection and Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.
Infect Drug Resist. 2019 Jul 4;12:1951-1967. doi: 10.2147/IDR.S178381. eCollection 2019.
Human papillomavirus (HPV) types 16 and 18 cause 70% of cervical cancer cases globally. The nonavalent HPV vaccine (9vHPV) was licensed in 2014 and protects against the next five most common cancer-causing HPV types (HPV 31/33/45/52/58) after HPV 16/18. Phase III clinical studies have demonstrated high vaccine efficacy (>90%) against cervical, vulvar, and vaginal precancers caused by these additional types, and have shown comparable immunogenicity to the shared genotypes to quadrivalent HPV vaccine (4vHPV). Vaccine efficacy and antibody responses for 9vHPV are found to persist for at least five years while longer-term observational studies are ongoing to monitor long-term vaccine effectiveness. The implementation of 9vHPV has the potential to prevent up to 93% of cervical cancer cases, as well as a significant proportion of other HPV-related anogenital cancers. This review article summarizes the current evidence for 9vHPV in terms of vaccine efficacy against HPV infection and related anogenital precancers, safety, and immunogenicity, as well as discussing the potential impact of this vaccine on the cervical cancer burden globally.
全球70%的宫颈癌病例由16型和18型人乳头瘤病毒(HPV)引起。九价人乳头瘤病毒疫苗(9vHPV)于2014年获得许可,可预防继16/18型HPV之后的接下来五种最常见的致癌HPV类型(HPV 31/33/45/52/58)。III期临床研究表明,该疫苗对这些额外类型所引起的宫颈、外阴和阴道癌前病变具有很高的效力(>90%),并且与四价人乳头瘤病毒疫苗(4vHPV)的共同基因型具有相当的免疫原性。9vHPV的疫苗效力和抗体反应至少持续五年,同时正在进行长期观察性研究以监测长期疫苗效果。9vHPV的应用有可能预防高达93%的宫颈癌病例,以及相当比例的其他HPV相关的肛门生殖器癌。这篇综述文章总结了目前9vHPV在针对HPV感染及相关肛门生殖器癌前病变的疫苗效力、安全性和免疫原性方面的证据,并讨论了该疫苗对全球宫颈癌负担的潜在影响。