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原发性卵巢功能不全与人类乳头瘤病毒疫苗:当前证据的综述。

Primary ovarian insufficiency and human papilloma virus vaccines: a review of the current evidence.

机构信息

Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.

Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA.

出版信息

Am J Obstet Gynecol. 2020 Mar;222(3):239-244. doi: 10.1016/j.ajog.2019.08.045. Epub 2019 Aug 31.

Abstract

Human papilloma virus is the primary causative agent for cervical cancer, and vaccination is the primary means of preventing anogenital cancers caused by human papilloma virus infection. Despite the availability of human papilloma virus vaccines for more than a decade, coverage rates lag behind those for other vaccines. Public concerns regarding safety of human papilloma virus vaccines have been identified as an important barrier to vaccination, including concerns that the human papilloma virus vaccine may cause primary ovarian insufficiency, driven in part by isolated reports of ovarian failure following the human papilloma virus vaccine. We summarize published peer-reviewed literature on human papilloma virus vaccines and primary ovarian insufficiency, reviewing information contained in the case reports and series. Healthcare providers should address any patient concerns about primary ovarian insufficiency and the human papilloma virus vaccine by acknowledging the case reports but noting the lack of association found in a recently published epidemiologic study of approximately 60,000 female individuals. Current evidence is insufficient to suggest or to support a causal relationship between human papilloma virus vaccination and primary ovarian insufficiency.

摘要

人乳头瘤病毒是宫颈癌的主要致病因子,疫苗接种是预防人乳头瘤病毒感染引起的肛门生殖器癌症的主要手段。尽管人乳头瘤病毒疫苗已经问世十余年,但接种率落后于其他疫苗。公众对人乳头瘤病毒疫苗安全性的担忧已被确定为接种疫苗的一个重要障碍,其中包括担心人乳头瘤病毒疫苗可能导致原发性卵巢功能不全,部分原因是少数关于接种人乳头瘤病毒疫苗后卵巢衰竭的孤立报告。我们总结了已发表的关于人乳头瘤病毒疫苗和原发性卵巢功能不全的同行评议文献,回顾了病例报告中包含的信息。医疗保健提供者应该通过承认这些病例报告,但注意到最近对大约 60000 名女性进行的流行病学研究中未发现关联,来解决任何患者对原发性卵巢功能不全和人乳头瘤病毒疫苗的担忧。目前的证据还不足以表明或支持人乳头瘤病毒疫苗接种与原发性卵巢功能不全之间存在因果关系。

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