Vinkenes Emeline, Nielsen Martine A, Blaakaer Jan
Odense University Hospital, Dept. of Obstetrics. & Gyn, Sdr. Boulevard 29, Odense 5000 C, Denmark.
Eur J Obstet Gynecol Reprod Biol X. 2019 Apr 20;4:100015. doi: 10.1016/j.eurox.2019.100015. eCollection 2019 Oct.
Human papillomavirus (HPV) infection is one of the most common sexually transmitted infections worldwide and is associated with precancerous lesions and cancers of the cervix, vulva, vagina, penis, anus, tonsils and base of the tongue. Several studies show an increased risk of HPV-associated cancers in solid organ transplant recipients (SOTR). The aims of this review are to investigate the evidence of efficacy for the HPV vaccination in transplant recipients and to discuss the known national guidelines. A systematic literature search has been conducted to identify studies where SOTR received the HPV vaccination to evaluate the efficacy of the HPV vaccine on this population. The primary outcome was antibody response against the HPV genotypes included in the vaccines and the secondary outcome was national guidelines recommending HPV vaccination of SOTR. Three cohort studies evaluated immunogenicity. Two studies found suboptimal effect of the HPV vaccine, while an early terminated study detected 100% seropositivity. We have identified four national guidelines in the following countries; United States of America, Canada, Australia and Ireland, along with a recommendation from the World Health Organization (WHO). The results from the three studies were inconclusive due to the small sample sizes and the diverging results. Recommendations of HPV vaccination of SOTR is based on the knowledge about safety and efficiency in the general population and the safety of other inactivated (not live) vaccines in SOTR. Theoretically, the nonavalent vaccine should be recommended as the first choice in SOTR without age- or sex restrictions.
人乳头瘤病毒（HPV）感染是全球最常见的性传播感染之一，与子宫颈、外阴、阴道、阴茎、肛门、扁桃体和舌根的癌前病变及癌症相关。多项研究表明，实体器官移植受者（SOTR）患HPV相关癌症的风险增加。本综述的目的是调查HPV疫苗接种对移植受者有效性的证据，并讨论已知的国家指南。已进行系统的文献检索，以确定SOTR接受HPV疫苗接种的研究，以评估HPV疫苗对该人群的有效性。主要结果是针对疫苗中所含HPV基因型的抗体反应，次要结果是推荐SOTR接种HPV疫苗的国家指南。三项队列研究评估了免疫原性。两项研究发现HPV疫苗效果欠佳，而一项提前终止的研究检测到血清阳性率为100%。我们在以下国家确定了四项国家指南：美利坚合众国、加拿大、澳大利亚和爱尔兰，以及世界卫生组织（WHO）的一项建议。由于样本量小且结果存在分歧，三项研究的结果尚无定论。对SOTR进行HPV疫苗接种的建议基于对普通人群安全性和有效性的了解以及SOTR中其他灭活（非活）疫苗的安全性。理论上，九价疫苗应被推荐为SOTR的首选，无年龄或性别限制。
