Kim Jimin, Choe Young June, Park Jungeun, Cho Jahyun, Cheong Chelim, Oh Jin-Kyoung, Park Mihai, Shim Eunha, Yu Su-Yeon
Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
Infect Chemother. 2024 Mar;56(1):37-46. doi: 10.3947/ic.2023.0064. Epub 2023 Nov 20.
Human papillomavirus (HPV) infection is a major global disease burden and the main cause of cervical cancer. Certain HPV genotypes, with are the most common etiologic pathogens and cause a significant disease burden, are being targeted for vaccine development. However, few studies have focused on the comparative effectiveness of the bivalent HPV (2v-HPV), quadrivalent HPV (4v-HPV), and nonavalent HPV (9v-HPV) vaccines against HPV strain-specific infection. This study investigated the comparative effects of these vaccines against genotype-specific infection.
We conducted a pairwise and network meta-analysis of published randomized clinical trials of HPV vaccines according to sex and HPV infection status for nine HPV genotypes (HPV 6/11/16/18/31/33/45/52/58).
Overall, 10 randomized controlled trials (12 articles) were included in this study. In the network meta-analysis, no statistically significant differences were observed in the prevention of carcinogenic HPV strains (16/18/31/33/45/52/58) between the 2v-HPV and 4v-HPV vaccines in female HPV infection-naïve populations. However, the 9v-HPV vaccine showed a significantly superior effect compared with 2v-HPV and 4v-HPV vaccines in preventing HPV 31/33/45/52/58 infections. Although 2v-HPV and 4v-HPV vaccines provided some cross-protection against HPV 31/33/45/52/58 infections, the effect was significant only on HPV 31 infection. For HPV 16 and 18, neither statistically significant nor small differences were found in the prevention of HPV infection among the 2v-HPV, 4v-HPV, and 9v-HPV vaccines.
Our study complements previous understanding of how the effect of HPV vaccines differs according to the HPV genotype. This is important because HPV genotype prevalence varies among countries. We advocate for continued efforts in vaccinating against HPV, while public health agencies should consider the difference in the vaccine effect and HPV genotype prevalence when implementing HPV vaccination in public vaccination programs.
人乳头瘤病毒（HPV）感染是一项重大的全球疾病负担，也是宫颈癌的主要病因。某些HPV基因型是最常见的病原体，会造成重大疾病负担，目前正针对这些基因型进行疫苗研发。然而，很少有研究关注二价HPV（2v-HPV）、四价HPV（4v-HPV）和九价HPV（9v-HPV）疫苗针对HPV菌株特异性感染的比较效果。本研究调查了这些疫苗针对基因型特异性感染的比较效果。
我们根据性别和HPV感染状况，对已发表的针对9种HPV基因型（HPV 6/11/16/18/31/33/45/52/58）的HPV疫苗随机临床试验进行了成对和网状荟萃分析。
总体而言，本研究纳入了10项随机对照试验（12篇文章）。在网状荟萃分析中，在未感染HPV的女性人群中，2v-HPV和4v-HPV疫苗在预防致癌性HPV菌株（16/18/31/33/45/52/58）方面未观察到统计学上的显著差异。然而，在预防HPV 31/33/45/
