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The Human Papillomavirus (HPV) vaccines have been widely introduced in the national immunization programs in most of the medium and high income countries following endorsement from national and international advisory bodies. HPV vaccine is unique and its introduction is challenging in many ways – it is the first vaccine developed to prevent. Human papillomavirus (HPV) infection is very common. Most people—about 9 in 10—will get an HPV infection at some point in their lives. HPV infections can cause health problems, including several kinds of cancer in both women and men. There are safe and effective vaccines recommended to prevent. Lead developer of HPV vaccine admits it's a giant, deadly scam 9/29/ - An expert involved in the approval process for the human papilloma virus (HPV) vaccines Gardasil and Cervarix, is speaking out about the dangers and why you shouldn't risk your child's health in getting them.


Cervical Cancer / HPV Vaccine News from Medical News Today


The Human Papillomavirus HPV vaccines have been widely introduced in the national immunization programs in most of the medium and high income countries following endorsement from national and international advisory bodies. HPV vaccine is unique and its introduction is challenging in many ways — it is the first vaccine developed to prevent any cancer, the vaccine is gender specific, it targets adolescent females who are difficult to reach by any health intervention hpv articles. It is not unusual for such a vaccine to face scepticism and reservations not only from lay public but also from professionals in spite of hpv articles clinical hpv articles results convincingly and consistently proving their efficacy and safety.

Over the last few years millions of doses of the HPV vaccine have been administered round the world and the efficacy and safety data have started coming from the real life programs. A comprehensive cervical cancer control program involving HPV vaccination of the adolescent girls and screening of the adult women has been proved to be the most cost-effective approach to reduce the burden of cervical cancer, hpv articles.

The present article discusses the justification of HPV vaccination in the backdrop of natural history of cervical cancer, the mechanism of action of the vaccines, efficacy and safety data from phase III randomized controlled trials as well as from the national immunization programs of various countries. India ranking number one globally in terms of cervical cancer burden has an estimatednew cases of cervical hpv articles every year and 72, deaths from the disease.

A hpv articles approach to cervical cancer prevention and control involving health education, vaccinating girls before initiation of sexual activity, screening women for precancerous lesions and treatment before progression to invasive disease can significantly reduce the morbidity and mortality from the disease. Women are at highest risk of acquiring HPV when they initiate their sexual hpv articles. Peak prevalence of infection is observed between 20 and 25 years and the prevalence comes down drastically after 30 years of age since most of the infected women clear the infection due to natural hpv articles. More than 90 percent of the immune-competent women have been found to clear the HPV 16 infection within 5 years without any treatment, hpv articles.

The papillomavirus infects the basal keratinocytes through micro-abrasions present in the cervical epithelium. If there is persistent infection, the viral genome gets integrated to the host genome that over-expresses two onco-proteins, E6 and E7, hpv articles. The E6 proteins degrade p53 genes resulting in genetic instability and accumulation of mutated deoxyribonucleic acid DNA that trigger uncontrolled cellular multiplication.

Given adequate follow up time, hpv articles, specially the CIN3 lesions, 30 percent hpv articles 50 percent of them will progress to invasive cancers, hpv articles.

These vaccines aim to prevent infection from HPV types 16 and 18, since these two types are most hpv articles and are responsible for majority of cervical cancers.

The risk of developing squamous cell carcinoma of cervix is times higher if someone is infected by HPV 16 and times higher if someone is infected by HPV 18, compared to a non-infected individuals. The antigens for both the vaccines are virus like particles VLP derived from the L1 surface protein of the respective types of the virus. The VLPs are non-pathogenic and cannot infect cells, since they do not have viral genome.

The vaccines induce high titer of serum immunoglobulin G antibody against respective HPV types, which is secreted in the cervico-vaginal secretion and is also exuded from the micro-abrasions in the epithelium. Presence of the antibodies at the point of viral entry ensures the neutralization of the virus before it gets an opportunity to bind to infect the basal keratinocytes.

Both bivalent and the quadrivalent vaccines have been rigorously evaluated through phase III randomized placebo controlled trials RCT. The primary efficacy end point hpv articles these studies was prevention of CIN 2 or worse disease, hpv articles. An advisory committee of the World Health Organization WHO in which the pharmaceutical agencies had no role to play agreed upon such endpoint as surrogate for cervical cancer, since it is not ethically acceptable to allow any subject of a study to be followed up until she develops ICC.

To compensate for the expected difference in outcomes in these two major subgroups, hpv articles, the hpv articles analyzed the hpv articles efficacy in two different efficacy cohorts - per-protocol population and the intention-to-treat population. The per-protocol population included those who neither had positive serology indicative of past infection nor DNA in cervix indicates active infection for the target HPV types and received three doses of the vaccines within one year.

The Intention to treat analysis included subjects who might or might not have evidence hpv articles past or active HPV infection and received at least one dose of the vaccine. Some of them even had abnormal cytology at the time of entry in the studies. The efficacies of the vaccines observed in the RCTs should be judged in the light of these two efficacy cohorts reflecting two different real life scenarios. The summary of the efficacies of the vaccines for various endpoints from the phase III trials is given in Table 1, hpv articles.

Vaccine efficacy against various end-points in per-protocol and intention to treat cohorts from phase III RCTs-Risk ratio of zero indicates percent efficacy, whereas one indicates no difference with controls[ 12 ].

As per the WHO guidelines hpv articles primary target for the HPV vaccine for the national immunization programs should be girls aged between 9 years and 13 years.

There is an exciting possibility that even two doses of the vaccine may be as protective as three doses, going by the initial results of the Costa Rican phase III trial. Concerns have been expressed about the possible increase in the risk of cervical neoplasias in the women with HPV infection past or present from quadrivalent vaccination.

They were included in the intention-to-treat analysis and obviously some of them in either group went on to develop CIN 2 or CIN 3 lesions. The baseline demographic analysis showed that the vaccinated group had hpv articles prevalence of other risk factors like current smokers, other STIs and most importantly HSIL cytology at baseline 6, hpv articles.

This imbalance in baseline demographic characteristics and the small number of events hpv articles responsible for the observed discrepancy in the sub-group analysis. In subsequent studies of quadrivalent vaccines and all studies with bivalent vaccines where the subgroups were more balanced in terms of the other risk factors, no such increase in risk of neoplasias was observed.

All these information was presented to Food and Drug Administration FDA prior to obtaining the license and are still available in the public domain. WHO recommended in that HPV vaccination of year old girls should be considered as part of comprehensive cervical cancer control through effective, affordable and equitable delivery strategies, hpv articles. Australia was the first country in the world to provide free quadrivalent HPV vaccines protecting against genital warts as well as cervical cancer to 12 to 18 year old girls starting from mid The earliest effect of the HPV vaccination is evident from the protection from genital warts since the natural history of the warts hpv articles much shorter compared to cervical neoplasias.

The very first report of reduction of incidence of genital wart in the vaccinated population was from the sexual health clinics in Melbourne, Australia, hpv articles. Data from the Victoria Cervical Cytology Registry, Australia showed that within 3 years after the introduction of the vaccination program, the incidence of high grade abnormalities in young women became hpv articles half of that reported before the introduction of the vaccine. The most robust evidence of the effectiveness of the vaccine in cervical cancer prevention was obtained from Finland.

The study participants hpv articles unblinded, and the placebo recipients were hpv articles the quadrivalent vaccine. Nearly half of the placebo recipients were vaccinated at this hpv articles. An age-matched reference unvaccinated cohort was linked with the cancer registry as the control group to identify all cases of CIN3 and ICC during hpv articles follow up.

During the follow up no CIN3 or cervical cancer was detected in the vaccinated cohort, three CIN3 cases but no cancers were detected in the original placebo cohort nearly 50 percent were vaccinated. In the unvaccinated reference cohort 59 CIN3 and three cervical cancers were detected.

All RCTs reported serious and non-serious adverse events AE in similar fashions following standard good clinical practice hpv articles from more than 20, trial participants.

Pain at the injection site, headache and fatigue were the most frequently reported vaccine related AEs, hpv articles.

For any new vaccine there are concerns about vaccine-induced medical conditions, especially systemic autoimmune disorders and neurological disorders, hpv articles.

The long term follow up of the subjects participating in the RCTs did not have higher incidence of these conditions compared with the control group.

In Australia millions of doses of the vaccine have been administered and the most serious adverse event reported is anaphylactic and allergic reactions. The current estimated rate of anaphylaxis based on doses given in Australia is 1.

They concluded that no serious new risks have been identified during its extensive use over 2 hpv articles. To ascribe the deaths to any intervention HPV vaccination in this case certain conditions need to be fulfilled — proportion of deaths should be higher hpv articles the intervention group than that observed in non-intervention group, there should be a consistent pattern and a biologically plausible explanation after hpv articles out other more apparent causes.

Following these criteria none of the deaths initially suspected due to vaccination deaths due to accidents, snakebites or suicides in India, due to the rupture of an intra-thoracic tumor in UK etc. The cost-effectiveness study of all possible options for cervical cancer prevention showed that the most effective strategy with the lowest incremental cost-effectiveness ratio per quality adjusted life year is one combining HPV vaccination at age 12 years with triennial conventional cytologic screening beginning at age 25 years.

The prices at which the vaccines are sold in the private market are being drastically reduced for national programs. Other important vaccines, e. The Strategic Advisory Group of Experts SAGE on immunization, which reports to the Hpv articles of WHO on issues ranging from vaccine research and development to immunization delivery, surmised that the introduction of vaccines is likely to bring great benefits worldwide, particularly to those developing countries where cervical cancer is a major cause of death, hpv articles, and screening programs are limited or absent.

Source of Support: Nil. Conflict of Interest: Declaration of Dr. National Center for Biotechnology InformationU. South Asian J Hpv articles. Author information Copyright and License information Disclaimer. Correspondence to: Dr. Partha Basu, E-mail: moc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.

This article has been cited by other articles in PMC. Abstract The Human Papillomavirus HPV vaccines have been widely introduced in the national immunization programs in most of the medium and hpv articles income countries following endorsement from national and international advisory bodies. Keywords: Human Papillomavirus vaccine, efficacy, safety, hpv articles, Phase Hpv articles randomized trials, national immunization programs.

Table 1 Vaccine efficacy against various end-points in per-protocol and intention to treat cohorts from phase III RCTs-Risk ratio of zero indicates percent efficacy, whereas one indicates no difference with controls[ 12 ]. Open in a separate window. Efficacy of HPV Vaccine in National Immunization Programs WHO recommended in that HPV vaccination of year old girls should be considered as part of comprehensive cervical cancer control through effective, hpv articles, affordable and equitable delivery strategies.

Safety Data from Phase III trials All RCTs reported serious and non-serious adverse events AE in similar fashions following standard good clinical practice guidelines from more hpv articles 20, trial participants. Safety Data from National Immunization Programs In Australia millions of doses of the vaccine have been administered and the most serious adverse event reported is anaphylactic and allergic reactions.

Cost Effectiveness of HPV Vaccines Hpv articles cost-effectiveness study of all possible options for cervical cancer prevention showed that the most effective strategy with the lowest incremental cost-effectiveness ratio per quality adjusted life year is one combining HPV vaccination at age 12 years with triennial conventional cytologic screening hpv articles at age 25 years. Footnotes Source of Support: Nil. References 1. The causal relation between human papillomavirus and cervical cancer.

J Clin Pathol, hpv articles. Updated in September Modifiable risk factors associated with clearance of type-specific cervical human papillomavirus infections in a cohort of university students. Cancer Epidemiol Biomarkers Prev, hpv articles. Mantovani F, Banks L. The human papillomavirus E6 protein and its contribution to malignant progression. E7 protein of human papilloma virus induces degradation of retinoblastoma protein through the ubiquitin-proteasome pathway, hpv articles.

Cancer Research, hpv articles. Natural history of cervical neoplasia and risk of invasive cancer in women hpv articles cervical intraepithelial neoplasia 3: A retrospective cohort study. Lancet Oncol, hpv articles. Epidemiologic classification of human papillomavirus types associated with cervical cancer, hpv articles. Hpv articles Engl J Med, hpv articles.

Against which human papillomavirus types shall we vaccinate and screen. The international perspective? Int J Cancer. J Clin Microbiol.

 

Human Papillomavirus (HPV), HPV-Related Disease, and the HPV Vaccine

 

hpv articles

 

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, and persistent HPV infection is strongly associated with risk of cervical cancer and genital warts. The recently approved quadrivalent HPV vaccine targets the HPV strains responsible for approximately 70% of cervical cancers and 90% of genital xblasteers.cf by: Human papillomavirus (HPV) infection is very common. Most people—about 9 in 10—will get an HPV infection at some point in their lives. HPV infections can cause health problems, including several kinds of cancer in both women and men. There are safe and effective vaccines recommended to prevent. The latest cervical cancer and hpv vaccine research from prestigious universities and journals throughout the world. For full functionality, it is necessary to enable JavaScript.