Human papilloma virus& vaccine-preventable diseases

By Zeena Nackerdien

LOW-RISK HPV & DISEASES

~70% of cervical cancers (HPV 16/18) (1)

Others: 31, 33, 35, 39, 41, 45, 51, 52, 56, 58, 59 & 66 (2)

HPV 18 HPV 16

HIGH-RISK HPV & CANCERS

•Comparison Page LayoutClassification, incidence of types of associated cancers

Benign/low-grade cervical changes,

Ano-genital warts, juvenile or recurrent respiratory

papillomatosis (1)

HPV 11

HPV 6

1. US Centers for Disease Control and Prevention. Manual for the Surveillance of Vaccine-Preventable Diseases - Chapter 5 (5th edition): Human Papillomavirus (HPV) 2011 http://www.cdc.gov/vaccines/pubs/surv-manual/chpt05-hpv.html2. Cutts F.T., Franceschi S., Goldie S. ea. Bulletin of the World Health Organization. Human papillomavirus and HPV vaccines: a review. Volume 85, Number 9, September 2007, 719-726 http://www.who.int/bulletin/volumes/85/9/06-038414/en/#

•Prevention with approved vaccinesACOG recommendations for target populations (3)

“Routinely recommending HPV vaccination as cancer prevention to be co-administered with other vaccines at age 11 years can improve vaccination rates. (3)

Sexually active women (13-26

y)Counseling, some efficacy, ongoing cervical cytology in women ≥21 y

Sexually active women (>26 y)

Vaccine not approved for this purpose; case-by-case off-label use

may provide marginal benefit

Adolescents & young women*Vaccines can be

given, with emphasis on

limited benefits and continued management

Pregnant & lactating women

HPV vaccination during pregnancy

not recommended;

Lactating women can receive either

approved vaccine.

Immunosuppressed patients

Immune response may be less

robust, but disease status is not a

contra-indication

*cervical intracellular epithelial neoplasia or genital warts. The American Committee of Obstetricians and Gynecology (Committee on Adolescent Health Care Opinion): Human Papilloma Virus Vaccination. Number 588 2014. 1. http://www.acog.org/-/media/Committee-Opinions/Committee-on-Adolescent-Health-Care/co588.pdf?dmc=1&ts=20141015T1435561626.4. Perkins RB, Clark JA, Apte G, Vercruysse JL, Sumner JJ, Wall-Haas CL, et al. Missed Opportunities for HPV Vaccination in Adolescent Girls: A Qualitative Study. Pediatrics. 2014 (e-pub)

Bivalent and quadrivalent vaccines