Human papillomavirus vaccines

Abstract

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It has been barely 5 years since medicine and public health gained an extraordinary new weapon for preventing cervical cancer, one of the most important neoplastic diseases of women worldwide and a major cause of premature female death in developing countries. The two commercially available vaccines against human papillomavirus (HPV) infection are very effective in preventing infections with the two major cancer-causing genotypes, HPV-16 and HPV-18, and the cervical precancerous lesions that originate from such infections. The clinical trial data are among the strongest of any new vaccines, their safety meets today's standards of low tolerance to risk of adverse events, and protection seems to extend at least to 10 years and probably well beyond. One of the approved vaccines adds protection against two other HPV genotypes (HPV-6 and HPV-11) that cause genital warts and respiratory papillomatosis, diseases that bring substantial suffering and stigmatization to those affected. Both vaccines seem to protect also against other HPV genotypes that are closely related phylogenetically to HPV-16 and -18, although the duration of that protection remains to be established. Clinical trials of men and mid-adult women have also shown promising results. At least one country, Australia (an early adopter of publicly funded HPV vaccination), has already begun to reap the benefits of HPV vaccination via reductions in rates of cervical abnormalities and genital warts.