Efficacy, duration of immunity and cross protection after HPV vaccination: A review of the evidence
Efficacy, duration of immunity and cross protection after HPV vaccination: A review of the evidence
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DOI：
10.1016/j.vaccine.2008.10.085
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发表时间：
2009-05-29
期刊：
影响因子：
5.5
通讯作者：
Bechini, Angela
中科院分区：
文献类型：
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作者：
Bonanni, Paolo;Boccalini, Sara;Bechini, Angela
HPV疫苗的有效性和免疫原性已在涉及数万名妇女的几项2期和3期试验中证明是极好的。在对接种者的后续研究中观察到抗体滴度下降，最初急剧下降，在较长时间内达到稳定水平。只有少数受试者在接种疫苗后5-6年内失去了抗体。然而，即使在这些受试者中也没有发生突破性疾病。在随访的第60个月给予四价疫苗的攻击剂量导致强烈的回忆反应。疫苗接种提供保护的机制和疫苗持续有效的原因仍有待阐明。这同样适用于通过生殖器粘膜进行病毒攻击后诱导回忆应答的可能性。数据强烈表明，两种疫苗对HPV类型具有不同水平的交叉保护作用，遗传和抗原性与疫苗类型密切相关。证明对组合终点的交叉保护四价疫苗已达到联合HPV类型（CIN 2/3和AIS），以及作为单一类型，HPV-31，并且有证据表明对HPV 31和45持续感染具有交叉保护作用。用于抗体检测的测定对于两种疫苗是不同的，目前正在进行抗HPV L1蛋白检测方法的标准化。使用普遍接受的抗体测量测试的可能性将使疫苗之间和不同研究之间的比较更加容易。(C)2008爱思唯尔有限公司保留所有权利。
The efficacy and immunogenicity of HPV vaccines has proven excellent in several phase 2 and phase 3 trials involving tens of thousand women. A decrease in antibody titres was observed in follow-up studies of vaccinees, with initial sharp decline reaching a plateau in the longer term. Only few subjects lost their antibodies during the 5-6 years after vaccination. However, no breakthrough disease occurred even in those subjects. The administration of a challenge dose of quadrivalent vaccine at month 60 of follow-up resulted in a strong anamnestic response. The mechanism by which vaccination confers protection and the reasons for continuing vaccine efficacy remain to be elucidated. The same applies to the possibility of inducing an anamnestic response following viral challenge via genital mucosa.Data strongly suggest that both vaccines can have a variable level of cross protection against HPV types genetically and antigenically-closely related to vaccine types. Demonstration of cross protection against combined endpoints (CIN2/3 and AIS) for combined HPV types, and, as a single type, for HPV-31, has been reached for the quadrivalent vaccine, and there is evidence of cross protection against HPV 31 and 45 persistent infections (as single types) for the bivalent vaccine.Assays used for antibody detection were different for the two vaccines, and standardisation of methods for anti-HPV L1 protein detection is presently underway. The possibility to use universally accepted tests for antibody measurement would make comparison between vaccines and among different studies much easier. (C) 2008 Elsevier Ltd. All rights reserved.