Abstract
Since the discovery of the causal association between human papillomavirus (HPV) and cervical cancer, efforts to develop an effective prophylactic vaccine to prevent high-risk HPV infections have been at the forefront of modern medical research. HPV causes 530,000 cervical cancer cases worldwide, which is the second most common cause of cancer deaths in women; a worldwide collaboration among epidemiologists, molecular biologists, vaccinologists, virologists, and clinicians helped lead to the development of two highly effective prophylactive HPV vaccines. The first, Gardasil, is a quadrivalent vaccine made up of recombinant HPV L1 capsid proteins from the two high-risk HPV types (16/18) responsible for 70% of cervical cancer cases as well as two low-risk HPV types (6/11) which are the causative agent for genital warts. The second, Cervarix, is a bivalent vaccine that was FDA approved three years after Gardasil and is also composed of L1 capsid proteins from HPV types 16/18. This review article focuses on the safety and efficacy data of both FDA-approved vaccines, as well as highlighting a few advances in future HPV vaccines that show promise in becoming additional treatment options for this worldwide disease.
Highlights
One of the most groundbreaking scientific discoveries in the last 50 years is the causal association between human papillomavirus (HPV) and cervical cancer
The Future II study concluded that the quadrivalent vaccine was 100% effective in preventing incident CIN 2/3 and cervical adenocarcinoma in situ caused by HPV-16 and HPV-18 in women negative for HPV at enrollment and 94% effective in preventing vulvar or vaginal
This study demonstrated the protection that quadrivalent vaccination provides, in women positive for 1–3 of the HPV vaccine types, against neoplasia and genital lesions caused by the remaining HPV types, supporting the utility of quadrivalent HPV
Summary
One of the most groundbreaking scientific discoveries in the last 50 years is the causal association between human papillomavirus (HPV) and cervical cancer. 16 in cervical cancer specimens, received a Nobel Prize in Physiology and Medicine in 2008 for this accomplishment This discovery catapulted HPV into the forefront of medical research in an effort to develop an effective prophylactic vaccine to prevent HPV and HPV associated cancers [1]. There are over a 100 HPV genotypes, differentiated by varying viral genome sequences [3] These diverse genotypes can be differentiated into cutaneous and mucosal types. Papaniclolau smears have reduced cervical cancer incidence by 80%, it is still the second most common cause of cancer deaths in women. A key factor in reducing the morbidity and mortality associated with HPV lies in prevention of initial HPV infection This has led to a worldwide collaboration among epidemiologists, molecular biologists, vaccinologists, virologists and clinicians to develop a highly effective prophylactic HPV vaccine
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