Human papillomavirus vaccines and adolescents.
OBJECTIVE
This review will describe human papillomavirus (HPV) vaccines in development, summarize data regarding safety and efficacy of these vaccines, and discuss key issues related to HPV vaccine implementation.


RESULTS
Evidence from epidemiologic and genetic studies has confirmed that HPV infection is a necessary cause of cervical cancer and contributes to the development of other cancers. HPV infection also may cause nonmalignant conditions such as external genital warts and recurrent respiratory papillomatosis. Over the past decade, several vaccines that target common HPV types have entered clinical trials. These vaccines are classified as prophylactic or therapeutic. The goal of prophylactic vaccines is to prevent primary or persistent HPV infections, and thus prevent cervical cancer and/or genital warts. Recent evidence indicates that prophylactic vaccines are well tolerated, highly immunogenic and effective in preventing persistent HPV infection and cervical intraepithelial neoplasia (CIN). Questions remain, however, concerning vaccine efficacy against HPV-related diseases other than cervical cancer, the duration of protection, vaccine acceptability and feasibility of vaccine delivery in the developing world. The goal of therapeutic vaccines is to prevent progression of HPV infection, induce regression of CIN or condylomata, or eradicate residual cervical cancer. Although therapeutic vaccines appear to induce both humoral and cell-mediated immunity, they have not consistently demonstrated clinical efficacy.


CONCLUSIONS
HPV vaccines in development have the potential to reduce the substantial morbidity and mortality associated with cervical cancer and other HPV-associated diseases. Large-scale efficacy studies that are planned or underway will provide additional information about vaccine tolerance and efficacy.
Kahn
Jessica A
JA
Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. jessica.kahn@cchmc.org
Bernstein
David I
DI
D000293:Adolescent; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000276:immunology*; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000628:therapy; D053918:Papillomavirus Vaccines; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014765:Viral Vaccines / Q000276:immunology / Q000627:therapeutic use
D053918:Papillomavirus Vaccines; D014765:Viral Vaccines