[Should the antipapillomavirus vaccination after the age of 25 be advised?].
Antipapillomavirus vaccination of young girls before their first sexual encounter is now a common practice. However, this prophylactive measure could also be extended to older patients. The HPV infection is indeed not limited to teenagers even if the highest incidence rate is noticed between the age of 18 and 30, it can also be found in older women. These older women show a sustained prevalence due to the longer persistence of the infection. This is clearly illustrated by the incidence of cervical cancer after the age of 50. Moreover, phase 3 studies in large unselected populations have shown the effectiveness of HPV vaccination in patients who had previously been infected by HPV (and got cured of it) as well as with patients who had never had any papillomavirus contact. Actually, less than 1 % of women who present simultaneously a HPV 16 and a HPV 18 infection will not derive any benefit from a HPV vaccination. Therefore, it seems logical to positively consider a HPV prophylaxis in patients who are above the age of 25 and who do not present any papillomavirus induced cervical lesion.
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Service de gynécologie-obstétrique, ULB hôpital Erasme, route de Lennik 808, 1070 Bruxelles, Belgique. philippe.simon@erasme.ulb.ac.be
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