[Efficacy of commercially available vaccines against HPV infection in women: a systematic review and meta-analysis].
Persistent HPV infection is a necessary condition for the occurrence of cervical cancer. Prophylactic HPV vaccines have been developed to reduce the incidence of cervical cancer. Two vaccines are commercially available: bivalent (types 16, 18) and quadrivalent (6, 11, 16 and 18). This study aimed to perform a systematic review and metaanalysis of the HPV vaccines' efficacy in women, focusing its performance stratified by clinical outcomes. Randomized controlled trials (RCT) published between 2000 and 2009 were identified from searches of MEDLINE, LILACS and Cochrane Library, and evaluated by two independent reviewers. Six RCT were selected. The vaccines reduced the risk of precursor lesions of cervical cancer, presenting efficacy of 97% (95%CI: 90-99) for CIN 2 and 96% (95%CI: 89-99) for CIN 3, in the per protocol analysis. The efficacies in the analysis by intention to treat were smaller: 63% (95%CI: 52-71) and 42% (95%CI: 26-55), respectively. In order to evaluate its effectiveness on the incidence and mortality rates for cervical cancer, longer-term studies will be needed.
Secretaria Municipal de Saúde e Defesa Civil do Rio de Janeiro, Rio de Janeiro, Brasil. silvia.araujo@smsdc.rio rj.gov.br
Silvia Cristina Fonseca de
SC
Araujo
Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
Rosângela
R
Caetano
Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
Jose Ueleres
JU
Braga
Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
Frances Valéria
FV
Costa e Silva
D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000517:prevention & control*
D053918:Papillomavirus Vaccines