Human papillomavirus 9-valent vaccine for cancer prevention: a systematic review of the available evidence

SUMMARYIn 2014, the Food and Drug Administration approved a new human papillomavirus 9-valent vaccine (9vHPV), targeting nine HPV types: HPV types 6, 11, 16, and 18, which are also targeted by the quadrivalent HPV vaccine (qHPV), plus five additional high cancer risk HPV types (HPV types 31, 33, 45, 52, and 58). The aim of the current study was to systematically retrieve, qualitatively and quantitatively pool, as well as critically appraise all available evidence on 9vHPV from randomized controlled trials (RCTs). We conducted a systematic review of the literature on 9vHPV efficacy, immunogenicity and safety, as well as a systematic search of registered, completed, and ongoing RCTs. We retrieved and screened 227 records for eligibility. A total of 10 publications reported on RCTs’ results on 9vHPV and were included in the review. Sixteen RCTs on 9vHPV have been registered on RCT registries. There is evidence that 9vHPV generated a response to HPV types 6, 11, 16 and 18 that was non-inferior to qHPV. Vaccine efficacy against five additional HPV type-related diseases was directly assessed on females aged 16–26 years (risk reduction against high-grade cervical, vulvar or vaginal disease = 96·7%, 95% CI 80·9%–99·8%). Bridging efficacy was demonstrated for males and females aged 9–15 years and males aged 16–26 years (the lower bound of the 95% CIs of both the geometric mean titer ratio and difference in seroconversion rates meeting the criteria for non-inferiority for all HPV types). Overall, 9vHPV has been proved to be safe and well tolerated. Other RCTs addressed: 9vHPV co-administration with other vaccines, 9vHPV administration in subjects that previously received qHPV and 9vHPV efficacy in regimens containing fewer than three doses. The inclusion of additional HPV types in 9vHPV offers great potential to expand protection against HPV infection. However, the impact of 9vHPV on reducing the global burden of HPV-related disease will greatly depend on vaccine uptake, coverage, availability, and affordability.

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Prevalence of Oral Human Papillomavirus Infection among Indian HIV-Positive Men Who Have Sex With Men: A Cross-Sectional Study

10.21203/rs.3.rs-60960/v1 ◽

2020 ◽

Author(s):

Alexandra Lydia Hernandez ◽

Rajiv Karthik ◽

Murugesan Sivasubramanian ◽

Anantharam Raghavendran ◽

Shelly Lensing ◽

...

Keyword(s):

Human Papillomavirus ◽

Hpv Infection ◽

Sexual History ◽

Hiv Positive ◽

Increased Risk ◽

Oral Hpv ◽

Hpv Types ◽

Sex With Men ◽

The Impact ◽

Hiv Positive Men

Abstract Background: Oral human papillomavirus (HPV) infection has been causally linked to a subset of oropharyngeal cancers in Western populations15-20, and both oropharyngeal cancer and oral HPV infection are increased among HIV-positive individuals24,41. India has high incidences of oral and oropharyngeal cancers, and Indian HIV-positive men who have sex with men (MSM) may be at increased risk of developing oropharyngeal cancers. However, there is little information available on the prevalence of oral HPV in this population.Methods: We tested 302 HIV-positive Indian MSM for oral HPV infection using L1 HPV DNA PCR with probes specific for 29 types and a mixture of 10 additional types. CD4+ level and plasma HIV viral load (VL) were measured. Participants completed an interviewer-administered questionnaire including a sexual history.Results: The prevalence of oral HPV was 23.7% (95% CI: 19-29%) and 2.4% of participants had oncogenic HPV types. No participants had oral HPV type 16 (HPV-16) and the prevalence of other anogenital HPV types was low. Participants with higher CD4+ levels had reduced odds of having any oral HPV infection (OR: 3.1 [1.4-6.9]) in multivariable analyses.Conclusions: This is the first report of oral HPV among Indian HIV-positive MSM. Our results show a high prevalence of oral HPV infection consistent with studies from Western populations. However, oncogenic anogenital HPV types were relatively uncommon in our study population. It is unknown what the impact of this distribution of oral HPV will be on oropharyngeal cancers. HIV-positive MSM in India should be monitored closely for oral and oropharyngeal pre-cancer and cancer.

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High human papillomavirus prevalence among females attending high school in the Eastern Cape Province of South Africa

PLoS ONE ◽

10.1371/journal.pone.0253074 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253074

Author(s):

Zizipho Z. A. Mbulawa ◽

Nontuthuzelo I. Somdyala ◽

Sikhumbuzo A. Mabunda ◽

Anna-Lise Williamson

Keyword(s):

South Africa ◽

Human Papillomavirus ◽

African Ancestry ◽

Vaccination Strategy ◽

Hpv Infection ◽

Eastern Cape Province ◽

Eastern Cape ◽

Hpv Prevalence ◽

Hpv Types ◽

The Impact

As part of the human papillomavirus (HPV) vaccination strategy in South Africa, it is essential to have information on HPV prevalence, and HPV types distribution among the unvaccinated population. Information on the prevalence of HPV and the distribution of HPV types in adolescents and young women in South Africa’s Eastern Cape Province is minimal. Therefore, this study investigates the prevalence, distribution of HPV types, and factors associated with HPV infection amongst unvaccinated female learners. A sample composed of 213 sexually active female learners attending high schools in the Eastern Cape Province of South Africa; median age 18 years, who provided self-collected vaginal specimens. Roche Linear Array HPV genotyping assay that detects 37 HPV genotypes was used to detect HPV infection. HPV infection was detected in 76.06% (162/213) of participants. Of these 14.55% (31/213) were positive for HPV types targeted by the Cervarix® HPV vaccine (HPV-16 and/or 18), 20.66% (44/213) by Gardasil®4 (HPV-6, -11, -16 and/or -18) and 37.09% (79/213) by Gardasil®9 (HPV-6, -11, -16, -18, -31, -33, -45, -52 and/or -58). HPV-35, commonly detected in cervical cancer cases among women of African ancestry, was frequently detected (9.40%). Participants who reported to have ever consumed alcohol had a significantly higher risk of HPV infection (OR: 2.91, 95% CI: 1.38–6.11, p = 0.005). High HPV prevalence was observed among participants. The high prevalence of HPV types targeted by the Gardasil®9 vaccine encourages the introduction of the Gardasil®9 vaccine. Data from this study will inform both vaccination campaigns and monitor the impact on HPV types after vaccination.

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Prevalence of Oral Human Papillomavirus Infection among Indian HIV-positive Men who have Sex with Men: A Cross-Sectional Study

10.21203/rs.3.rs-60960/v2 ◽

2021 ◽

Author(s):

Alexandra Lydia Hernandez ◽

Rajiv Karthik ◽

Murugesan Sivasubramanian ◽

Anantharam Raghavendran ◽

Shelly Lensing ◽

...

Keyword(s):

Human Papillomavirus ◽

Hpv Infection ◽

Sexual History ◽

Hiv Positive ◽

Increased Risk ◽

Oral Hpv ◽

Hpv Types ◽

Sex With Men ◽

The Impact ◽

Hiv Positive Men

Abstract Background: Oral human papillomavirus (HPV) infection has been causally linked to a subset of oropharyngeal cancers in Western populations15-20, and both oropharyngeal cancer and oral HPV infection are increased among HIV-positive individuals24,41. India has high incidences of oral and oropharyngeal cancers, and Indian HIV-positive men who have sex with men (MSM) may be at increased risk of developing oropharyngeal cancers. However, there is little information available on the prevalence of oral HPV in this population.Methods: We tested 302 HIV-positive Indian MSM for oral HPV infection using L1 HPV DNA PCR with probes specific for 29 types and a mixture of 10 additional types. CD4+ level and plasma HIV viral load (VL) were measured. Participants completed an interviewer-administered questionnaire including a sexual history.Results: The prevalence of oral HPV was 23.7% (95% CI: 19-29%) and 2.4% of participants had oncogenic HPV types. No participants had oral HPV type 16 (HPV-16) and the prevalence of other anogenital HPV types was low. Participants with higher CD4+ levels had reduced odds of having any oral HPV infection (OR: 3.1 [1.4-6.9]) in multivariable analyses. Conclusions: This is the first report of oral HPV among Indian HIV-positive MSM. Our results show a high prevalence of oral HPV infection consistent with studies from Western populations. However, oncogenic anogenital HPV types were relatively uncommon in our study population. It is unknown what the impact of this distribution of oral HPV will be on oropharyngeal cancers. HIV-positive MSM in India should be monitored closely for oral and oropharyngeal pre-cancer and cancer.

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Prevalence and Genotype Distribution of Genital Human Papillomavirus Infection in Female Sex Workers in the World: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-18665/v2 ◽

2020 ◽

Author(s):

Mohammad Farahmand ◽

Mohsen Moghoofei ◽

Abolfazl Dorost ◽

Saeedeh Abbasi ◽

Seyed Hamidreza Monavari ◽

...

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Hpv Infection ◽

Hpv Prevalence ◽

High Prevalence ◽

The World ◽

Hpv Types

Abstract Background: Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and the distribution of HPV types among FSWs across the world. Methods: Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta. Results: Sixty-two studies involving 21402 FSWs from 33 countries were included in this meta-analysis, and the pooled HPV prevalence was 42.60% (95% confidence interval (CI): 38.58%-46.71%). HPV-16 (10.16%, 95% CI: 8.20%–12.51%), HPV-52 (7.98%, 95% CI: 5.91%–10.70%), and HPV-53 (6.01%, 95% CI: 4.40%–8.15%) were the most common high-risk HPV types identified among FSWs. The pooled estimated prevalence of HPV infection among FSWs before and after 2010 were slightly different, 43.64% (95% CI: 36.12%-51.46%) and 41.97% (95% CI: 37.28%-46.81%), respectively. Conclusion: Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and the incidence of HPV-associated malignancies among the general population.

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Prevalence and genotype distribution of genital human papillomavirus infection in female sex workers in the world: a systematic review and meta-analysis

BMC Public Health ◽

10.1186/s12889-020-09570-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Mohammad Farahmand ◽

Mohsen Moghoofei ◽

Abolfazl Dorost ◽

Saeedeh Abbasi ◽

Seyed Hamidreza Monavari ◽

...

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Hpv Infection ◽

Hpv Prevalence ◽

High Prevalence ◽

The World ◽

Hpv Types

Abstract Background Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and the distribution of HPV types among FSWs across the world. Methods Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta. Results Sixty-two studies involving 21,402 FSWs from 33 countries were included in this meta-analysis, and the pooled HPV prevalence was 42.6% (95% confidence interval (CI): 38.5–46.7%). HPV-16 (10.1, 95% CI: 8.2–12.5%), HPV-52 (7.9, 95% CI: 5.9–10.7%), and HPV-53 (6.0, 95% CI: 4.4–8.1%) were the most common high-risk HPV types identified among FSWs. The pooled estimated prevalence of HPV infection among FSWs before and after 2010 were slightly different, 43.6% (95% CI: 36.1–51.4%) and 41.9% (95% CI: 37.2–46.8%), respectively. Conclusion Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and the incidence of HPV-associated malignancies among the general population.

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Prevalence and Genotype Distribution of Genital Human Papillomavirus Infection in Female Sex Workers in the World: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-18665/v3 ◽

2020 ◽

Author(s):

Mohammad Farahmand ◽

Mohsen Moghoofei ◽

Abolfazl Dorost ◽

Saeedeh Abbasi ◽

Seyed Hamidreza Monavari ◽

...

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Hpv Infection ◽

Hpv Prevalence ◽

High Prevalence ◽

The World ◽

Hpv Types

Abstract Background: Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and the distribution of HPV types among FSWs across the world. Methods: Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta. Results: Sixty-two studies involving 21402 FSWs from 33 countries were included in this meta-analysis, and the pooled HPV prevalence was 42.6% (95% confidence interval (CI): 38.5%-46.7%). HPV-16 (10.1%, 95% CI: 8.2%–12.5%), HPV-52 (7.9%, 95% CI: 5.9%–10.7%), and HPV-53 (6.0%, 95% CI: 4.4%–8.1%) were the most common high-risk HPV types identified among FSWs. The pooled estimated prevalence of HPV infection among FSWs before and after 2010 were slightly different, 43.6% (95% CI: 36.1%-51.4%) and 41.9% (95% CI: 37.2%-46.8%), respectively. Conclusion: Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and the incidence of HPV-associated malignancies among the general population.

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P–071 Human Papillomavirus Infection and impact on men fertility

Human Reproduction ◽

10.1093/humrep/deab130.070 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

N Madzunkov ◽

K Madjunkova

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Male Infertility ◽

Sperm Quality ◽

Hpv Infection ◽

Hpv Dna ◽

Hpv Types ◽

Adverse Pregnancy ◽

High Risk Hpv ◽

The Impact

Abstract Study question Is there any correlation between men infertility and HPV infection and its impairment on sperm quality? Summary answer There is a significantly higher prevalence of high-risk HPV in infertile men than fertile men. HPV infection does not impair sperm quality. What is known already Many factors may cause the infertility in males and females. Human papillomavirus are the most frequently sexually transmitted DNA viruses and etiological agents of cervical cancers. There is association between HPV infection in females and adverse pregnancy outcomes such as spontaneous abortion and spontaneous preterm delivery. Previous studies have reported the detection of HPV DNA in semen and in different sites of the male reproductive tract, such as glans penis and scrotum. Recent reports suggested that HPV may affect sperm parameters and lead to male infertility. The impact of HPV infection upon male fertility abnormality has received far less attention. Study design, size, duration In this study case control study we examined 38 fertile and 36 men from infertle couples. Participants/materials, setting, methods we examined the swabs of the entire penile surface and semen samples for HPV detection and genotyping from 38 fertile men and 36 from men from infertile couples.HPV were detected with PCR method. Sperm was also examined for its motility, sperm quantity and morphology . Main results and the role of chance Among 36 confirmed infertile males, only 8 (22.22%) cases were tested positive for HPV of semen samples and 2 among fertile men were HPV-positive (5.26%) of semen samples. Among infertile males 14 (38.88%) had HPV positive penile swabs, and only 1 (2,63%) had positive HPV swab among fertile men. The most prevalent HPV types in the male external genitalia were HPV–16. The most prevalent HPV types in semen were HPV–53. This data revealed a significant association between high-risk HPV and male infertility (P = 0.03). Sperm quality (morphology and motility) did not differ significantly between men with seminal HPV infection and uninfected men. Limitations, reasons for caution There were some limitations in the study such as differences in age. sample sizes and the number of HPV genotypes detected. Wider implications of the findings: We need larger studies and more further investigations to confirm the impact of HPV on male infertility. Trial registration number 2

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Prevalence and Genotype Distribution of Genital Human Papillomavirus Infection in Female Sex Workers in the World: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-18665/v1 ◽

2020 ◽

Author(s):

Mohammad Farahmand ◽

Mohsen Moghoofei ◽

Seyed Hamidreza Monavari ◽

Seyed Jalal Kiani ◽

Ahmad Tavakoli

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Hpv Infection ◽

Hpv Prevalence ◽

High Prevalence ◽

The World ◽

Hpv Types

Abstract Background: Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and distribution of HPV types among FSWs across the world. Methods: Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta. Results: Sixty-six studies involving 22938 FSWs from 34 countries were included in this meta-analysis, and the pooled HPV prevalence was 41.97% (95% confidence interval (CI): 37.99%-46.05%). HPV-16 (10.42%, 95% CI: 8.61%–12.55%), HPV-52 (7.76%, 95% CI: 5.75%–10.39%), and HPV-53 (6.09%, 95% CI: 4.55%–8.12%) were the most common high-risk HPV types identified among FSWs. The polled estimated prevalence of HPV infection among FSWs before and after 2010 were slightly different, 43.64% (95% CI: 36.12%-51.46%) and 41.01% (95% CI: 36.35%-45.83%), respectively. Conclusion: Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and incidence of HPV-associated malignancies among the general population.

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Universal Human Papillomavirus Vaccination and its Impact on the Southern Italian Region

Current Pharmaceutical Design ◽

10.2174/1381612826666200212115840 ◽

2020 ◽

Vol 26 (3) ◽

pp. 343-357 ◽

Cited By ~ 1

Author(s):

Marcello Guido ◽

Annarita Bruno ◽

Luigi Tagliaferro ◽

Valerio Aprile ◽

Andrea Tinelli ◽

...

Keyword(s):

Vaccination Coverage ◽

Hpv Vaccination ◽

Invasive Cervical Cancer ◽

Hpv Infection ◽

Vaccine Uptake ◽

Local Health ◽

Italian Region ◽

Vaccine Type ◽

Hpv Types ◽

The Impact

HPV is still the most common sexually transmitted infection, leading to the onset of many disorders while causing an increase in direct and indirect health costs. High Risk (HR) HPV is the primary cause of invasive cervical cancer and contributes significantly to the development of anogenital and oropharyngeal cancers. The introduction of universal HPV vaccination has led to a significant reduction in vaccine-targeted HPV infections, cross-protective genotypes, precancerous lesions and anogenital warts. Despite the several limitations of HPV vaccination programs, including vaccine type specificity, different schedules, target age-groups and poor communication, the impact has become increasingly evident, especially in countries with high vaccine uptake. We carried out a review of the most recent literature to evaluate the effects of HPV vaccination on vaccinetargeted HPV genotypes and to assess the level of cross-protection provided against non-vaccine HPV types. Subsequently, to assess the rates of HPV infection in a southeast Italian region, we performed an epidemiological investigation on the impact of vaccination on genotypes and on the prevalence and distribution of HPV infection during the twelve-year period 2006-2017 in the Local Health Unit (LHU) of Lecce. The vaccination coverage of about 70% among girls in the LHU led to an initial reduction in vaccine-targeted HPV types and cross-protective genotypes. However, the results on this population should be interpreted cautiously because the period since the start of vaccination is too short and the coverage rate is not yet optimal to evaluate the efficacy of vaccination in lowering the prevalence of non-vaccine HR HPV types in the vaccinated cohort and in older subjects. Nevertheless, it is expected that direct effects will increase further and that herd immunity will begin to emerge as vaccination coverage increases.

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Prevalence and Genotype Distribution of Genital Human Papillomavirus Infection in Female Sex Workers in the World: a Systematic Review and Meta-Analysis

10.21203/rs.2.17779/v1 ◽

2019 ◽

Author(s):

Mohammad Farahmand ◽

Seyed Hamidreza Monavari ◽

Mohsen Moghoofei ◽

Seyed Jalal Kiani ◽

Mehdi Tavakoli ◽

...

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Hpv Infection ◽

Hpv Prevalence ◽

High Prevalence ◽

The World ◽

Hpv Types

Abstract Background: Female sex workers (FSWs) are amongst the most susceptible groups to acquire Human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and distribution of HPV types among FSWs across the world. Methods: Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable source of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta. Results: Sixty-six studies involving 22938 FSWs from 34 countries were included in this meta-analysis, and the pooled HPV prevalence was 41.97% (95% confidence interval (CI): 37.99%-46.05%). HPV-16 (10.42%, 95% CI: 8.61%–12.55%), HPV-52 (7.76%, 95% CI: 5.75%–10.39%), and HPV-53 (6.09%, 95% CI: 4.55%–8.12%) were the most common high-risk HPV types identified among FSWs. Geographically, the highest and the lowest prevalence of HPV were obtained from Hungary (82.35%, 95%CI: 65.90%–91.85%) and Mexico (13.30%, 95%CI: 1.67%–58.06%), respectively. Conclusion: Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and incidence of HPV-associated malignancies among the general population.

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