lunes, noviembre 30, 2015

¿Hacia dónde vamos con la vacuna HPV?

Graffiti / Montevideo / Autor RSK / Foto del editor Nov 2015
Ensayo clínico sobre vacuna HPV
Conclusión: En las mujeres con resultados positivos para el ADN VPH, VPH-16/18 de la vacunación no acelera el aclaramiento del virus y la vacuna, no debe ser utilizada para tratar las infecciones prevalentes.

Hildesheim A, Herrero R, Wacholder S, et al. Effect of human papillomavirus 16/18 l1 viruslike particle vaccine among young women with preexisting infection: A randomized trial. JAMA [Internet]. 2007 Aug 15 [cited 2015 Nov 29];298(7):743–53. Available from: http://dx.doi.org/10.1001/jama.298.7.743

Results There was no evidence of increased viral clearance at 6 or 12 months in the group who received HPV vaccine compared with the control group. Clearance rates for HPV-16/18 infections at 6 months were 33.4% (82/248) in the HPV vaccine group and 31.6% (95/298) in the control group (vaccine efficacy for viral clearance, 2.5%; 95% confidence interval, −9.8% to 13.5%). Human papillomavirus 16/18 clearance rates at 12 months were 48.8% (86/177) in the HPV vaccine group and 49.8% (110/220) in the control group (vaccine efficacy for viral clearance, −2.0%; 95% confidence interval, −24.3% to 16.3%). There was no evidence of a therapeutic effect for other oncogenic or nononcogenic HPV categories, among women receiving all vaccine doses, among women with single infections, or among women stratified by the following entry variables: HPV-16/18 serology, cytologic results, HPV DNA viral load, time since sexual debut, Chlamydia trachomatis or Neisseria gonorrhoeae infection, hormonal contraceptive use, or smoking.

Conclusion: In women positive for HPV DNA, HPV-16/18 vaccination does not accelerate clearance of the virus and should not be used to treat prevalent infections.

Trial Registration clinicaltrials.gov Identifier: NCT00128661

Turner TB, Huh WK. HPV Vaccines: translating immunogenicity into efficacy. Human Vaccines & Immunotherapeutics [Internet]. 2015 Oct 29 [cited 2015 Nov 27];0(ja):00–00. Available from: http://dx.doi.org/10.1080/21645515.2015.1103936

Meijer CJ, Berkhof J, Heideman DA, Snijders PJ. Cervical cancer prevention: who should receive vaccination? Nature Clinical Practice Oncology [Internet]. 2008 [cited 2015 Nov 29];5(1):12–3. Available from: http://www.nature.com/nrclinonc/journal/v5/n1/full/ncponc0976.html#close

Gt P4 Uy
Miguel Pizzanelli