HPV Vaccination after Primary Treatment of HPV-Related Disease across Different Organ Sites: A Multidisciplinary Comprehensive Review and Meta-Analysis

• Published in: Vaccines (Basel) Vol. 10; no. 2; p. 239
• Main Authors: Di Donato, Violante, Caruso, Giuseppe, Bogani, Giorgio, Cavallari, Eugenio Nelson, Palaia, Gaspare, Perniola, Giorgia, Ralli, Massimo, Sorrenti, Sara, Romeo, Umberto, Pernazza, Angelina, Pierangeli, Alessandra, Clementi, Ilaria, Mingoli, Andrea, Cassoni, Andrea, Tanzi, Federica, Cuccu, Ilaria, Recine, Nadia, Mancino, Pasquale, de Vincentiis, Marco, Valentini, Valentino, d'Ettorre, Gabriella, Della Rocca, Carlo, Mastroianni, Claudio Maria, Antonelli, Guido, Polimeni, Antonella, Muzii, Ludovico, Palaia, Innocenza
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 04-02-2022; MDPI
• Subjects: Anogenital; anogenital warts; Antibodies; Bias; Cancer; cervical cancer; Clinical trials; Confidence intervals; Disease prevention; Dysplasia; FDA approval; Health services; HPV; Human papillomavirus; Infections; Meta-analysis; Papilloma; Patients; Penis; Public health; Risk management; Surgery; Systematic Review; Vaccination; Vaccines; Vagina; vulvar cancer; Warts; Womens health; laryngeal papillomatosis; vulvar cancer; human papillomavirus; cervical cancer; HPV; anogenital warts; vaccination
• ISSN: 2076-393X; 2076-393X
• DOI: 10.3390/vaccines10020239

To assess evidence on the efficacy of adjuvant human papillomavirus (HPV) vaccination in patients treated for HPV-related disease across different susceptible organ sites.
A systematic review was conducted to identify studies addressing the efficacy of adjuvant HPV vaccination on reducing the risk of recurrence of HPV-related preinvasive diseases. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI).
Sixteen studies were identified for the final analysis. Overall, 21,472 patients with cervical dysplasia were included: 4132 (19.2%) received the peri-operative HPV vaccine, while 17,340 (80.8%) underwent surgical treatment alone. The recurrences of CIN 1+ (OR 0.45, 95% CI 0.27 to 0.73;
= 0.001), CIN 2+ (OR 0.33, 95% CI 0.20 to 0.52;
< 0.0001), and CIN 3 (OR 0.28, 95% CI 0.13 to 0.59;
= 0.0009) were lower in the vaccinated than in unvaccinated group. Similarly, adjuvant vaccination reduced the risk of developing anal intraepithelial neoplasia (
= 0.005) and recurrent respiratory papillomatosis (
= 0.004). No differences in anogenital warts and vulvar intraepithelial neoplasia recurrence rate were observed comparing vaccinated and unvaccinated individuals.
Adjuvant HPV vaccination is associated with a reduced risk of CIN recurrence, although there are limited data regarding its role in other HPV-related diseases. Further research is warranted to shed more light on the role of HPV vaccination as adjuvant therapy after primary treatment.