Indication of prophylactic vaccines as a tool for secondary prevention in HPV-linked disease.

Abstract:

PURPOSE:To determine whether quadrivalent HPV vaccination is effective in reducing recurrent disease in women with a previous history of HPV disease. METHODS:All women under 45 years of age treated for HPV-linked disease and with negative HPV test, cytology and colposcopy 3 months after treatment were enrolled. Women were randomly assigned into two groups: a group that received HPV vaccine post treatment and a group that was only submitted to follow-up. Follow-up was performed every 6 months for a duration of at least 3 years. Kaplan-Meier curve was used to estimate the overall disease-free survival during the follow-up period. Statistical analysis was performed by Fisher's exact test. RESULTS:From November 2013 to October 2014, we enrolled a total of 178 women at Careggi University Hospital in Florence and at Azienda USL in Massa Carrara. 12 out of 89 patients in the non-vaccination group recurred (13.5%), while 3 out of 89 patients in the vaccination group recurred (3.4%). The Kaplan-Meier curves showed a statistically difference in the log rank test (p = 0.0147) for the overall disease-free survival in the study groups during follow-up. The rate of recurrence was significantly higher in the non-vaccination group, with a p = 0.0279 by Fisher exact test. CONCLUSION:The introduction of anti-HPV vaccination during the follow-up post treatment for HPV-linked disease is recommended to reduce the risk of recurrence. The clinical implication of this could be very important to influence post-treatment management of HPV disease.

journal_name

Arch Gynecol Obstet

authors

Pieralli A,Bianchi C,Auzzi N,Fallani MG,Bussani C,Fambrini M,Cariti G,Scarselli G,Petraglia F,Ghelardi A

doi

10.1007/s00404-018-4926-y

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

1205-1210

issue

6

eissn

0932-0067

issn

1432-0711

pii

10.1007/s00404-018-4926-y

journal_volume

298

pub_type

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