Der Hautarzt

, Volume 58, Issue 6, pp 507–514

Bedeutung der prophylaktischen HPV-Vakzine für die Dermatologie und Venerologie

Leitthema

Zusammenfassung

Die prophylaktischen HPV-L1-VLP-quadrivalenten und -bivalenten Impfstoffe sind von großer Bedeutung für Patienten, die von Dermatologen und Venerologen betreut werden. Beide Impfstoffe schützen vor HPV16- und HPV18-assoziierten genitoanalen Karzinomen und vor Karzinomen der Mundhöhle, des oberen Respirationstrakts und extragenitalen Karzinomen der Haut v. a. im Bereich der Finger und der periungualen Region. Die quadrivalente HPV6-, -11-, -16-, -18-Vakzine schützt auch vor genitoanalen Warzen. Hierbei handelt es sich um die häufigsten gutartigen Neoplasien des Genitale und der Perianalregion. Seit Oktober ist Gardasil® in Deutschland für junge Mädchen zwischen 9 und 16 Jahren und für junge Frauen zwischen 16 und 26 Jahren zugelassen. Zahlreiche Experten votieren dafür, Knaben und männliche Jugendliche in HPV-Immunisierungsprogramme mit einzuschließen. Männer würden direkt von einem Impfstoff profitieren, der vor der HPV-Infektion, vor genitoanalen Warzen und vor dem Peniskarzinom sowie dem Analkarzinom schützt. Da bei immunsupprimierten organtransplantierten und bei HIV-seropositiven Patienten ausgeprägte und oft chronische Krankheitsbilder resultieren und rascher bzw. häufiger maligne Tumore auftreten, wäre die Einführung der prophylaktischen HPV-Impfung für diese Personen von besonders großer Bedeutung.

Schlüsselwörter

HPV-Impfung Quadrivalenter L1-VLP-HPV6-, -11-, -16-, -18-Impfstoff Bivalenter L1-VLP-HPV16-, -18-Impfstoff Genitoanale Karzinome Genitoanale Warzen 

Impact of prophylactic HPV vaccines on dermatology and venereology

Abstract

Prophylactic HPV L1 VLP quadrivalent and bivalent vaccines are of great importance for patients seen by dermatologists and venereologists. Both vaccines protect against HPV16- and HPV18-associated anogenital cancers, as well as cancers of the mouth, the upper respiratory tract and skin, especially of the fingers and periungual region. The quadrivalent HPV6, 11, 16, 18 vaccine also prevents anogenital warts (condylomata acuminata) which are the most common benign tumors of this body region. HPV-vaccination (Gardasil®) has been approved in Germany since October 2006 for young girls between 9–16 and young women between 16-26 years of age. Many experts feel that boys and young men should also be vaccinated. Men would profit from a vaccine that protects against HPV infections, especially anogenital warts, as well as penile and anal carcinomas. In immunosuppressed organ transplant recipients and HIV-positive individuals, HPV can be widespread, chronic and often rapidly progressive to malignant tumors; thus these groups would greatly benefit from HPV immunization.

Keywords

HPV vaccines Quadrivalent L1 VLP HPV6, 11, 16, 18 vaccine Bivalent L1 VLP HPV16, 18 vaccine Anogenital carcinomas Anogenital warts 

Literatur

  1. 1.
    Adach A, Fleming I, Burk RD et al. (1993) Women with human immunodeficiency virus infection and abnormal Papanicolaou smears: a prospective study of colposcopy and clinical outcome. Obstet Gynecol 81: 372–377PubMedGoogle Scholar
  2. 2.
    Block SL, Nolan T, Sattler C et al. (2006) Comparison of the immunogenicity and reactogenicity of a prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in male and female adolescents and young adult women. Pediatrics 118: 2135–2145CrossRefPubMedGoogle Scholar
  3. 3.
    Bosch FX, Maros MM, Munoz N et al. (1995) Prevalence of human Papillomavirus in cervical cancer: a world-wide perspective. International biological study on cervical cancer (IBSCC) Study group: J Natl Cancer Inst 87: 796–802Google Scholar
  4. 4.
    Breese PL, Judson FN, Penley KA, Douglas JM Jr (1995) Anal human papillomavirus infection among homosexual and bisexual men: prevalence of type-specific infection and association with human immunodeficiency virus. Sex Transm Dis 22: 7–14PubMedGoogle Scholar
  5. 5.
    Byrne MA, Taylor-Robinson D, Munday PE, Harris JR (1989) The common occurrence of human papillomavirus infection and intraepithelial neoplasia in women infected by HIV. AIDS 3: 379–382CrossRefPubMedGoogle Scholar
  6. 6.
    Center for Disease Control and Prevention (2002) Age-adjusted cancer strategiesGoogle Scholar
  7. 7.
    Chang MH, Chen TH, Hsu HM et al. (2005) Prevention of hepatocellular carcinoma by universal vaccination against hepatitis B virus: the effect and problems. Clin Cancer Res 11: 7953–7957CrossRefPubMedGoogle Scholar
  8. 8.
    Chuang TY, Perry HO, Kurland LT, Ilstrup DM (1984) Condyloma acuminatum in Rochester, Minn., 1950–1978. I. Epidemiology and clinical features. Arch Dermatol 120: 469–475CrossRefPubMedGoogle Scholar
  9. 9.
    Clifford GM, Gallus S, Herrero R et al. (2005) Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet 366: 991–998CrossRefPubMedGoogle Scholar
  10. 10.
    Colgrave J (2006) The ethics and politics of compulsory HPV vaccination. N Engl J Med 355: 2389–2391CrossRefPubMedGoogle Scholar
  11. 11.
    Critchlow CW, Hawes SE, Kuypers JM et al. (1998) Effect of HIV infection on the natural history of anal human papillomavirus infection. AIDS 12: 1177–1184CrossRefPubMedGoogle Scholar
  12. 12.
    Cupp MR, Malek RS, Goellner JR et al. (1995) The detection of human papillomavirus deoxyribonucleic acid in intraepithelial, in situ, verrucous and invasive carcinoma of the penis. J Urol 154: 1024–1029CrossRefPubMedGoogle Scholar
  13. 13.
    Daling JR, Madeleine MM, Johnson LG et al. (2005) Penile cancer: importance of circumcision, human papillomavirus and smoking in in situ and invasive disease. Int J Cancer 116: 606–616CrossRefPubMedGoogle Scholar
  14. 14.
    De Villiers EM (1989) Prevalence of HPV 7 papillomas in the oral mucosa and facial skin of patients with human immunodeficiency virus. Arch Dermatol 125: 1590CrossRefPubMedGoogle Scholar
  15. 15.
    De Villiers EM, Sandstrom RE, Hausen H zur, Buck CE (2005) Presence of papillomavirus sequences in condylomatous lesions of the mamillae and in invasive carcinoma of the breast. Breast Cancer Res 7: R1–R11PubMedGoogle Scholar
  16. 16.
    Dillner J, Krogh G von, Horenblas S, Meijer CJ (2000) Etiology of squamous cell carcinoma of the penis. Scand J Urol Nephrol Suppl 205: 189–193CrossRefPubMedGoogle Scholar
  17. 17.
    Frazer IH, Medley G, Crapper RM et al. (1986) Association between anorectal dysplasia, human papillomavirus, and human immunodeficiency virus infection in homosexual men. Lancet 2: 657–660CrossRefPubMedGoogle Scholar
  18. 18.
    French MA, Lenzo N, John M et al. (2000) Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy. HIV Med 1: 107–115CrossRefPubMedGoogle Scholar
  19. 19.
    Frisch M, Glimelius B, Brule AJ van den et al. (1997) Sexually transmitted infection as a cause of anal cancer. N Engl J Med 337: 1350–1358CrossRefPubMedGoogle Scholar
  20. 20.
    Frisch M, Biggar RJ, Goedert JJ (2000) Human papillomavirus-associated cancers in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome. J Natl Cancer Inst 92: 1500–1510CrossRefPubMedGoogle Scholar
  21. 21.
    Garnett GP (2005) Role of herd immunity in determining the effect of vaccines against sexually transmitted disease. J Infect Dis (Suppl 1) 191: S97–S106Google Scholar
  22. 22.
    Gerber GS (1994) Carcinoma in situ of the penis. J Urol 151: 829–833PubMedGoogle Scholar
  23. 23.
    Gillison ML, Koch WM, Capone RB et al. (2000) Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst 92: 709–720CrossRefPubMedGoogle Scholar
  24. 24.
    Greenspan D, Villiers EM de, Greenspan JS et al. (1988) Unusual HPV types in oral warts in association with HIV infection. J Oral Pathol 17: 482–488CrossRefPubMedGoogle Scholar
  25. 25.
    Gross G, Hagedorn M, Ikenberg H et al. (1985) Bowenoid papulosis. Presence of human papillomavirus (HPV) structural antigens and of HPV 16-related DNA sequences. Arch Dermatol 121: 858–863CrossRefPubMedGoogle Scholar
  26. 26.
    Gross G (2001) Klinik und Therapie anogenitaler Warzen und HPV-assoziierter Krankheitsbilder. Hautarzt 52: 6–17CrossRefPubMedGoogle Scholar
  27. 27.
    Gross G, Pfister H (2004) Role of human papillomavirus in penile cancer, penile intraepithelial squamous cell neoplasias and in genital warts. Med Microbiol Immunol 193: 35–44CrossRefPubMedGoogle Scholar
  28. 28.
    Gross G, für das Deutsche HPV-Management-Forum (2006) Wer soll wann, wo und wie geimpft werden. Antworten des HPV.Management-Forums auf viel diskutierte Fragen, die mit Einführung von zwei unterschiedlichen HPV-Impfstoffen zur Prävention des Zervixkarzinoms und der Condylomata acuminata in Zusammenhang stehen. Dtsch Arztebl 103: 3384–3388Google Scholar
  29. 29.
    Gross G (2007a) Condylomata acuminata und andere HPV-assoziierte Krankheitsbilder von Genitale, Anus und Harnröhre. Leitlinie der Deutschen STD-Gesellschaft in Zusammenarbeit mit der Deutschen Dermatologischen Gesellschaft und der Paul-Ehrlich-Gesellschaft. Hautarzt 58: 179–186CrossRefGoogle Scholar
  30. 30.
    Gross G (2007b) HPV-vaccination against cervical carcinoma: will it really work? Med Microbiol Immunol: DOI: 10.1007/s00430-007-0039-0 (Springer Verlag; online first)Google Scholar
  31. 31.
    Holly EA, Ralston ML, Darragh TM et al. (2001) Prevalence and risk factors for anal squamous intraepithelial lesions in women. J Natl Cancer Inst 93: 843–849CrossRefPubMedGoogle Scholar
  32. 32.
    Hughes JP, Garnett GP, Koutsky L (2002) The theoretical population-level impact of a prophylactic human papilloma virus vaccine. Epidemiology 13: 631–639CrossRefPubMedGoogle Scholar
  33. 33.
    Ikenberg H, Gissmann L, Gross G et al. (1983) Human papillomavirus type-16-related DNA in genital Bowen’s disease and in Bowenoid papulosis. Int J Cancer 32: 563–565CrossRefPubMedGoogle Scholar
  34. 34.
    Insinga RP, Dasbach EJ, Myers ER et al. (2003) The health and economic burden of genital warts in a set of private health plans in the United States. Clin Infect Dis 36: 1397–1403CrossRefPubMedGoogle Scholar
  35. 35.
    Iversen T, Tretli S (1998) Intraepithelial and invasive squamous cell neoplasia of the vulva: trends in incidence, recurrence, and survival rate in Norway. Obstet Gynecol 91: 969–972CrossRefPubMedGoogle Scholar
  36. 36.
    Klussmann JP, Dinh S, Guntinas-Lichius O et al. (2004) HPV-associated tonsillar cancer. An update. HNO 52: 208–218CrossRefPubMedGoogle Scholar
  37. 37.
    Koshiol JE, Laurent SA, Pimenta JM (2004) Rate and predictors of new genital warts claims and genital warts-related healthcare utilization among privately insured patients in the United States. Sex Transm Dis 31: 748–752CrossRefPubMedGoogle Scholar
  38. 38.
    Koutsky LA, Galloway DA, Holmes KK (1988) Epidemiology of genital human papillomavirus infection. Epidemiol Rev 10: 122–163PubMedGoogle Scholar
  39. 39.
    Lacey CJ, Lowndes CM, Shah KV (2006) Chapter 4: Burden and management of non-cancerous HPV-related conditions: HPV-6/11 disease. Vaccine (Suppl 3) 24: S35–S41Google Scholar
  40. 40.
    Lee J, Smith R (2005) Recurrent respiratory papillomatosis: pathogenesis to treatment. Current Opin Otolaryngol Head Neck Surg 13: 354–359CrossRefGoogle Scholar
  41. 41.
    Lillo FB, Ferrari D, Veglia F et al. (2001) Human papillomavirus infection and associated cervical disease in human immunodeficiency virus-infected women: effect of highly active antiretroviral therapy. J Infect Dis 184: 547–551CrossRefPubMedGoogle Scholar
  42. 42.
    Louie JK, Hsu LC, Osmond DH et al. (2002) Trends in causes of death among persons with acquired immunodeficiency syndrome in the era of highly active antiretroviral therapy, San Francisco, 1994–1998. J Infect Dis 186: 1023–1027CrossRefPubMedGoogle Scholar
  43. 43.
    Minkoff H, Ahdieh L, Massad LS et al. (2001) The effect of highly active antiretroviral therapy on cervical cytologic changes associated with oncogenic HPV among HIV-infected women. AIDS 15: 2157–2164CrossRefPubMedGoogle Scholar
  44. 44.
    Naghasfar Z, McDonnell PJ, McDonnell JM et al. (1986) Genital tract papillomavirus type 6 in recurrent conjunctival papilloma. Arch Ophthalmol 104: 1814–1815PubMedGoogle Scholar
  45. 45.
    Paidas CN, Morreale RF, Holoski KM et al. (1999) Septation and differentiation of the embryonic human cloaca. J Pediatr Surg 34: 877–884CrossRefPubMedGoogle Scholar
  46. 46.
    Palefsky JM, Holly EA, Ralston ML et al. (1997) Anal cytological abnormalities and anal HPV infection in men with Centers for Disease Control group IV HIV disease. Genitourin Med 73: 174–180PubMedGoogle Scholar
  47. 47.
    Palefsky J (1995) Human papillomavirus-associated malignancies in HIV-positive men and women. Curr Opin Oncol 7: 437–441PubMedGoogle Scholar
  48. 48.
    Palefsky JM (2000) Anal squamous intraepithelial lesions in human immunodeficiency virus-positive men and women. Semin Oncol 27: 471–479PubMedGoogle Scholar
  49. 49.
    Palefsky JM, Holly EA, Efirdc JT et al. (2005) Anal intraepithelial neoplasia in the highly active antiretroviral therapy era among HIV-positive men who have sex with men. AIDS 19: 1407–1414CrossRefPubMedGoogle Scholar
  50. 50.
    Pao CC, Tsai PL, Chang YL et al. (1993) Possible non-sexual transmission of genital human papillomavirus infections in young women. Eur J Clin Microbiol Infect Dis 12: 221–222CrossRefPubMedGoogle Scholar
  51. 51.
    Piketty C, Darragh TM, Heard I et al. (2004) High prevalence of anal squamous intraepithelial lesions in HIV-positive men despite the use of highly active antiretroviral therapy. Sex Transm Dis 31: 96–99CrossRefPubMedGoogle Scholar
  52. 52.
    Rubin MA, Kleter B, Zhou M et al. (2001) Detection and typing of human papillomavirus DNA in penile carcinoma: evidence for multiple independent pathways of penile carcinogenesis. Am J Pathol 159: 1211–1218PubMedGoogle Scholar
  53. 53.
    Seck AC, Faye MA, Critchlow CW et al. (1994) Cervical intraepithelial neoplasia and human papillomavirus infection among Senegalese women seropositive for HIV-1 or HIV-2 or seronegative for HIV. Int J STD AIDS 5: 189–193PubMedGoogle Scholar
  54. 54.
    Simms I, Fairley CK (1997) Epidemiology of genital warts in England and Wales: 1971 to 1994. Genitourin Med 73: 365–367PubMedGoogle Scholar
  55. 55.
    Slater PE, Roitman M, Leventhal A, Anis E (1996) Control of rubella in Israel: progress and challenge. Public Health Rev 24: 183–192PubMedGoogle Scholar
  56. 56.
    Sonnex C, Strauss S, Gray JJ (1999) Detection of human papillomavirus DNA on the fingers of patients with genital warts. Sex Transm Infect 75: 317–319PubMedGoogle Scholar
  57. 57.
    Steinberg BM, DiLorenzo TP (1996) A possible role for human papillomaviruses in head and neck cancer. Cancer Metastasis Rev 15: 91–112CrossRefPubMedGoogle Scholar
  58. 58.
    Strickler HD, Schiffman MH, Shah KV et al. (1998) A survey of human papillomavirus 16 antibodies in patients with epithelial cancers. Eur J Cancer Prev 7: 305–313CrossRefPubMedGoogle Scholar
  59. 59.
    Syrjänen S (2005) Human papillomavirus (HPV) in head and neck cancer. J Clin Virol (Suppl 1) 32: S59–S66Google Scholar
  60. 60.
    Tay SK, Ho TH, Lim-Tan SK (1990) Is genital human papillomavirus infection always sexually transmitted? Aust N Z J Obstet Gynaecol 30: 240–242PubMedGoogle Scholar
  61. 61.
    Viac J, Chardonnet Y, Euvrard S et al. (1992) Langerhans cells, inflammation markers and human papillomavirus infections in benign and malignant epithelial tumors from transplant recipients. J Dermatol 19: 67–77PubMedGoogle Scholar
  62. 62.
    Villa LL, Costa RL, Petta CA et al. (2005) Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol 6: 271–278CrossRefPubMedGoogle Scholar
  63. 63.
    Von Krogh G, Lacey CJ, Gross G et al. (2000) European course on HPV associated pathology: guidelines for primary care physicians for the diagnosis and management of anogenital warts. Sex Transm Infect 76: 162–168CrossRefPubMedGoogle Scholar
  64. 64.
    Walboomers JM, Jacobs MV, Manos MM et al. (1999) Human papillomavirus necessary cause of invasive cervical cancer worldwide. J Pathol 189: 12–19CrossRefPubMedGoogle Scholar
  65. 65.
    Wiatrak BJ (2003) Overview of recurrent respiratory papillomatosis. Curr Opin Otolaryngol Head Neck Surg 11: 433–441CrossRefPubMedGoogle Scholar
  66. 66.
    Winer RL, Lee SK, Hughes JP et al. (2003) Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students. Am J Epidemiol 157: 218–226CrossRefPubMedGoogle Scholar
  67. 67.
    www.awmf-leitlinien.de S3-Leitlinie „Impfprävention HPV-assoziierter Neoplasien“ (Fertigstellung in 12/2007) AWMF-Leitlinien-Register Nr. 082/002Google Scholar

Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Dermatologie und VenerologieUniversitätsklinikum AöR, Universität RostockRostockDeutschland

Personalised recommendations