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.

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Funding

This was funded by research grants of Fondazione Cassa di Risparmio di Florence

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Authors

Contributions

Protocol/project development: AP, AG, MF. Conceptualization: AP. Funding acquisition: CB, MF. Data collection and management: CB, NA. Blind colposcopists and physicians: AP, AG, MGF. Blind biologists: CB. Data Analysis: CB, NZ. Manuscript writing/editing: CB, NA, GC, FP. Supervision: GC, FP.

Corresponding author

Correspondence to Claudia Bianchi.

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We declare that we have no conflict of interest.

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Pieralli, A., Bianchi, C., Auzzi, N. et al. Indication of prophylactic vaccines as a tool for secondary prevention in HPV-linked disease. Arch Gynecol Obstet 298, 1205–1210 (2018). https://doi.org/10.1007/s00404-018-4926-y

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Keywords

  • HPV vaccination
  • Squamous intraepithelial lesion
  • HPV
  • Secondary prevention