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Dagens #fsvoversigt:
The efficacy and duration of vaccine protection against human papillomavirus: a
systematic review and meta-analysis.
Dtsch Arztebl Int. 2014 Sep 1;111(35-36):584-91
Authors: Deleré Y, Wichmann O, Klug SJ, van der Sande M, Terhardt M, Zepp F,
Harder T
Abstract
BACKGROUND: The German Standing Committee on Vaccination (STIKO) recommends
vaccination against human papillomaviruses (HPV) of the high-risk types 16 and
18. The duration of protection afforded by HPV vaccines has been reported in
multiple studies to date but has not been systematically evaluated.
METHOD: Systematic literature review and meta-analysis on the efficacy of
vaccination, with assessment of evidence by the GRADE criteria (Grading of
Recommendations Assessment, Development and Evaluation).
RESULTS: 15 studies were identified: 10 randomized controlled trials (RCTs) and
5 observational studies. The RCTs included a total of 46 436 participants. The
duration of follow-up was short (median, 3 years) in 8 RCTs and long (median, 6
years) in 2 RCTs. During the period of short-term follow up, the pooled
efficacy of vaccination for the study endpoint of incident HPV infection
(percentage of infections prevented) was 83% (95% confidence interval [CI]:
70-90% ), while the pooled efficacy against persistent HPV infection was 90%
(95% CI: 79-95% ). In this period, CIN 2+ lesions were prevented with 84%
efficacy (95% CI: 50-95% ), and CIN 3+ lesions with 94% efficacy (95% CI:
83-98% ). During the period of long-term follow-up, incident infections were
prevented with 94% efficacy (95% CI: 80-98% ) and persistent infections with
95% efficacy (95% CI: 84-99% ). The long-term efficacy against CIN 2+ lesions
was 86% (95% CI: -166-99% ). No data are available on the long-term effic
acy of vaccination against CIN 3+ lesions.
CONCLUSION: Long-term observation does not indicate any loss of antiviral
protection after vaccination against HPV 16 and 18, although the evidence for
long-term protection is of lesser quality than that for short-term protection.
PMID: 25249360 [PubMed - indexed for MEDLINE]
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
(http://www.ncbi.nlm.nih.gov/About/disclaimer.html).
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Se abstractet i PubMed: http://evidens.link/1LmvYjs
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