Reducing the health burden of HPV infection through vaccination

Abstract

Human papillomavirus (HPV), a sexually transmitted infection and the etiologic cause of genital warts and cervical cancer, is highly prevalent in sexually active men and women. Although cervical screening procedures have significantly reduced the disease burden associated with HPV infection, they are expensive and abnormal results cause significant emotional distress. Therefore, prevention may be an effective strategy for reducing the economic, psychosocial, and disease burden of HPV infection. Multivalent vaccines are now in clinical development. A bivalent vaccine that protects against HPV 16 and 18, and a quadrivalent vaccine which protects against HPV types 6, 11, 16, and 18, have been shown to significantly reduce the occurrence of incident and persistent HPV infections in phase 2 clinical trials; phase 3 trials are currently underway. HPV vaccines will be most effective when administered prior to initiation of sexual activity, and vaccination campaigns should aggressively target preadolescent and adolescent populations.

Figure 1

Estimated incidence of sexually transmitted infections in the United States [1].

Figure 2

Average health care costs of cervical HPV infection [16]. *Average age adjusted to the 1998 US female population; all cost estimates were converted to 2002 dollars; ASC = atypical squamous cells; AGC = atypical glandular cells; LSIL = low-grade squamous intraepithelial lesion; HSIL = high-grade squamous intraepithelial lesion.

Figure 3

Incidence of infection or disease associated with HPV 6, 11, 16, or 18 after vaccination with a quadrivalent vaccine versus placebo (*reported as incidence per 100 women-year at risk) [31].