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Human Papillomavirus (HPV) Vaccine

General Information

  • HPV is associated with development of3
    • anogenital cancer, including cervical, vaginal, vulvar, penile, and anal cancers
    • oropharyngeal cancer
    • genital warts
  • HPV transmission is common between sex partners, likely more frequent from females to males than from males to females1
  • about 90% of genital warts caused by HPV genotypes 6 and 113
  • of > 100 HPV genotypes, 13 genotypes associated with cervical cancer3
    • most cases of all HPV-associated cancer caused by HPV genotypes 16 and 18
    • in United States, HPV genotypes
      • 16 and 18 associated with 66% of cases of cervical cancer
      • 31, 33, 45, 52, and 58 account for another 15% of cervical cancers
  • reported 77% of HPV-positive anal cancers associated with HPV genotype 161
  • reported 72% of oropharyngeal cancers positive for HPV, of which, 61% associated with HPV genotype 161
    • reported 80% of tonsillar and 70% of base tongue cancers positive for 1 of 14 high-risk HPV genotypes
  • pathogenesis of HPV infection
    • epithelial changes associated with cervical HPV infection in women
      • viral particles enter basal layer through small tears in mucosa, infect metaplastic epithelium in ring of mucosa known as cervical transformation zone (ring of active squamous metaplasia where stratified squamous epithelium of ectocervix progressively replaces the glandular epithelium of endocervix)
      • molecular virology of HPV persistence, progression, and invasion poorly understood
        • frequency of precancerous development from mild lesion vs. an equivocal lesion or cytologically normal HPV-infected tissue unknown
        • persistent HPV infection of epithelium in cervical transformation zone causes most cases of cervical cancer
        • Reference - 17826171Lancet 2007 Sep 8;370(9590):890
      • progression from small cervical intraepithelial neoplasia lesion to cancer can take > 10 years (20567185Obstet Gynecol 2010 Jul;116(1):177)
    • anal HPV infection
    • oropharyngeal HPV infection
      • knowledge regarding carcinogenic process from HPV infection to cancer in oropharyngeal squamous cell carcinoma is mostly extrapolated from cervical cancer model
      • oral mucosa is exposed to HPV, HPV-related precancerous lesion may develop if infection persists
      • persistent infection may progress to invasive cancer within 10 years, however, most infections are cleared within 1-2 years
      • no oropharyngeal premalignant disorders have been well established
      • Reference - 28633362Ann Oncol 2017 Oct 1;28(10):2386full-text



General references used

  1. Markowitz LE, Dunne EF, Saraiya M, et al; Centers for Disease Control and Prevention (CDC). Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2014 Aug 29;63(RR-05):1-30full-text, correction can be found in MMWR Recomm Rep 2014 Dec 12;63(49):1182, commentary can be found in JAMA 2014 Nov 12;312(18):1920
  2. Petrosky E, Bocchini JA Jr, Hariri S, et al; Centers for Disease Control and Prevention. Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Updated HPV Vaccination Recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2015 Mar 27;64(11):300-4full-text
  3. American College of Obstetricians and Gynecologists (ACOG). Committee Opinion No. 704: Human Papillomavirus Vaccination. Obstet Gynecol. 2017 Jun;129(6):e173-e178

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How to cite

National Library of Medicine, or "Vancouver style" (International Committee of Medical Journal Editors):

  • DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 - . Record No. T908142, Human Papillomavirus (HPV) Vaccine; [updated 2018 Nov 30, cited place cited date here]. Available from Registration and login required.

Published by EBSCO Information Services. Copyright © 2020, EBSCO Information Services. All rights reserved. No part of this may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission.

EBSCO Information Services accepts no liability for advice or information given herein or errors/omissions in the text. It is merely intended as a general informational overview of the subject for the healthcare professional.


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