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Human Papillomavirus Vaccine against Cervical Cancer and Beyond: Opportunities, Challenges and New Perspectives

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A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Clinical Immunology".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 11677

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Special Issue Editors

Dr. Rosa De Vincenzo

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Guest Editor

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy
Interests: HPV gynecologic disease; colposcopy; vulvoscopy; cervical dysplasia; HPV vaccine; gynecological prevention strategies; fertility sparing surgery in early cervical cancer; cervical cancer in pregnancy

Dr. Alessandro Ghelardi

E-Mail Website
Co-Guest Editor

Institution of Azienda USL Toscana Nord Ovest, 56121 Pisa, Italy
Interests: HPV natural history and immunobiology; HPV veterinary research; HPV diseases and sexuality; HPV in men: diagnosis, treatment and research; adjuvant HPV vaccination; lower genital tract malignancies; cervical cancer screening; colposcopy; vulvoscopy; anoscopy; peniscopy; gynecologic oncology surgery
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Dr. Ankica Lukic

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Co-Guest Editor

Department of Surgical and Medical Sciences and Translation Medicine, Sapienza University of Rome, Sant’ Andrea Hospital, Rome, Italy
Interests: HPV gynecologic disease; lower genital tract malignancies; HPV vaccines; cervical cancer screening; colposcopy; vulvoscopy; laser in gynecology; gynecologic oncology surgery

Dr. Caterina Ricci

E-Mail Website
Co-Guest Editor

Gynecologic Oncology Unit, Woman and Child and Public Health Department, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Roma, Italy
Interests: colposcopy; cervical cancer prevention; HPV vaccine; gynecologic oncology; clinical trials

Special Issue Information

Dear Colleagues,

We are soliciting articles for a Special Issue of MDPI Vaccines, which will be entitled “Human Papillomavirus Vaccine against Cervical Cancer and Beyond: Opportunities, Challenges and New Perspectives”.

It is now well known that Human Papilloma Virus (HPV) infection can lead to the development of genital warts, as well as cervical, anogenital, and oropharyngeal cancer. The World Health Organization (WHO) has recognized the importance of HPV-related diseases as a global public health issue, promoting HPV vaccination all over the world. Therefore, since 2006, many countries have implemented publicly funded HPV immunization programs, first targeting female adolescents and then progressively expanding HPV vaccination campaigns. Following the growing evidence of HPV-related diseasesx also in males, vaccines were then extended from female-only to gender-neutral populations. However, cervical cancer still remains a significant public health burden that requires further research work. Increasing awareness and understanding about the clinical value of vaccination, as well as extended investigations on emerging features of this HPV-related cancer, are needed.

HPV vaccines are licensed for safe administration from nine years of age. The optimal time for HPV immunization is before sexual debut, but HPV vaccinations are now increasingly suggested also for adult women, as a personal preventive tool. Furthermore, preliminary results seem to suggest that the use of HPV vaccines after cervical disease treatment may lower the risk of recurrent disease.

Finally, the interest in the economic burden of HPV-related diseases and in the cost–effectiveness of vaccination strategies is increasing, leading to the development of several Health Technology Assessment (HTA) evaluations.

We invite researchers to submit research articles, review articles, and clinical studies on the subjects highlighted in title of this Special Issue, addressing these open and debated topics with a look at future prospects.

Prof. Dr. Rosa De Vincenzo
Dr. Alessandro Ghelardi
Dr. Ankica Lukic
Dr. Caterina Ricci
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

herd immunity, gender-neutral HPV vaccination
new frontiers in adult women population, adjuvant HPV vaccination
hesitancy, safety, and effectiveness of HPV vaccination
special target populations: immunocompromised, subfertile men/couple
HPV vaccination and microbiome
health Technology Assessment (HTA) of HPV vaccination
impact of HPV vaccination on cervical screening programs
HPV vaccination and cervical cancer eradication

Published Papers (4 papers)

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Research

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14 pages, 569 KiB

Open AccessArticle

HPV Vaccination in Women Treated for Cervical Intraepithelial Neoplasia: A Budget Impact Analysis

by Michele Basile, Giovanna Elisa Calabrò, Alessandro Ghelardi, Roberto Ricciardi, Rosa De Vincenzo and Americo Cicchetti

Vaccines 2021, 9(8), 816; https://doi.org/10.3390/vaccines9080816 - 22 Jul 2021

Cited by 5 | Viewed by 1933

Abstract

Human Papillomavirus (HPV) is the most common sexually transmitted infection. Its progression is related to the development of malignant lesions, particularly cervical intraepithelial neoplasias (CINs). CINs correlate with a higher risk of premature births, and their excisional and ablative treatment further increases this risk in pregnant women. These complications are also correlated with higher healthcare costs for their management. In Italy, more than 26,000 new cases of CINs are estimated to occur yearly and their economic burden is significant. Therefore, the management of these conditions is a public health priority. Since HPV vaccination is associated with a reduced risk of relapse in women surgically treated for HPV-related injuries, we estimated the economic impact of extending HPV vaccination to this target population. This strategy would result in a significant reduction in the general costs of managing these women, resulting in an overall saving for the Italian Health Service of €155,596.38 in 5 years. This lower cost is due not only to the reduced incidence of CINs following vaccination, but also to the lower occurrence of preterm births. Extending HPV vaccination to this target population as part of a care path to be offered to women treated for HPV injuries is therefore desirable. Full article

(This article belongs to the Special Issue Human Papillomavirus Vaccine against Cervical Cancer and Beyond: Opportunities, Challenges and New Perspectives)

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13 pages, 832 KiB

Open AccessArticle

HPV and Cytology Testing in Women Undergoing 9-Valent HPV Opportunistic Vaccination: A Single-Cohort Follow Up Study

by Rosa De Vincenzo, Nicola Caporale, Valentina Bertoldo, Caterina Ricci, Maria Teresa Evangelista, Nicolò Bizzarri, Luigi Pedone Anchora, Giovanni Scambia and Giovanni Capelli

Vaccines 2021, 9(6), 643; https://doi.org/10.3390/vaccines9060643 - 12 Jun 2021

Cited by 5 | Viewed by 2288

Abstract

Background: This study evaluates the possible effect of 9-valent (9vHPV) vaccination on the results of HPV and cytological tests in a cohort of adult women. Methods: This study is a retrospective, single-cohort, monocentric study. Sexually active women aged 14–70 years, who underwent 9vHPV vaccination, were enrolled. Dose administration dates, side effects and data on Pap smears and HPV tests performed before and after the first vaccine dose were collected. Subjects were considered “unexposed” to the vaccine for all time intervals before the first dose administration, and “exposed” to the first, second and third vaccine doses in all time intervals following each specific dose. Results: A total of 512 women underwent the first 9vHPV dose administration and were enrolled in the study. Median age at vaccination was 30.5 (14–70). Log-rank tests and Cox regression analyses showed a highly statistically significant (p < 0.0001) difference in the time to negativization after the exposure to the third vaccine dose in the 207 women starting with a Pap+ smear (HR (95% C.I.), 2.66 (1.83–3.86)) and in the 198 women starting with an HPV HR+ test (HR (95% C.I.), 7.80 (4.83–12.60)). Conclusions: 9vHPV vaccination may play a role in shortening the clearance time of HPV HR+ or Pap positivity in sexually active adult women. Full article

(This article belongs to the Special Issue Human Papillomavirus Vaccine against Cervical Cancer and Beyond: Opportunities, Challenges and New Perspectives)

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12 pages, 1376 KiB

Open AccessArticle

Surgical Treatment of Vulvar HSIL: Adjuvant HPV Vaccine Reduces Recurrent Disease

by Alessandro Ghelardi, Roberto Marrai, Giorgio Bogani, Francesco Sopracordevole, Paola Bay, Arianna Tonetti, Stefania Lombardi, Gloria Bertacca and Elmar A. Joura

Vaccines 2021, 9(2), 83; https://doi.org/10.3390/vaccines9020083 - 25 Jan 2021

Cited by 27 | Viewed by 4305

Abstract

Data suggest that adjuvant human papillomavirus (HPV)-vaccination in women treated for cervical HPV diseases reduces recurrent disease. This study investigates adjuvant HPV-vaccination and the rate of recurrence in women undergoing surgery for vulvar high-grade squamous intraepithelial lesions (HSIL). From January 2013 to April 2020, we enrolled 149 women in a prospective case-control study. The control group (NV-group) was treated by standard surgery alone, while the study group received adjuvant vaccination soon after surgery (V-group). A follow-up was performed by vulvoscopy and HPV test. Statistical analysis was performed by Fisher’s exact test. HSIL recurrence was observed in 24/76 (32%) patients in NV-group and in 8/42 patients (19%) of the vaccinated group. By analysing the recurrence rate related to the incident and reactivated latent HPV infection, we found a significant difference between (17/76) 22.3% in NV-group and (2/42) 4.8% in V-group (p = 0.01). A reduction of 78.5% in incident/reactivated HPV infections was demonstrated. Data results add to the current knowledge about the mechanism of post-surgical adjuvant HPV vaccination. Our prospective study is the first to document the vaccine clinical effectiveness in preventing “reactivation” of latent HPV infections. Quadrivalent HPV vaccine administered after the surgical treatment for vulvar HSIL appears to be useful in preventing recurrent disease. Full article

(This article belongs to the Special Issue Human Papillomavirus Vaccine against Cervical Cancer and Beyond: Opportunities, Challenges and New Perspectives)

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Other

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15 pages, 481 KiB

Open AccessCommentary

Are We Facing a New Colposcopic Practice in the HPV Vaccination Era? Opportunities, Challenges, and New Perspectives

by Ankica Lukic, Rosa De Vincenzo, Andrea Ciavattini, Caterina Ricci, Roberto Senatori, Ilary Ruscito and Antonio Frega

Vaccines 2021, 9(10), 1081; https://doi.org/10.3390/vaccines9101081 - 26 Sep 2021

Cited by 9 | Viewed by 2220

Abstract

The combination of primary and secondary prevention has already influenced the colposcopic practice by reduction in HPV (human papillomavirus) vaccine-type HSIL (HIGH-GRADE SIL), colposcopy referral numbers, colposcopic positive predictive value (PPV) for CIN2+, and by modification of referral pattern, colposcopic performance, and procedures. Different strategies, both isolated and combined, have been proposed in order to maintain the diagnostic accuracy of colposcopy: patient risk stratification based on immediate or future risk of CIN3+ or on HPV genotyping after a positive screening test. Data are needed to support alternative colposcopic strategies based on vaccination status and on the application of artificial intelligence where the patient’s risk stratification is implicit in precision medicine which involves the transition from an operator-dependent morphology-based to a less-operator dependent, more biomolecular management. The patient’s risk stratification based on any combination of “history” and “test results” to decrease colposcopy workload further reduce colposcopic and histologic morphological approaches, while adding genotyping to the risk stratification paradigm means less cytologic morphologic diagnosis. In Italy, there is a strong colposcopic tradition and there is currently no immediate need to reduce the number of colposcopies. Instead, there is a need for more accredited colposcopists to maintain the diagnostic accuracy of colposcopy in the vaccination era. Full article

(This article belongs to the Special Issue Human Papillomavirus Vaccine against Cervical Cancer and Beyond: Opportunities, Challenges and New Perspectives)

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