Human papillomavirus vaccination: review of the current evidence

Öz

Human papillomaviruses (HPV) can cause numerous cancers in males and females, including anogenital cancers. Cervical cancer, which is mainly caused by HPV, is one of the most preventable type of cancers. Since the understanding of the etiological association between HPV and cervical cancer, three HPV vaccines have been developed to date. HPV vaccines have been a controversial issue since the first vaccine was recommended to prevent cervical cancer in 2006. Although there are still ongoing controversial topics about HPV vaccines, such as efficacy in HPV-associated cancers, usage in HPV infected individuals and males, these vaccines present an opportunity for HPV-associated precancerous lesions prevention. World Health Organization (WHO) recognizes HPV-associated diseases as global health problems, and recommends that routine HPV vaccination should be included in national immunization programs. While some high-income countries have relatively high uptake of HPV vaccination rates, the low income countries are lagging in the introduction of HPV vaccine. In Turkey, the available vaccines are not in routine immunization schedule. The HPV vaccines are not only need to be more effective, but also be cheap and affordable for everyone in order to increase and sustain introductions of HPV vaccine in low-income and middle-income countries. We need more time to obtain follow-up data for the real-world efficacy, and more research in HPV vaccination.

Anahtar Kelimeler

• HPV vaccine,human papillomaviruses,vaccination

İnsan papilloma virüs aşısı: Güncel kanıtların gözden geçirilmesi

Öz

İnsan papilloma virüsleri (HPV), erkeklerde ve kadınlarda, anogenital kanserler dâhil, çok sayıda kansere neden olabilir. Ağırlıklı olarak HPV’nin neden olduğu serviks kanseri, en önlenebilir kanser türlerinden biridir. HPV ve serviks kanseri arasındaki etiyolojik ilişkinin anlaşılmasından bu yana, bugüne kadar üç HPV aşısı geliştirilmiştir. HPV aşıları, 2006’da serviks kanserinin önlenmesi için önerilen ilk aşı ortaya çıktığından beri tartışmalı bir konu olmuştur. Her ne kadar aşıların HPV-ilişkili kanserlerdeki etkinliği, erkeklerde ve HPV ile enfekte bireylerdeki kullanımı gibi konularda tartışmalar hala devam etse de, HPV aşıları, HPV ilişkili prekanseröz lezyonların önlenmesi konusunda bir fırsat sunmaktadır. Dünya Sağlık Örgütü, HPV ile ilişkili hastalıkları küresel sağlık sorunları olarak kabul etmekte ve rutin HPV aşılarının ulusal aşılama programlarına dahil edilmesi gerektiğini önermektedir. Bazı yüksek gelirli ülkeler nispeten yüksek oranda HPV aşılama oranlarına sahipken, düşük gelirli ülkeler HPV aşısına ulaşma konusunda gecikmektedir. Türkiye’de mevcut HPV aşıları ulusal aşılama programında değildir. HPV aşılarının, düşük gelirli ve orta gelirli ülkelere ulaşımını artırmak ve sürdürmek için daha etkili olmasının ötesinde herkes için ucuz ve uygun olması da gerekir. Gerçek dünyadaki etkinliği açısından takip verilerine, bunun için de daha fazla zamana ve HPV aşıları ile ilgili daha çok araştırmaya ihtiyacımız vardır.

Anahtar Kelimeler

• Aşılama,insan papilloma virusleri,HPV aşısı

Kaynakça

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