Fuente: Eddie A. Angles Y.
Medico Infectologo / Tropicalista
ver en:
Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males — Advisory Committee on Immunization Practices (ACIP), 2011
Vaccine Watch
Quadrivalent Human Papillomavirus Vaccine Now for Males, Too
New recommendations — for males — include routine use of HPV4 at ages 11 or 12 years and vaccination through age 26 for those who have not completed the three-dose series.
Background: Human papillomavirus (HPV) infection is the most common sexually transmitted disease in the U.S. HPV serotypes 16 and 18 are responsible for about 70% of cervical cancers; serotypes 6 and 11 underlie about 90% of genital warts. Quadrivalent HPV vaccine (HPV4), which contains these four serotypes, received FDA approval in June 2006 for use in females. Bivalent HPV vaccine (HBV2; serotypes 16 and 18) was licensed in October 2009, also for use in females.
In October 2009, on the basis of additional studies, the FDA licensed HPV4 for use in males aged 9 through 26 years to prevent genital warts. At that time, the Advisory Committee on Immunization Practices (ACIP) stated that the vaccine may be given to males in this age group. Now, after reviewing data showing efficacy in preventing anal cancer, the ACIP is recommending routine vaccination with HPV4 in males aged 11 or 12 years, with the three-dose vaccination series beginning as early as age 9 years, and catch-up for unvaccinated males aged 13 through 21 years. In addition, males aged 22 through 26 may be vaccinated. Recommendations for females areunchanged.
Vaccine Composition: Each 0.5-mL dose contains approximately 20 µg of HPV 6 L1 protein, 40 µg of HPV 11 L1 protein, 40 µg ofHPV 16 L1 protein, and 20 µg of HPV 18 L1 protein.
Target Population and Immunization Schedule: The new recommendations target all males aged 11 or 12 years but extend to those aged 9 through 26. (Administration at an early age maximizes the chance that children will be immunized before being exposed to HPV through sexual contact; the vaccine is not effective in individuals who are already infected.) The vaccine contains no live virus and can be given to immunocompromised individuals. It could be particularly beneficial for HIV-infected males, as well as males who have sex with males, who are at increased risk for HPV-associated genital cancers.
HPV4 is given as three intramuscular injections, with the second and third doses administered 2 and 6 months after the first.
Efficacy: In a phase III trial, HPV4 had high efficacy in preventing genital warts in males aged 16 through 26. Among a subset of males who have sex with males, it was efficacious in preventing anal intraepithelial neoplasia (AIN) — a precursor of anal cancer. Additional studies showed high seroconversion rates for all four HPV vaccine types in males aged 9 through 26, although antibody titers were significantly higher in those aged 9 through 15 than in those who were older.
Adverse Effects: Safety was evaluated in approximately 5300 males. Most adverse events involved mild or moderate local reactions (e.g.,pain or tenderness at the injection site).
Comment: HPV4 is indicated in males for the prevention of AIN andgenital warts. Although the vaccine may be effective in preventing other HPV-associated conditions (penile and oropharyngeal cancers, laryngeal papillomatosis), data are not available. Vaccination of males is expected to prevent HPV transmission to females — an especially important feature, given that uptake of HPV vaccines in females has been disappointing.
— RobertS. Baltimore, MD
Published in Journal Watch Infectious Diseases January 11, 2012
Citation(s):
Centers for Disease Control and Prevention (CDC). Recommendations on the use of quadrivalent human papillomavirus vaccine in males — Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep 2011 Dec 23; 60:1705.
Medlineabstract (Free)
Atentamente
Eddie A. Angles Y.
Medico Infectologo / Tropicalista
Medico Infectologo / Tropicalista
Hospital Nacional Arzobispo Loayza (HNAL)
Grupo de Investigacion Peruano de Enfermedades Infecciosas y Tropicales (GIPEIT)
Cel. 511-996470205 www.gipeit.org
Cel. 511-996470205 www.gipeit.org
No hay comentarios:
Publicar un comentario