J Clin Pathol. 2007 Jan 26;
Prophylactic HPV Vaccines.
Authors:
Stanley M.
University of Cambridge, United Kingdom. The ability to generate human papillomavirus (HPV) virus like particles (VLPs) by the synthesis and self-assembly in vitro of the major virus capsid protein L1 has transformed our prospects for preventing both benign and malignant HPV associated genital disease and in particular for reducing significantly the incidence of cervical carcinoma in women. Two HPV L1 VLP vaccines have been developed, both have been shown to be safe and highly immunogenic generating high titres of neutralising antibody that persist at measurable levels higher than those measured in natural infections for at least 60 months post vaccination suggesting that strong immune memory is generated At present the assumption is that the protection achieved by these vaccines against HPV induced ano-genital pathology is mediated via serum neutralising IgG. However, since there have been no vaccine failures thus far, immune correlates of protection have not been established. The available evidence is that the immunodominant neutralising antibodies generated in natural infections are type-specific and are not cross-neutralising although highly homologous HPV pairs share cross-neutralisation epitopes. Cross reactive and cross neutralising antibodies are generated in HPV L1 vaccinees but at lower concentrations, cross protect ion against incident infection has been shown but the duration of any cross protection that might be elicited is uncertain. L1 VLP vaccines are prophylactic not therapeutic vaccines and for maximal population effectiveness should be delivered before the sexual debut to pre pubertal females (or males) and robust antibody responses have been demonstrated in immunogenicity bridging studies in 9-15 year old boys and girls. However social and cultural issues may be important in determining vaccine take up in the optimal cohort.
Please click on the required question.
- 1 What is the cervix?
- 2 What is a cervical polyp?
- 3 What is meant by cervical erosion (ectopy) and cervicitis?
- 4 What is the transformation zone?
- 5 What is a 'Paptest' (PAP test (cervical smear) test)
- 6 My PAP smear test (cervical smear) shows inflammation. Should I be worried?
- 7 What are cells and what is an abnormal (pre- malignant) cell?
- 8 My PAP smear test (cervical smear) shows abnormal cells. Does this mean that I have cancer?
- 9 What is meant by the terms pre-malignant cells, dyskaryosis, dysplasia and CIN?
- 10 What are the symptoms of pre-malignancy of the cervix?
- 11 What are benign and malignant tumours?
- 12 Why have I developed a pre-malignant condition of my cervix?
- 13 What is colposcopy?
- 14 What treatments are available for pre-malignant conditions of the cervix?
- 15 Can pre-malignant conditions of the cervix be cured?
- 16 How can I be re-assured that the pre-malignant changes will not recur?
- 17 How can we prevent carcinoma of the cervix?
- 18 Is there a reason to screen for HPV?
- 19 Support Groups.
- 20 Are there any support groups?
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