Prophylactic HPV vaccines

The prophylactic HPV vaccines consist of virus-like particles (VLP) of HPV 16 and 18 produced by recombinant DNA technology. These viruses induce about 70% of the worldwide occurring cases of cervical cancer as well as a substantial fraction of malignant tumors of the vulva, penis, perianum and oropharynx. One of the vaccines contains in addition VLPs of HPV 6 and 11 for prevention of genital warts (condylomata acuminata). In clinical trials with up to 6.4 years of follow-up the vaccines demonstrated an efficacy of almost 100% against infection by HPV 16 and 18 and the high-grade intraepithelial lesions (CIN, VIN, VaIN) they induce. Most likely due to cross-neutralizing antibodies one of the vaccines also protects significantly against lesions that are induced by genetically related non-vaccine types. Prevention of cases of cervical cancer will only be realized about 10 years after introduction of the vaccine in populations-based trials. First success of a vaccination campaign was already appreciated in Australia by reduction of the incidence of genital warts. Vaccinating males is a reasonable means to reduce the risk of infection in women but also provides to them a direct benefit through the recently documented efficacy of the quadrivalent vaccine against genital warts.