자궁경부암 예방 백신의 효과와 공중보건학적 의의

Abstract

Objectives: Aim of study is to review efficacies of two human papilloma virus vaccines in different study populations and examine importance of HPV vaccine as a routine vaccine. Methods: Four phase-3 efficacy studies of two HPV vaccines were reviewed. Magnitude of efficacies were compared among different study populations. Results: Recently, two kinds of papillornavir us (HPV) vaccines were developed. "Cervarix" is a bivalent vaccine which contained L1 protein of HPY 16 and HPY 18. and "Gardasil" is a quadrivalent vaccine which contained L1 protein of HPV 6 and HPV 11 in addition. Efficacy study showed that both vaccine are highly effective to prevent cervical, vaginal and vulvar precancerous lesion in the population who are naive to HPV infection. Quadrivalent vaccine also showed high efficacy to prevent genital warts. Efficacy of the vaccine decreased in the general population who included both HPV-naive and HPV-infected peoples. Both vaccines showed high immune responses for 5 years after vaccination. Conclusions: From the point of public health, HPY vaccine is an important vaccine for young adolescents who have not begun sexual activity. However, development of guidelines for HPV vaccination for each country will be dependent on cost effectiveness of HPV vaccines of each population.