Marcello Guido*, Annarita Bruno, Luigi Tagliaferro, Valerio Aprile, Andrea Tinelli, Alberto Fedele, Giambattista Lobreglio, Paola Menegazzi, Giancarlo Pasanisi, Vittorio Tassi, Bruno Forcina, Francesca Fortunato, Laura Isabella Lupo and Antonella Zizza Pages 343 - 357 ( 15 )
HPV is still the most common sexually transmitted infection, leading to the onset of many disorders while causing an increase in direct and indirect health costs. High Risk (HR) HPV is the primary cause of invasive cervical cancer and contributes significantly to the development of anogenital and oropharyngeal cancers. The introduction of universal HPV vaccination has led to a significant reduction in vaccine-targeted HPV infections, cross-protective genotypes, precancerous lesions and anogenital warts. Despite the several limitations of HPV vaccination programs, including vaccine type specificity, different schedules, target age-groups and poor communication, the impact has become increasingly evident, especially in countries with high vaccine uptake. We carried out a review of the most recent literature to evaluate the effects of HPV vaccination on vaccinetargeted HPV genotypes and to assess the level of cross-protection provided against non-vaccine HPV types. Subsequently, to assess the rates of HPV infection in a southeast Italian region, we performed an epidemiological investigation on the impact of vaccination on genotypes and on the prevalence and distribution of HPV infection during the twelve-year period 2006-2017 in the Local Health Unit (LHU) of Lecce. The vaccination coverage of about 70% among girls in the LHU led to an initial reduction in vaccine-targeted HPV types and cross-protective genotypes. However, the results on this population should be interpreted cautiously because the period since the start of vaccination is too short and the coverage rate is not yet optimal to evaluate the efficacy of vaccination in lowering the prevalence of non-vaccine HR HPV types in the vaccinated cohort and in older subjects. Nevertheless, it is expected that direct effects will increase further and that herd immunity will begin to emerge as vaccination coverage increases.
HPV, vaccination, cervical cancer, anal cancers, HPV genotype test, sexual transmitted disease.
Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Laboratory of Molecular Virology, “S. Caterina Novella” Hospital, Galatina, Anatomical Pathology Unit, “Sacro cuore di Gesù” Hospital, Gallipoli, Prevention Dept, Hygiene and Public Health Service, Local Health Agency, Lecce, Department of Obstetrics and Gynecology, “Veris delli Ponti” Hospital, Scorrano, Lecce, Prevention Dept, Hygiene and Public Health Service, Local Health Agency, Lecce, Clinical Pathology and Microbiology Laboratory, Vito Fazzi Hospital, Lecce, Laboratory Mater Gratiae, Squinzano (Lecce), Laboratory Medicine Dept, “Card. G. Panico” Hospital, Tricase, Clinical Pathology and Microbiology Laboratory, Vito Fazzi Hospital, Lecce, Clinical Analysis Laboratory, Galatina, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Clinical Pathology and Microbiology Laboratory, Vito Fazzi Hospital, Lecce, Institute of Clinical Physiology, National Research Council, Lecce