Clinical Health Updates

HPV vaccine not effective in treating women with preexisting HPV infection

Clinical Question:
Is the human papillomavirus vaccine useful in the treatment of women already infected with the virus?

Bottom Line:
This study found no evidence to support the human papillomavirus (HPV) vaccine in the treatment of women already infected with HPV. Viral clearance rates were comparable in women regardless of vaccination status.

Reference:
Hildesheim A, Herrero R, Wacholder S, et al. Effect of human papillomavirus 16/18 L1 viruslike particle vaccine among young women with preexisting infection: a randomized trial. JAMA 2007;298:743-753.

Study Design:
Randomized controlled trial (double-blinded)

Synopsis:
These investigators identified 2376 women, aged 18 to 25 years, initially positive for known HPV DNA. Of these, 2055 (86%) and 1671 (70%) completed follow-up at 6 and 12 months, respectively. Eligible patients randomly received (concealed allocation assignment) 3 doses of bivalent HPV 16/18 L1 protein viruslike particle vaccine or a control hepatitis A vaccine over 6 months. Measurement of HPV DNA was performed using standard laboratory procedures; samples were either self-collected or collected by a clinician during a pelvic examination. Individuals assessing outcomes remained unaware of treatment group assignment. Using intention-to-treat analysis, the clearance rate for HPV-16/18 infections were similar in the vaccine and control groups at 6 months (33.4% vs 31.6%, respectively) and at 12 months (48.8% vs 49.8%, respectively).