Case report
Development of Prophylactic HPV Vaccines
Lutz Gissmann
Martin Müller
Abstract
Since several years it has been accepted that persistent infection with certain (so called-high risk: HR) types of Human
papillomaviruses (HPV) represents a strong risk factor for cervical cancer. The most frequent HR HPV types 16 and 18
account for about 70% of this tumour, which is the second most frequent malignancy in women worldwide. Several studies
in animal papillomavirus models revealed that protection against infection is conferred by neutralizing antibodies
directed against conformational epitopes of the major structural protein L1. Such antibodies can most efficiently be induced
by immunization with virus-like particles (VLP) that assemble spontaneously following expression of L1 in recombinant
vectors. Large-scale production of HPV 16 and 18 VLPs proved to be successful facilitating, a few years ago, first
clinical trials on safety and immunogenicity. In the meantime more than 25,000 women have been included into several
efficacy trials which demonstrated protection against persistent infection with HPV 16 and 18 and against the development
of precursor lesions to cervical cancer. Although the ultimate proof of success, i.e. reduction of cancer incidence still
requires the immunization of large populations and many years of follow-up, the existing data are so persuasive that the
responsible agencies in several countries permitted the licensing of the first HPV vaccine in 2006. Several questions such
as the duration of protection, the need development of for post-exposure vaccination strategies and availability of such
vaccine in low-budget countries are open and will be discussed.
Keywords
human papillomavirus (HPV) vaccines; cervical cancer
Hrčak ID:
27445
URI
Publication date:
13.4.2007.
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