Human papilloma virüs aşılarına genel bakış

Serviks kanseri kadınlarda meme kanserinde sonra ikinci sıklıkta görülen kanser türüdür. Her yıl dünya genelinde yaklaşık 500.000 yeni kanser vakası saptanmakta ve bunların yarısına yakını ölmektedir. Serviks kanseri ile human papilloma virüs HPV arasındaki ilişkinin saptanmasının ardından hem profilaktik hem de hastalığı tedavi edici aşı bulunmasına yönelik çalışmalar hızlanmıştır. 2006 yılında HPV tip 6-11-16-18 L1 kapsid antijeni içeren bir kuadrivalan aşı, 2007 yılında HPV tip 16-18 L1 kapsid antijeni içeren bir bivalan aşı piyasaya sürülmüştür. HPV aşıları HPV'nin dört tipine karşı koruyucu antikor oluşturabilmektedir. Yapılan çalışmalarda aşıların güvenli, iyi tolere edilebilir, serviks kanseri öncü lezyonları ve serviks kanserine karşı koruyucu olduğu yönünde bulgular saptanmıştır. HPV aşılarının 926 yaş aralığında ve mümkünse ilk cinsel temastan önce yapılması önerilmektedir. Profilaktik aşı serviks kanserine karşı koruyucu olsa da aşı yapıldıktan sonra serviks kanseri tarama yöntemlerine devam edilmelidir

Anahtar Kelimeler:

Serviks kanseri, human papilloma virüs, aşılama

Human Papılloma Virus Vaccines: Overvıew

Cervical cancer is the second common form of cancer in women after the breast cancer. Each year, approximately 500,000 new cases of cancer worldwide recognize and nearly half of them die. After detection of the relationship between cervical cancer and human papilloma virus HPV studies both the prophylactic and therapeutic vaccine was accelerated. In 2006, a quadrivalent HPV 6-11-16-18 vaccine containing L1 capsid antigen, in 2007, a bivalent vaccine containing HPV 16-18 L1 capsid antigen were released. HPV vaccines produce protect antibodies against four types of HPV. Vaccines are safe and well tolerated, and leading lesions of cervical cancer and cervical cancer can be prevented. HPV vaccines are recommended in the possible range of 9-26 years, and especially before the first sexual contact. Although the prophylactic vaccine protective against cervical cancer, cervical cancer screening should be continued after vaccinations

Keywords:

Cervical cancer, human papilloma virus, vaccination,

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Taşkın L (2006). Kadın Hastalıkları ve Doğum
Hemşireliği, Palme Yayıncılık. John A. Rock, Howard W. Jones “Te Linde's Operative Gynecology” s:1231-2005
Gül P, Topuz Ş, An Ş, Doğan N, Kaya N, Algıer L “Başkent Üniversitesi Ankara Hastanesi Kadın Hastalıkları ve Doğum Polikliniğine Başvuran kadınların HPV Aşısı ve Serviks Kanseri İle İlgili Bilgi Düzeyleri” Türk Jinekolojik Onkoloji Dergisi 1: 11-8
American Cancer Society. (2006). Cancer facts and figures 2006. Retrieved November 7, 2006, f r o m h t t p : / / w w w. c a n c e r. o r g / d o w n l o a d s / STT/CAFF2006
Ayhan A., Durukan T., Günalp S., Gürgan T., Önderoğlu LS., Yaralı H., Yüce K. (2008). Temel
Kadın Hastalıkları ve Doğum Bilgisi Güneş Tıp Kitapevi.2. Baskı. Ankara. s.1027.
T.C. Sağlık Bakanlığı: Türkiye'de Bölgelere ve Cinsiyete Göre Kanser Olguları, 2003 yılı verileri, www.saglik. gov.tr.
SlomovitzBm,Sun CC, Frumovitz M, Soliman PT, Schmeler KM, Pearson HC, Brenson A, Rammez PT, Lu KH, Bodurka DC “Are women ready for the HPV vaccine” Gynecolgic Oncology : 103: 151-4
Va n c h i e r e J A , D e m m l e r G J : H u m a n Polyomavirusesand Papillomaviruses, “Feigin RD, Cherry JD, Demmler GJ, Kaplan SL (eds): Textbook of Pediatric Infectious Diseases, 5.baskı” kitabında s.1809-31, Saunders, Philadelphia (2004).
Cogliano V, Baan R, Straif K, Grosse Y, Secretan B, ElGhissassi F. Carcinogenicity of human papillomaviruses. Lancet Oncol 2005; 6
Munoz N, Bosch FX, Castellsague X, et al. E p i d e m i o l o g i c c l a s s i f i c a t i o n o f h u m a n papillomavirus types associated with cervical cancer. N Engl J Med 2003; 348: 518-27.
Smith JS, Lindsay L, Hoots B, et al. Human Papillomavirus type distrubution in invasive cervical cancer and highgrade cervical lesions: a meta–analysis update. Int J Cancer 2007; 3: 621
Bosch FX, de Sanjosé S: Chapter 1: Human papillomavirus and cervical cancer-burden and assessment of causality, J Natl Cancer Inst Monogr ; 31: 3-13. Trottier H, Franco EL: The epidemiology of genital human papillomavirus infection, Vaccine ; 24: 1-15. World Health Organization: Report of the consultation on human papillomavirus vaccines, WHO, Geneva (2005).
Dede M “Profilaktik HPV Aşıları: Güncel Yaklaşımlar” Gülhane Tıp Dergisi 2010: 52: 148-156
Stanley M. Immunobiology of HPV and HPV vaccines. Gynecol Oncol 2008; 109: 15-21.
Atasü T “Jinekoloji onkoloji(genişletilmiş) Logos yayıncılık, İstanbul 1999(2. Baskı)
Pagliusi SR, Aguado TM: Efficacy and other milestones for human papillomavirus vaccine introduction, Vaccine 2004; 23: 569-78.
Greenstone HL, Nieland JD, de Visser KE, et al. Chimerc papillomavirus virus-like particules elicit antitumor immunity aganist the E7 oncoprotein in an HPV 16 tumor model. Proc Natl Acad Sci USA 1998; : 1800-5.
Carter JJ, Koutsky LA, Wipf H, et al. The natural history of human papilloma virus type 16 capsid antibodies among a cohort of university women. J Infect Dis 1996; 174: 927-36.
Villa LL, Costa RLR, Petta CA, et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double- blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol 2005; 6: 271-8.
Harper DM, Franco EL, Wheeler C, et al. Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus type 16 and 18 in young women: a randomised controlled trial. Lancet 2004; 364: 1757-65.
Harper DM, Franco EL, Wheeler CM et al: Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: A randomised controlled trial, Lancet 2004; 364: 1757-65.
Koutsky LA, Ault KA, Wheeler CM et al: A controlled trial of human papillomavirus type 16 vaccine, N Eng J Med 2002; 347: 1645-51.
Munoz N, Bosch FX, de Sanjosé et al: E p i d e m i o l o g i c c l a s s i f i c a t i o n o f h u m a n papillomavirus types associated with cervical cancer, N Eng J Med 2003; 348: 518-27.
Villa LL, Ault KA, Giuliano AR et al: I m m u n o l o g i c 1 0 0 r e s p o n s e s f o l l o w i n g administration of a vaccine targeting human papillomavirus types 6, 11, 16, and 18, Vaccine ; 24: 5571-83.
Block SL, Nolan T, Sattler C et al: Comparison of the immunogenicity and reactogenicity of a p r o p h y l a c t i c q u a d r i v a l e n t h u m a n papillomavirus(types 6, 11, 16 and 18) L1 virus-like particle vaccine in male and female adolescents and young adult women, Pediatrics 2006; 118: 2135-45.
Markowitz LE, Dunne EF, Saraiya M et al:Quadrivalent human papillomavirus vaccine. Recommendations of the Advisory Committee on mmunization Practices (ACIP), MMWR Recomm Rep ; 56: 1-24. Ault KA, The FUTURE II Study Group: Effect ofprophylactic human papillomavirus L1 virus- l i k e p a r t i c l e v a c c i n e o n r i s k o f c e r v i c a l intraepithelialneoplasia grade 2, grade 3, and adenocarcinoma in situ: A combined analysis of four randomised clinical trials, Lancet 2007; 369: 1861-8.
Garland S, Hernandez-Avila M, Wheeler CM et a l : Q u a d r i v a l e n t v a c c i n e a g a i n s t h u m a n papillomavirus to prevent anogenital diseases, N Eng J Med 2007; 356: 1928-43.
Villa LL, Ault KA, Giuliano AR et al: Immunologic responses following administration of a vaccine targeting human papillomavirus types 6, 11, 16, and , Vaccine 2006; 24: 5571-83.
The FUTURE II Study Group: Quadrivalent vaccine against human papillomavirus to prevent highgrade cervical lesions, N Engl J Med 2007; 356: 27.
Joura EA, Leodolter S, Hernandez-Avila M et al: Efficacy of a quadrivalent prophylactic human papillomavirus (types 6, 11, 16, and 18) L1 viruslike- particle vaccine against high-grade vulval and vaginal lesions: A combined analysis of three randomised clinical trials, Lancet 2007; 369: 1693-702.
Harper DM, Franco EL, Wheeler CM et al: Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle against human papillomavirus types and 18: Follow-up from a randomised control trial, Lancet 2006; 367: 1247-55.
Somer A “Human Papillomavirüs Aşıları” Ankem Dergisi 2009; 23: 96-101
Pedersen C, Petaja T, Strauss G and for the HPV Vaccine Adolescent Study Investigators Network: Immunization of early adolescent females with human papillomavirus type 16 and 18 L1 viruslike particle vaccine containing ASO4 adjuvant, J Adolesc Health ; 40: 564-71. Winer RL, Lee SK, Hughes JP, Adam DE, Kiviat NB, Koutsky LA. Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students. J Epidemiol 2003; 157: 26.
Schiffman M, Castle PE: The promise of global cervical cancer prevention, N Eng J Med 2005; 353: 4.
Wright TC, Van Damme P, Schmitt HJ, Meheus A: HPV vaccine introduction in industrialized countries, Vaccine 2006; 24: 122-31.