HPV Vaccine Post-Surgery Cuts Viral Persistence
The administration of the human papillomavirus nonavalent (9vHPV) vaccine after a surgical treatment for low- and high-grade cervical intraepithelial neoplasia resulted in a significant reduction in the proportion of women positive for HPV over the 15-month study period.
METHODOLOGY:
Researchers conducted a retrospective study to examine the effectiveness of the 9vHPV vaccine after surgical treatment in women with cervical intraepithelial neoplasia.
They included 326 women (mean age, 40.7 years) who underwent carbon dioxide laser ablation for low-grade cervical intraepithelial neoplasia (CIN1) or the loop electrosurgical excision procedure for high-grade lesions (CIN2-3) between 2020 and 2024 at a centre in Italy.
Participants were divided into two groups: Vaccinated (n = 222) and unvaccinated (n = 104) groups; the vaccinated group received the 9vHPV vaccine either before surgery or within 30 days post-surgery.
Patients were followed up at 6 and 15 months post-treatment; HPV test results and colposcopy findings were analysed to determine the effect of vaccination on viral clearance.
TAKEAWAY:
During the 6-month follow-up period, HPV positivity rates were significantly lower for patients with CIN1 in the vaccinated group than for those in the unvaccinated group (18% vs 38%; P = .0169). The findings were consistent at the 15-month follow-up.
= .0169). The findings were consistent at the 15-month follow-up. During the 15-month follow-up period, HPV positivity rates were significantly lower for patients with CIN2-3 in the vaccinated group than for those in the unvaccinated group (8% vs 18%; P = .0353).
= .0353). Vaccination showed a significant effect in reducing HPV positivity among women aged 40 years or older with CIN1 ( P = .0100).
= .0100). At the end of the follow-up, post-treatment colposcopy findings were comparable between the groups, regardless of vaccination status.
IN PRACTICE:
"A comprehensive approach to cervical cancer prevention — including primary prevention (prophylactic vaccination), secondary prevention (cervical screening), and tertiary prevention (therapeutic interventions and post-treatment vaccination) — could play a crucial role in accelerating the elimination of cervical cancer worldwide," the authors wrote.
SOURCE:
This study was led by Mario Palumbo, School of Medicine, University of Naples "Federico II," Naples, Italy. It was published online on April 19, 2025, in the European Journal of Obstetrics & Gynecology and Reproductive Biology .
LIMITATIONS:
This study was limited by its retrospective observational study design.
DISCLOSURES:
This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors reported having no conflicts of interest or personal relationships that could have influenced the study.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Medscape
3 hours ago
- Medscape
Should Kids Get the HPV Vaccine Earlier?
Recommending the human papillomavirus (HPV) vaccination to parents of 9- to 10-year-old children allowed clinicians to discuss cancer prevention and avoid the sticky subject of sexual activity that often comes up with older age groups, new research showed. The study, published in Pediatrics , also found that parents were generally open to having their 9- to 10-year-old children vaccinated for HPV. 'At ages 9-10, sexual activity was less salient, and HPV was the only vaccine to discuss,' said Caroline Tietbohl, PhD, an assistant professor in the Department of Family Medicine at the University of Colorado in Aurora, Colorado, and lead author of the study. 'This made discussions shorter and easier and also paid forward to the 11-year-old visit, where there was now one less vaccine to discuss.' HPV is the most common sexually transmitted infection in the US, with approximately 42 million people currently infected. The US CDC currently recommends the HPV series vaccine as part of routine vaccination beginning at age 11 years, but states that vaccination can start at age 9 years. The vaccine is highly effective for preventing several types of cancer, including cervical and oropharyngeal cancers. Two doses are recommended for most people who start the series before age 15 years, and three doses are recommended for those who start the series after age 15 years, as well as immunocompromised individuals. Yet only 40% of children between 9 years and 17 years of age have received at least one dose. Tietbohl said her team was motivated to conduct the research by persistently low completion rates of the HPV series despite strong evidence that the vaccine is safe and highly effective at preventing cancer. 'We anticipated that bringing up the HPV vaccine at this age could make the discussion easier by decoupling it from sexual activity and focusing on its purpose — cancer prevention — and this seems to have been true for many parents in our study,' Tietbohl said. She and her colleagues surveyed and interviewed pediatricians and staff between 2021 to 2022 at 17 clinics in Colorado and 16 in California. The practices were randomly assigned to either recommend the HPV vaccine to parents of the younger children or to continue at the current standard at ages of 11-12 years. Surveys assessed how the shift was implemented, while interviews provided more detail about any challenges or benefits observed. Prior to the intervention, none of the clinics had recommended the vaccine to younger patients, instead following the current standard recommendation. One month after the intervention, over 90% of clinicians in Colorado and 77% of those in California reported routinely recommending the vaccine to children at ages 9 years or 10 years. Most clinicians and staff in the intervention group reported that parents were largely receptive to the earlier recommendation, sometimes to the clinician's surprise. Many said they had expected parents to push back, assuming that discussions of the HPV vaccine would raise concerns about sexual activity or be met with hesitation. Instead, they found that conversations were easier at ages 9 years and 10 years because sexual activity was less of a consideration for parents at that age. Angela Myers, MD The findings build on evidence that parents may be more receptive when the discussion starts earlier, said Angela Myers, MD, professor of pediatrics and pediatric infectious diseases at the University of Missouri-Kansas City, who was not involved in the study. 'The earlier we get kids vaccinated against HPV, the better their immune response,' Myers said. 'Sexual activity becomes kind of a nonthought at age 9. That's as it should be because this is a cancer prevention vaccine.' Despite the positive response, some clinicians noted challenges, including electronic health record reminders that still reflected the older age recommendation, as well as occasional parental surprise at being offered the vaccine at a younger age. 'The main hitch was that some parents were not expecting to discuss the HPV vaccine until age 11 and had already promised their kids that the 9- or 10-year-old visit would not include shots,' Tietbohl said. The next phase of the research will focus on analyzing whether earlier vaccination improves rates of series completion by age 13 years, Tietbohl said. Myers said recommending the vaccine earlier could help improve vaccination rates by giving families more time to complete the series before adolescence. 'Every new study that gets published adds a little bit more to the story,' Myers said. 'Collectively, all of the data can help in saying, 'Perhaps we should take another look at this and perhaps we should change the language slightly.' Tietbohl and Myers did not report any relevant conflicts of interest. The study was supported by the National Cancer Institute of the National Institutes of Health.
Medscape
3 hours ago
- Medscape
Mailed Kits Beat Office Visits for Cervical Cancer Screening
Mailed self-collection kits and a telephone reminder helped increase cervical cancer screening (CCS) rates more than twice as much as telephone reminders for an office visit, according to new data from a randomized clinical trial in a safety-net population. The home kits paired with additional patient contact increased numbers even further. In a trial that included 2474 people overdue for CCS (94% of them from minority populations), participants randomized to a telephone reminder with a mailed self-collection kit had 41.1% participation compared to those with a phone reminder to come in for an office visit (17.4%). CCS rates were modestly higher (46.6%) when people received contact in addition to the telephone reminder and mailed self-collection kit for testing human papillomavirus (HPV). Self-collection with additional patient contact was designed to be different from self-collection with a telephone reminder in terms of the dose of patient interactions rather than content, minimizing potential contamination across the self-collection with telephone reminder and self-collection with additional patient contact groups. The study, led by Jane R. Montealegre, PhD, with the Department of Behavioral Science, The University of Texas MD Anderson Cancer Center in Houston, was conducted from February 20, 2020, to August 31, 2023, and published in JAMA Internal Medicine . Cervical Cancer Could be Eliminated in the US in 10-20 Years Estimates show that cervical cancer in the US could see national-level elimination in the next one to two decades if CCS rates hit 90%. However up-to-date screening has declined in recent years and was 75.2% in 2021, with rates notably lower among underserved populations, including women and people with a cervix who are uninsured or publicly insured, live in rural areas, and are from minority populations. The study researchers noted that the results in this trial, the PRESTIS trial, are consistent with the relative participation rates of previous trials. In a recent meta-analysis of 28 trials, Stefanie Costa and colleagues reported a 2.5-fold higher participation in screening with mailed self-collection vs usual care. 'Notably distinct from previous trials are the large screening proportions attained in the [self-collection (SC) group] (41.1%) and SC with patient navigation (46.6%) groups, as compared to the global estimate of 24% reported in the meta-analysis,' the authors wrote. In an accompanying editorial, Eve Rittenberg, MD, MA, with the Division of Women's Health, Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues wrote that home self-collection 'has the potential to meaningfully reduce cervical cancer burden, especially among underserved populations.' They pointed out that self-collection has previously been studied in a clinical setting, where women can collect a sample privately without undergoing an invasive Pap smear and that 'self-collected HPV samples have similar specificity and sensitivity to clinician-collected samples.' But it hasn't been known whether the tests need to be performed in a clinic. Home Screening May Further Eliminate Barriers Montealegre's team shows that 'home self-collection demonstrates that people can adequately obtain usable samples in the privacy of their homes, as only 6% of samples were deemed inadequate for evaluation,' the editorialists wrote. Home-based screening, they explained, may further eliminate screening barriers for underserved populations with lower costs and fewer logistical hurdles. Additionally, screening via pelvic exam can be uncomfortable and may be culturally unacceptable for some. Pelvic exam-based screening may be particularly distressing to those who have experienced sexual trauma, they wrote. They pointed out that options for CCS are growing with the approval last month by the FDA of a home HPV self-collection kit, which will be available for clinical use within months. Self-collection of HPV samples is included in the World Health Organization's global strategy to eliminate cervical cancer by 2030, and the draft US Preventive Services Task Force CCS guidance now includes self-collection as an option. Future research should help determine whether more home self-collected HPV screening leads to higher rates of treating precancerous lesions and eventually lower cervical cancer rates, the editorialists wrote. They also noted that efforts to increase CCS rates should be accompanied by efforts to increase HPV vaccination rates. The research was funded through grants from the National Institute on Minority Health and Health Disparities and the National Cancer Institute through an MD Anderson Cancer Center Support Grant, the Dan L Duncan Comprehensive Cancer Center Support Grant, and the Hollings Cancer Center Support Grant. The authors reported having no relevant financial relationships. An editorialist, Cary Gross, MD, reported receiving grants from Johnson & Johnson and the National Comprehensive Cancer Network (with funding provided by AstraZeneca) outside the submitted work. No other disclosures were reported.
Yahoo
13 hours ago
- Yahoo
Vaxart to Host Conference Call on June 11 at 8:30 AM ET to Discuss Topline Results from Its Phase I Norovirus Trial
SOUTH SAN FRANCISCO, Calif., June 10, 2025 (GLOBE NEWSWIRE) -- Vaxart, Inc. (NASDAQ: VXRT), a clinical-stage biotechnology company developing a range of oral recombinant pill vaccines based on its proprietary delivery platform, today announced it will release topline data from the norovirus Phase I trial before the market open on Wednesday, June 11, 2025. The Vaxart senior management team will host a live conference call on the same date beginning at 8:30 a.m. Eastern Time to review the data and provide a trial update. The conference call can be accessed using the following information: Webcast: Click hereDate: Wednesday, June 11, 2025 – 8:30 a.m. ETDomestic: (877) 407-0832International: (201) 689-8433Conference ID: 13754315 Investors may submit written questions in advance of the conference call to ir@ A replay of the webcast will be available on the Company's website at following the conclusion of the event. About VaxartVaxart is a clinical-stage biotechnology company developing a range of oral recombinant vaccines based on its proprietary delivery platform. Vaxart vaccines are designed to be administered using pills that can be stored and shipped without refrigeration and eliminate the risk of needle-stick injury. Vaxart believes that its proprietary pill vaccine delivery platform is suitable to deliver recombinant vaccines, positioning the company to develop oral versions of currently marketed vaccines and to design recombinant vaccines for new indications. Vaxart's development programs currently include pill vaccines designed to protect against coronavirus, norovirus and influenza, as well as a therapeutic vaccine for human papillomavirus (HPV), Vaxart's first immune-oncology indication. Vaxart has filed broad domestic and international patent applications covering its proprietary technology and creations for oral vaccination using adenovirus and TLR3 agonists. Contact Vaxart Media and Investor Relations: Matt Steinberg FINN Partners IR@ (646) 871-8481 This press release was published by a CLEAR® Verified in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
