American Association for Cancer Research
21598290cd110131-sup-cd-11-0131.mp3 (6.73 MB)

Interview with Dr. Herrero from Prevention of Persistent Human Papillomavirus Infection by an HPV16/18 Vaccine: A Community-Based Randomized Clinical Trial in Guanacaste, Costa Rica

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posted on 2023-04-03, 20:25 authored by Rolando Herrero, Sholom Wacholder, Ana C. Rodríguez, Diane Solomon, Paula González, Aimee R. Kreimer, Carolina Porras, John Schussler, Silvia Jiménez, Mark E. Sherman, Wim Quint, John T. Schiller, Douglas R. Lowy, Mark Schiffman, Allan Hildesheim

mp3 file (6.7 MB). In the October edition of the Cancer Discovery podcast, Executive Editor Judy Quong talks with Rolando Herrero about his paper, which describes a community-based randomized clinical trial for the prevention of persistent human papillomavirus infection by an HPV16/18 vaccine.



Target groups for human papillomavirus (HPV) vaccination are controversial. We evaluated vaccine efficacy (VE) against 1-year persistent infection, stratified by age and sexual behavior, among young women in Costa Rica. We randomized 7,466 healthy women 18 to 25 years of age to HPV16/18 or hepatitis A vaccine (follow-up, 50.4 months). According-to-protocol (ATP) cohorts included compliant HPV-negative women; intention-to-treat (ITT) included all randomized women. ATP VE was 90.9% (95% CI, 82.0–95.9) against HPV16/18 infections, 44.5% against HPV31/33/45 (95% CI, 17.5–63.1), and 12.4% (95% CI, −3.2 to 25.6) against any oncogenic infection. Overall ITT VE against HPV16/18 infections was 49.0%, but ATP and ITT VE almost reached 100% in year 4 of follow-up. ATP efficacy against HPV16/18 was similar by age, but ITT VE was greatest among youngest women (68.9% among those 18–19 years of age; 21.8% among those 24–25 years of age) and 79.8% among virgins. Among previously unexposed women, vaccination is highly efficacious against HPV16/18 and partially against HPV31/33/45. Vaccination is most effective in women and girls before they initiate sexual activity, with programmatic and individual decision implications.Significance: In an independent trial of the bivalent ASO4-adjuvanted HPV16/18 vaccine (Cervarix) conducted among young women in Costa Rica, we confirmed the high efficacy against HPV16/18 persistent infection and partial cross-protection against HPV31/33/45. Furthermore, efficacy data suggest that the benefit of HPV vaccination is maximal when the vaccine is given to young women before they initiate sexual activity. Cancer Discovery; 1(5): 408–19. ©2011 AACR.Read the Commentary on this article by Bosch et al., p. 377This article is highlighted in the In This Issue feature, p. 367

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