Effect of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment: A systematic review and meta-analysis

Qinxue Cao; Yantao Hou; Chaoyang Wang; Juntao Yin

doi:10.1371/journal.pone.0312128

Effect of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment: A systematic review and meta-analysis

PLoS One. 2024 Dec 31;19(12):e0312128. doi: 10.1371/journal.pone.0312128. eCollection 2024.

Authors

Qinxue Cao¹, Yantao Hou², Chaoyang Wang³, Juntao Yin⁴

Affiliations

¹ Department of Obstetrics and Gynecology, Huaihe Hospital, Henan University, Henan, China.
² Henan Technical Institute, School of Mechanical and Electrical Engineering, Zhengzhou, China.
³ Department of General Surgery, Huaihe Hospital, Henan University, Henan, China.
⁴ Department of Pharmacy, Huaihe Hospital, Henan University, Henan, China.

Abstract

Background: The prophylactic vaccines available to protect against infections by human papillomavirus (HPV) are well tolerated and highly immunogenic. This systematic review and meta-analysis aimed to explore the efficacy of HPV vaccination on the risk of HPV infection and recurrent diseases related to HPV infection in individuals undergoing local surgical treatment.

Methods: A literature search was performed using PubMed/MEDLINE, Embase, the Cochrane Library, Scopus, Web of Science, and bioRxiv/medRxiv from inception to July 15, 2024. Randomized controlled trials (RCTs) reporting the effect of HPV vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment vs no HPV vaccination were included. The primary outcome measure was risk of recurrence cervical high-grade squamous intraepithelial lesion (HSIL) after local surgical treatment, with follow-up as reported by individual studies. Included studies were assessed for risk of bias using the Revised Cochrane risk-of-bias (RoB 2.0 tool). Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated. No restrictions were applied on language, the date of publication, age, sex, and country. All analyses were carried out using the Review Manager 5 software (version 5.4).

Results: Eight RCTs (n = 3068) met the inclusion criteria. The risk of cervical HSIL recurrence was not reduced in individuals who were vaccinated compared with those who were not vaccinated (RR 0.92, 95% CI: 0.66-1.27; I2 = 40%). However, HPV vaccination reduced the risk of recurrence of cervical HSIL related to the HPV types HPV16/18, but uncertainty was large (RR 0.57, 95% CI: 0.18-1.84; I2 = 29%).

Conclusions: Adjuvant HPV vaccination after surgical excision is not associated with a reduced risk of recurrent HSIL overall or a reduced risk of recurrent lesions caused by the most oncogenic strains (HPV16/18). Therefore, HPV vaccination should not be considered for adjuvant treatment in patients undergoing surgical excision.

Copyright: © 2024 Cao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Systematic Review
Meta-Analysis

MeSH terms

Female
Human Papillomavirus Viruses
Humans
Neoplasm Recurrence, Local / prevention & control
Neoplasm Recurrence, Local / virology
Papillomavirus Infections* / prevention & control
Papillomavirus Infections* / virology
Papillomavirus Vaccines* / administration & dosage
Papillomavirus Vaccines* / immunology
Papillomavirus Vaccines* / therapeutic use
Randomized Controlled Trials as Topic
Uterine Cervical Neoplasms / prevention & control
Uterine Cervical Neoplasms / surgery
Uterine Cervical Neoplasms / virology
Vaccination*

Substances

Papillomavirus Vaccines

Grants and funding

This research was funded by grant from Science and Technology Department of Henan Province (Award Number 112102310306). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.