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The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis

BACKGROUND: The quadrivalent human papillomavirus (HPV) vaccine has been assumed to give protection against genital warts (GW) as well as cervical cancer. Our main question was whether HPV vaccine has any effects on the prevention of GW reported in randomised controlled clinical trials (RCTs) and ti...

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Autores principales: Lukács, Anita, Máté, Zsuzsanna, Farkas, Nelli, Mikó, Alexandra, Tenk, Judit, Hegyi, Péter, Németh, Balázs, Czumbel, László Márk, Wuttapon, Sadaeng, Kiss, István, Gyöngyi, Zoltán, Varga, Gábor, Rumbus, Zoltán, Szabó, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254696/
https://www.ncbi.nlm.nih.gov/pubmed/32460747
http://dx.doi.org/10.1186/s12889-020-08753-y
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author Lukács, Anita
Máté, Zsuzsanna
Farkas, Nelli
Mikó, Alexandra
Tenk, Judit
Hegyi, Péter
Németh, Balázs
Czumbel, László Márk
Wuttapon, Sadaeng
Kiss, István
Gyöngyi, Zoltán
Varga, Gábor
Rumbus, Zoltán
Szabó, Andrea
author_facet Lukács, Anita
Máté, Zsuzsanna
Farkas, Nelli
Mikó, Alexandra
Tenk, Judit
Hegyi, Péter
Németh, Balázs
Czumbel, László Márk
Wuttapon, Sadaeng
Kiss, István
Gyöngyi, Zoltán
Varga, Gábor
Rumbus, Zoltán
Szabó, Andrea
author_sort Lukács, Anita
collection PubMed
description BACKGROUND: The quadrivalent human papillomavirus (HPV) vaccine has been assumed to give protection against genital warts (GW) as well as cervical cancer. Our main question was whether HPV vaccine has any effects on the prevention of GW reported in randomised controlled clinical trials (RCTs) and time-trend analyses. METHODS: This meta-analysis was performed according to the PRISMA guidelines using the PICO format. We searched in three electronic databases (PubMed, Embase, Cochrane Trials), and assessed heterogeneity using the Q-test and I-squared statistics, meta-regression was also performed. Odds ratios (OR) and their confidence intervals (CI) were calculated. The sensitivity was tested by leave-one-out method. We evaluated the presence of publication bias using the funnel plot graph and the Copas selection model. The strength of evidence was assessed using the GRADE approach. RESULTS: Eight RCTs (per-protocol populations) and eight time-trend ecological studies were included in this meta-analysis. A significant reduction (pooled OR = 0.03, 95% CI: 0.01–0.09; I-squared = 53.6%) of GW in young women was recorded in RCTs, and in time-trend analyses both in young women (pooled OR = 0.36, CI 95% = 0.26–0.51; I-squared = 98.2%), and in young men (pooled OR = 0.69, 95% CI = 0.61–0.78; I-squared = 92.7%). In subgroup analysis, a significant reduction of the number of GW events was observed especially in women under 21 years (pooled OR = 0.33, 95% CI = 0.17–0.63). Leave-one-out analysis showed that similar results could be obtained after excluding one study, meta-regression did not show significant difference. CONCLUSIONS: Prophylactic, quadrivalent HPV vaccination can prevent GW in healthy women and men, therefore, it should be included in routine immunization programme.
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spelling pubmed-72546962020-06-07 The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis Lukács, Anita Máté, Zsuzsanna Farkas, Nelli Mikó, Alexandra Tenk, Judit Hegyi, Péter Németh, Balázs Czumbel, László Márk Wuttapon, Sadaeng Kiss, István Gyöngyi, Zoltán Varga, Gábor Rumbus, Zoltán Szabó, Andrea BMC Public Health Research Article BACKGROUND: The quadrivalent human papillomavirus (HPV) vaccine has been assumed to give protection against genital warts (GW) as well as cervical cancer. Our main question was whether HPV vaccine has any effects on the prevention of GW reported in randomised controlled clinical trials (RCTs) and time-trend analyses. METHODS: This meta-analysis was performed according to the PRISMA guidelines using the PICO format. We searched in three electronic databases (PubMed, Embase, Cochrane Trials), and assessed heterogeneity using the Q-test and I-squared statistics, meta-regression was also performed. Odds ratios (OR) and their confidence intervals (CI) were calculated. The sensitivity was tested by leave-one-out method. We evaluated the presence of publication bias using the funnel plot graph and the Copas selection model. The strength of evidence was assessed using the GRADE approach. RESULTS: Eight RCTs (per-protocol populations) and eight time-trend ecological studies were included in this meta-analysis. A significant reduction (pooled OR = 0.03, 95% CI: 0.01–0.09; I-squared = 53.6%) of GW in young women was recorded in RCTs, and in time-trend analyses both in young women (pooled OR = 0.36, CI 95% = 0.26–0.51; I-squared = 98.2%), and in young men (pooled OR = 0.69, 95% CI = 0.61–0.78; I-squared = 92.7%). In subgroup analysis, a significant reduction of the number of GW events was observed especially in women under 21 years (pooled OR = 0.33, 95% CI = 0.17–0.63). Leave-one-out analysis showed that similar results could be obtained after excluding one study, meta-regression did not show significant difference. CONCLUSIONS: Prophylactic, quadrivalent HPV vaccination can prevent GW in healthy women and men, therefore, it should be included in routine immunization programme. BioMed Central 2020-05-28 /pmc/articles/PMC7254696/ /pubmed/32460747 http://dx.doi.org/10.1186/s12889-020-08753-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Lukács, Anita
Máté, Zsuzsanna
Farkas, Nelli
Mikó, Alexandra
Tenk, Judit
Hegyi, Péter
Németh, Balázs
Czumbel, László Márk
Wuttapon, Sadaeng
Kiss, István
Gyöngyi, Zoltán
Varga, Gábor
Rumbus, Zoltán
Szabó, Andrea
The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis
title The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis
title_full The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis
title_fullStr The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis
title_full_unstemmed The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis
title_short The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis
title_sort quadrivalent hpv vaccine is protective against genital warts: a meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254696/
https://www.ncbi.nlm.nih.gov/pubmed/32460747
http://dx.doi.org/10.1186/s12889-020-08753-y
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