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HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review

Bryan, S; Barbara, C; Thomas, J; Olaitan, A; (2019) HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review. BMC Womens Health , 19 (1) , Article 3. 10.1186/s12905-018-0707-9. Green open access

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Abstract

BACKGROUND: HPV DNA is found in almost 80% of VIN/VaIN. Current management is inadequate, with high recurrence rates. Our objective was to review the literature regarding the role of HPV vaccine in secondary prevention and treatment of VIN/VaIN. METHODS: Database searches included Ovid Medline, Embase, Web of Science, The Cochrane Library and Clinicaltrials.gov . Search terms included HPV vaccine AND therapeutic vaccine* AND VIN OR VAIN, published in English with no defined date limit. Searches were carried out with a UCL librarian in March 2018. We included any type of study design using any form of HPV vaccine in the treatment of women with a histologically confirmed diagnosis of VIN/VaIN. We excluded studies of other lower genital tract disease, vulval/vaginal carcinoma and prophylactic use of vaccines. The outcome measures were lesion response to vaccination, symptom improvement, immune response and HPV clearance. RESULTS: We identified 93 articles, 7 studies met our inclusion criteria; these were uncontrolled case series. There were no RCTs or systematic reviews identified. Reduction in lesion size was reported by all 7 studies, symptom relief by 5, HPV clearance by 6, histological regression by 5, and immune response by 6. CONCLUSIONS: This review finds the evidence relating to the use of HPV vaccine in the treatment of women with VIN/VaIN is of very low quality and insufficient to guide practice. Further longitudinal studies are needed to assess its use in prevention of progression to cancer.

Type: Article
Title: HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12905-018-0707-9
Publisher version: https://doi.org/10.1186/s12905-018-0707-9
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: HPV vaccine, Therapeutic vaccine, VAIN, VIN, Vulval disorders, Vulvar intraepithelial neoplasia
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10075942
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