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Profilaktik HPV aşıları: güncel yaklaşımlar

Prophylactic HPV vaccines: current approaches

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Abstract (2. Language): 
recognition of a strong etiological relationship between infection with high-risk human papillomaviruses and cervical cancer has prompted research to develop and evaluate prophylactic and therapeutic vaccines. One prophylactic quadrivalent vaccine using L1 virus-like particles (VLP) of HPV6, 11, 16 and 18 (Gardasil®) is available on the European market since the end of 2006 and a second bivalent vaccine containing virus-like particles of HPV16 and HPV18 (Cervarix®) is available since 2007. HPV16 and HPV18 cause approximately 43000 cases of cervical cancer each year. Results of the phase-IIb and III trials published thus far demonstrate that the L1 VLP HPV vaccine is safe and well-tolerated. It offers HPV-naive women a very high level of protection when compared to HPV persistent infection and cervical intra-epithelial lesions associated with the types included in the vaccine. HPV vaccination should be offered to girls before onset of sexual activity. Although prophylactic vaccination is likely to provide important future health gains, cervical screening should also be continued.
Abstract (Original Language): 
Yüksek riskli human papilloma virus (HPV) ile servikal kanser arasında sıkı etiyolojik bağlantının olduğunun ortaya konulmasından sonra profilaktik ve tedavi amaçlı aşı bulunması yönünde araştırmalar başlamıştır. HPV 6-11- 16-18’e ait L1 virüs benzeri partikül içeren bir kuadrivalan aşı (Gardasil®) 2006 yılının sonundan itibaren Avrupa ülkelerinde kullanılmaya başlanmıştır ve 2007 yılından itibaren HPV 16 ve 18’e karşı geliştirilen bivalan bir aşı (Cervarix®) piyasaya sürülmüştür. HPV 16 ve 18 her yıl yaklaşık 43000 servikal kanser vakasına sebep olmaktadır. Yayınlanan faz 2b ve faz 3 çalışmaları aşının güvenilir ve iyi tolere edilebilir olduğunu göstermektedir. Bu aşı HPV ile hiç karşılaşmamış bayanlarda, HPV ile persistan enfekte veya belirtilen tiplerde HPV içeren servikal intraepitelyal lezyonu olanlara göre daha iyi koruma sağlamaktadır. HPV aşılaması kızlarda ilk cinsel aktiviteden önce uygulanmalıdır. Profilaktik HPV aşılaması, ileride sağlıklı ve hastalıksız günler öngörse de, servikal tarama yine de yapılmalıdır.
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