The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis.
Adolescent
Adult
Child
Condylomata Acuminata
/ epidemiology
Female
Humans
Immunization Programs
/ statistics & numerical data
Male
Papillomavirus Infections
/ epidemiology
Papillomavirus Vaccines
/ administration & dosage
Randomized Controlled Trials as Topic
Uterine Cervical Neoplasms
/ epidemiology
Vaccination
/ statistics & numerical data
Young Adult
Genital wart
Human papillomavirus
Prevention
Vaccination
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
28 May 2020
28 May 2020
Historique:
received:
17
07
2019
accepted:
22
04
2020
entrez:
29
5
2020
pubmed:
29
5
2020
medline:
29
9
2020
Statut:
epublish
Résumé
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. 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. 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. Prophylactic, quadrivalent HPV vaccination can prevent GW in healthy women and men, therefore, it should be included in routine immunization programme.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
Prophylactic, quadrivalent HPV vaccination can prevent GW in healthy women and men, therefore, it should be included in routine immunization programme.
Identifiants
pubmed: 32460747
doi: 10.1186/s12889-020-08753-y
pii: 10.1186/s12889-020-08753-y
pmc: PMC7254696
doi:
Substances chimiques
Papillomavirus Vaccines
0
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
691Subventions
Organisme : Economic Development and Innovation Operative Programme Grant
ID : GINOP 2.3.2-15-2016-00048
Organisme : Human Resources Development Operational Programme Grant
ID : EFOP-3.6.2-16-2017-00006
Organisme : Human Resources Development Operational Programme Grant
ID : EFOP-3.6.3-VEKOP-16-2017-00009
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