HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review
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 Medlin...
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doaj-2aa585435d76404c83cf54d0526af3132020-11-25T02:43:18ZengBMCBMC Women's Health1472-68742019-01-011911610.1186/s12905-018-0707-9HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic reviewStacey Bryan0Cynthia Barbara1Jane Thomas2Adeola Olaitan3Research Fellow, Institute for Women’s Health, Gynaecology Cancer Research CentreUniversity College London HospitalsUniversity College London HospitalsUniversity College London HospitalsAbstract 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.http://link.springer.com/article/10.1186/s12905-018-0707-9HPV vaccineVINVAINTherapeutic vaccineVulval disordersVulvar intraepithelial neoplasia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stacey Bryan Cynthia Barbara Jane Thomas Adeola Olaitan |
spellingShingle |
Stacey Bryan Cynthia Barbara Jane Thomas Adeola Olaitan HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review BMC Women's Health HPV vaccine VIN VAIN Therapeutic vaccine Vulval disorders Vulvar intraepithelial neoplasia |
author_facet |
Stacey Bryan Cynthia Barbara Jane Thomas Adeola Olaitan |
author_sort |
Stacey Bryan |
title |
HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review |
title_short |
HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review |
title_full |
HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review |
title_fullStr |
HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review |
title_full_unstemmed |
HPV vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review |
title_sort |
hpv vaccine in the treatment of usual type vulval and vaginal intraepithelial neoplasia: a systematic review |
publisher |
BMC |
series |
BMC Women's Health |
issn |
1472-6874 |
publishDate |
2019-01-01 |
description |
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. |
topic |
HPV vaccine VIN VAIN Therapeutic vaccine Vulval disorders Vulvar intraepithelial neoplasia |
url |
http://link.springer.com/article/10.1186/s12905-018-0707-9 |
work_keys_str_mv |
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