臨床婦人科産科76巻8号

2022年08月発行

今月の臨床 HPVワクチン勧奨再開―いま知りたいことのすべて

HPVワクチンの有効性

2価・4価ワクチンを使用した日本・海外における臨床データ

著者： 黒澤めぐみ¹ 山口真奈子¹ 工藤梨沙¹ 関根正幸¹ 榎本隆之¹

所属機関： ¹新潟大学医学部産科婦人科学教室

ページ範囲：P.754 - P.761

文献概要

●世界からはHPV感染率や前がん病変の減少のみならず，浸潤子宮頸がんに対するHPVワクチンの有効性が報告されている．

●日本においても積極的勧奨中止前のHPVワクチン接種率の高かった世代でHPV感染率や前がん病変に対するワクチンの効果を認めている．

●日本では積極的勧奨中止による影響で，HPV16/18型感染率が上昇しており，将来的な子宮頸がんリスクの上昇が懸念される．

参考文献

1）Sekine M KR, et al : Japanese crisis of HPV vaccination. Int J Pathol Clin Res 2 : 039, 2016

2）Hanley SJ, et al : HPV vaccination crisis in Japan. Lancet 385 : 2571, 2015

3）Drolet M, et al : HPV Vaccination Impact Study Group : Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes : updated systematic review and meta-analysis. Lancet 394 : 497-509, 2019

4）Luostarinen T, et al : Vaccination protects against invasive HPV-associated cancers. Int J Cancer 142 : 2186-2187, 2018

5）Lei J, et al : HPV vaccination and the risk of invasive cervical cancer. N Engl J Med 383 : 1340-1348, 2020

6）Kudo R, et al : Bivalent human papillomavirus vaccine effectiveness in a Japanese population : high vaccine-type-specific effectiveness and evidence of cross-protection. J Infect Dis 219 : 382-390, 2019

7）Ikeda S, et al : Human papillomavirus vaccine to prevent cervical intraepithelial neoplasia in Japan : a nationwide case-control study. Cancer Sci 112 : 839-846, 2021

8）Tanaka H, et al : Preventive effect of human papillomavirus vaccination on the development of uterine cervical lesions in young Japanese women. J Obstet Gynaecol Res 43 : 1597-1601, 2017

9）Ozawa N, et al : Beneficial effects of human papillomavirus vaccine for prevention of cervical abnormalities in Miyagi, Japan. Tohoku J Exp Med 240 : 147-151, 2016

10）Konno R, et al : Effectiveness of HPV vaccination against high grade cervical lesions in Japan. Vaccine 36 : 7913-7915, 2018

11）Kurosawa M, et al : Long-term effectiveness of HPV vaccination against HPV infection in young Japanese women : real-world data. Cancer Sci 113 : 1435-1440, 2022

12）Kurosawa M, et al : Long-term effects of human papillomavirus vaccination in clinical trials and real-world data : a systematic review. Vaccines（Basel） 10 : 256, 2022

13）Machalek DA, et al : Very low prevalence of vaccine human papillomavirus types among 18- to 35-year old Australian women 9 years following implementation of vaccination. J Infect Dis 217 : 1590-1600, 2018

14）Thamsborg LH, et al : High-grade cervical lesions after vaccination against human papillomavirus : a Danish cohort study. Acta Obstet Gynecol Scand 99 : 1290-1296, 2020

15）Shilling H, et al : Human papillomavirus prevalence and risk factors among Australian women 9-12 years after vaccine program introduction. Vaccine 39 : 4856-4863, 2021

16）Kjaer SK, et al : Final analysis of a 14-year long-term follow-up study of the effectiveness and immunogenicity of the quadrivalent human papillomavirus vaccine in women from four nordic countries. EClinicalMedicine 23 : 100401, 2020

17）Porras C, et al : Efficacy of the bivalent HPV vaccine against HPV 16/18-associated precancer : long-term follow-up results from the Costa Rica Vaccine Trial. Lancet Oncol 21 : 1643-1652, 2020

18）Sekine M, et al : Suspension of proactive recommendations for HPV vaccination has led to a significant increase in HPV infection rates in young Japanese women : real-world data. Lancet Reg Health West Pac 16 : 100300, 2021

19）Yagi A, et al : The looming health hazard : a wave of HPV-related cancers in Japan is becoming a reality due to the continued suspension of the governmental recommendation of HPV vaccine. Lancet Reg Health West Pac 18 : 100327, 2022

20）Simms KT, et al : Impact of scaled up human papillomavirus vaccination and cervical screening and the potential for global elimination of cervical cancer in 181 countries, 2020-99 : a modelling study. Lancet Oncol 20 : 394-407, 2019

21）Haruyama R, et al : Japan resumes active recommendations of HPV vaccine after 8･5 years of suspension. Lancet Oncol 23 : 197-198, 2022