The human papillomavirus vaccine as a treatment for human papillomavirus–related dysplastic and neoplastic conditions: A literature review - 26/09/19

Doi : 10.1016/j.jaad.2019.04.067

Christine T. Pham, BS ^a,^b,^⁎ , Margit Juhasz, MD ^b, Calvin T. Sung, MD ^c, Natasha Atanaskova Mesinkovska, MD ^b
^a University of California, Irvine School of Medicine, Irvine, California
^b Department of Dermatology, University of California, Irvine, California
^c University of California, Riverside, California

^∗Correspondence to: Christine T. Pham, BS, University of California, Irvine, Department of Dermatology, 843 Health Sciences Rd, Irvine, CA.University of California, IrvineDepartment of Dermatology843 Health Sciences RdIrvineCA

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 26 September 2019
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Abstract

Background

Human papillomavirus (HPV) infections are associated with common dermatologic and nondermatologic diseases. Although HPV vaccines are well established as preventive measures for genital warts and cervical neoplasia, their use as therapeutic agents deserves greater attention.

Objective

To evaluate the use of HPV vaccine(s) as a treatment modality for cutaneous and/or mucosal disease.

Methods

A primary literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in January 2019 by using the PubMed and Cochrane databases.

Results

A total of 63 articles with 4439 patients were included. The majority of patients with cutaneous warts, recurrent respiratory papillomatosis, and squamous and basal cell carcinomas were successfully treated with HPV vaccination. Preliminary data on patients with pre-existing anogenital warts, cervical intraepithelial neoplasia, anal intraepithelial neoplasia, and vulvar intraepithelial neoplasia is promising.

Limitations

This review was limited by the lack of controls, patients' previous HPV vaccination status, and publication bias.

Conclusion

The commercially available three-dose, quadrivalent HPV vaccine is a potential therapeutic option for the treatment of cutaneous warts, recurrent respiratory papillomatosis, and squamous and basal cell carcinomas. Noncommercially available HPV vaccines demonstrate therapeutic response for treating anogenital warts, cervical intraepithelial neoplasia, anal intraepithelial neoplasia, and vulvar intraepithelial neoplasia. The vaccine's efficacy as an adjunct therapy for HPV-associated cutaneous and/or mucosal disease warrants further exploration.

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Key words : human papillomavirus, neoplasia, nonmelanoma skin cancer, vaccine, viral warts

Abbreviations used : AIN, BCC, CIN, HPV, RRP, SCC, VAIN, VIN