Potential impact of a nonavalent HPV vaccine on the occurrence of HPV-related diseases in France

International audienceBackground : Human Papillomavirus (HPV) infection is known to be associated with a number of conditions including cervical, vaginal, vulvar, penile, anal neoplasias and cancers, oropharynx cancers and genitals warts (GW). Two prophylactic vaccines are currently available: a bivalent vaccine designed to prevent HPV type 16 and 18 infection and a quadrivalent vaccine targeting HPV 6, 11, 16, and 18. In France, HPV vaccination is recommended in 11-14 year-old girls with a catch-up for girls aged 15-19. The objective of this study was to assess the potential impact of an HPV 6/11/16/18/31/33/45/52/58 nonavalent vaccine on anogenital and oropharyngeal HPV-related diseases in France.Methods : HPV genotype distributions from 6 multicentric retrospective studies (EDiTH I to VI) were analyzed including 516 cases of invasive cervical cancers (ICC), 493 high-grade cervical neoplasias (CIN2/3), 397 low-grade squamous intraepithelial lesions (LSIL), 423 GW, 366 anal cancer and 314 oropharyngeal carcinomas. Low and high estimates of HPV vaccine impact were calculated as follows: low estimate: prevalence of HPV 6/11/16/18/31/33/45/52/58 genotypes alone or in association but excluding presence of another HPV type; high estimate: prevalence of HPV 6/11/16/18/31/33/45/52/58 genotypes alone or in association, possibly in presence of another HPV type.Results : Estimates of potential impact varied from 85% (low estimate) to 92% (high estimate) for ICC, 77% to 90% for CIN2/3, 26% to 56% for LSIL, 69% to 90% for GW, 81% to 93% for anal cancer, and 41% to 44% for oropharyngeal carcinomas. Compared to the quadrivalent vaccine, the proportion of additional cases potentially prevented by the nonavalent vaccine was 9.9%-15.3% for ICC, 24.7%-33.3% for CIN2/3, 12.3%-22.7% for LSIL, 2.1%-5.4% for GW, 8.5%-10.4% for anal cancer, and 0.0%-1.6% for oropharyngeal carcinoma.Conclusions : The nonavalent HPV vaccine showed significant increased potential impact compared to the HPV 6/11/16/18 quadrivalent vaccine for ICC, CIN2/3 and LSIL. Considering a 100% vaccine efficacy and high vaccine coverage, about 90% of ICC, CIN2/3, GW or anal cancer cases could be prevented by a nonavalent HPV vaccine in France

Human papillomavirus genotype distribution in tonsil cancers.

International audienceBACKGROUND: The incidence of tonsil cancers has increased in several countries. French data on HPV prevalence in tonsil cancers are scarce. The objective of this study was thus to assess the overall and type specific HPV prevalence in tonsil histological samples. METHODS: This French retrospective multicenter study involved 12 centres located throughout the country. Were included 185 histological samples collected from year 2000 to 2009 with a validated diagnosis of tonsil invasive carcinomas. HPV prevalence was studied according to gender, age and histological type of cancer. RESULTS: Overall HPV prevalence was 57% in tonsil cancers. Mean age of diagnosis was comparable in HPV positive tonsils cases (60 ± 11.2) and HPV negative tonsil cases (59 ± 9.6). HPV prevalence was significantly higher in female than in male cases (28/35 versus 78/150 in tonsil cases, respectively, P = 0.003). About 53% of tonsil cases were infected by a single HPV type. Only eight (4%) samples were infected by more than one HPV type. Among HPV positive samples, HPV 16 was found in 89% of tonsil cases. All other HPV types had prevalence below 5%. CONCLUSIONS: Our results indicate that HPV is common in tonsil carcinomas and emphasize the predominant role of HPV 16

Évaluation de nouvelles stratégies thérapeutiques pour prévenir les résistances virales lors de l'infection chronique par le virus de l'hépatite B

Nous avons évalué l'efficacité d'une bithérapie L-FMAU + FTC associée à une thérapie génique par l'IFNg in vivo. L'activité antivirale du L-FMAU et du FTC est augmentée en combinaison, ce qui permet de réduire le pool d'ADNccc. Nous avons ensuite caractérisé l'efficacité antivirale d'un nouvel analogue de guanosine, le FLG. Nos résultats démontrent que le FLG-TP serait un terminateur de chaîne, inhibiteur compétitif de l'incorporation du dGTP naturel qui inhibe avec la même efficacité la réplication des VHB mutants résistants à la Lamivudine et/ou à l'Adéfovir in vitro. Enfin, nous avons caractérisé phénotypiquement, in vitro, une souche virale associant les mutations de résistance à la Lamivudine et à l'Adéfovir. Nos résultats indiquent que ce triple mutant est résistant à l'Adéfovir, à la Lamividine, à la bithérapie et présente une résistance croisée au b-L-FD4C, au FTC, et au L-FMAU. Le FLG reste la drogue la plus efficace contre la réplication du triple mutantLYON1-BU.Sciences (692662101) / SudocSudocFranceF

Human papillomavirus genotype distribution in high grade cervical lesions (CIN 2/3) in France: EDITH study.

International audienceHigh grade cervical intraepithelial neoplasia (CIN 2/3) have a high potential to progress to invasive cervical cancer (ICC). Pap testing including follow-up and treatment of CIN 2/3 is currently the best prevention of ICC, but is associated with morbidity, namely obstetrical adverse effects and psychological distress. Human papillomavirus (HPV) is universally accepted as the necessary cause of ICC. The objective of the present study was to describe the type-specific prevalence of HPV in CIN 2/3 in France and hereby to locally estimate the potential benefit of an HPV 16/18 L1 virus-like particles (VLP) vaccine. A total of 493 formalin-fixed and paraffin-embedded CIN 2/3 specimens were analyzed. Medical records were examined for patient related data. HPV were genotyped with the INNO-LiPA assay allowing the detection of 24 HPV genotypes. The overall prevalence of LiPA detectable HPV was 98%. The most prevalent genotype was HPV 16 (62%) followed by HPV 31 (15%), 33 (12%), 52 (9%), 51 (8%), 58 (7%), 35 and 18 (4%). Multiple infection with at least two different high-risk (HR) HPV genotypes was observed in 26% of all specimens including 2.6% with HPV 16 and 18 multiple infections. The present study indicates that HPV 16 is by far the most common HPV type associated with CIN 2/3 in France. With an HPV 16 and 18 prevalence of 64%, HPV 16/18 L1 VLP vaccines would be expected to significantly reduce the burden associated with the management and treatment of CIN 2/3 in France

Prevention of sexually transmitted infections among girls and young women in relation to their HPV vaccination status.

International audienceBACKGROUND: Having been vaccinated against the human papilloma virus (HPV) may affect other behaviours related to sexual health. This study assessed knowledge and behaviour relevant to the prevention of sexually transmitted infections (STIs) among girls/women aged 14-23 years in relation to their HPV vaccination status. METHODS: From November 2008 to February 2009, 328 girls/women from the Rhône-Alpes region were recruited by general practitioners and completed a self-administered questionnaire. RESULTS: In all, 316 of the 328 respondents provided information on their HPV vaccination status: 135 (42.7%) had been vaccinated (51.2% of girls aged 14-16 years, 44% of women aged 17-20 years and 18.9% of 21-23-year-olds). Knowledge about HPV and the Pap smear was poor overall but greater in those who had been vaccinated: vaccinated 14-16-year-olds were significantly more likely to know the aim of the Pap smear than those not vaccinated (72.7% vs. 41.3%, P 80% cited condoms as a means of STI prevention and >85% of those who were sexually active used them. No difference was observed between vaccinated and non-vaccinated groups regarding requests for HIV serology, history of abortions or emergency hormonal contraception. CONCLUSION: Knowledge about cervical cancer prevention was better among those who had been vaccinated against HPV than among those who had not. Knowledge and behaviour relevant to STI prevention seemed appropriate whatever the respondents' vaccination status