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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2024№12
Postexcision vaccination against human papillomavirus...

Postexcision vaccination against human papillomavirus as a method of secondary prevention of cervical intraepithelial neoplasia grade 2+

DOI
https://dx.doi.org/10.18565/aig.2024.214

Klinyshkova T.V.

Omsk State Medical University, Ministry of Health of Russia, Omsk, Russia

Cervical intraepithelial neoplasia (CIN) is one of the most important issues in gynecology and gynecologic oncology. Despite the efficacy of excisional treatment for CIN2+ patients, there is a risk of CIN2+ recurrence and late diagnosis of cervical cancer. The risk of developing cervical cancer after excisional treatment has been shown to triple compared to the general population. CIN2+/HSIL recurrence after excisional treatment occurs in 4.8–14.4% of cases. HPV persistence, in particular high-risk HPV (HR-HPV), is one of the main predictors of CIN2+ recurrence, regardless of the type of excisional treatment. Given the significance of HR-HPV in the development of recurrence, HPV vaccination is recommended as a method of modern prevention of HSIL recurrence. The benefit of postexcision immunization with HPV vaccine for the prevention of CIN2+, regardless of the specific HR-HPV genotype, has been demonstrated in studies published since 2011. Bivalent and quadrivalent HPV vaccines given on the day of conization or within one year after surgical excision can reduce the risk of CIN2+ recurrence by 67–85% during a follow-up period of up to 6 years. Evidence suggests that HSIL is reduced in vaccinated patients following treatment, despite the time when vaccination was initiated. It is noteworthy that the incidence of CIN2+ recurrence was reduced by 90% in patients who received 9vHPV vaccine compared to those who underwent only excision.
Conclusion: HR-HPV persistence has a prognostic value for the development of CIN 2+ recurrence after excisional treatment, which explains the need for HPV testing in the follow-up dynamics. Postexcision HPV vaccination proves highly effective in reducing the risk of recurrence of CIN2+ associated with HR-HPV.

Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was carried out without sponsorship.
For citation: Klinyshkova T.V. Postexcision vaccination against human papillomavirus as a method of 
secondary prevention of cervical intraepithelial neoplasia grade 2+.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (12): 20-24 (in Russian)
https://dx.doi.org/10.18565/aig.2024.214

Keywords

CIN
HSIL
human papillomavirus
conization
recurrence
HPV vaccination
Full text (in Russian)

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Received 27.08.2024

Accepted 29.11.2024

About the Authors

Tatyana V. Klinyshkova, Dr. Med. Sci., Professor, Professor at the Department of Obstetrics and Gynecology, Omsk State Medical University, Ministry of Health of Russia, 644099, Russia, Omsk, Lenin str., 12, klin_tatyana@mail.ru, https://orcid.org/0000-0002-0544-8184

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