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"tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "92" "paginaFinal" => "93" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Pedragosa-Jové, M. Salleras-Redonet" "autores" => array:3 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Pedragosa-Jové" "email" => array:1 [ 0 => "ramon.pedragosa@hospitalplato.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Salleras-Redonet" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:1 [ "colaborador" => "Miembros fundadores del Grupo de trabajo de Epidemiología y Prevención de la Salud en Dermatología" ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Plató, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital del Sagrado Corazón, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La vacuna frente al papilomavirus humano, ¿tiene interés en dermatología?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Two new human papillomavirus (HPV) vaccines have recently become available in Spain: Gardasi (Sanofi Pasteur MSD), a quadrivalent vaccine that protects against HPV types 6, 11, 16, 18, and Cervarix (Glaxo-SmithKline), a bivalent vaccine that protects against HPV types 16 and 18.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Both are indicated for the prevention of cervical cancer. They are composed of virus-like particles containing viral proteins and are administered in 3 doses to girls and young women prior to sexual debut; the preferred age for administration is 13 or 14 years.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">However, cervical cancer is not the only disease caused by these small cutaneotropic or mucosotropic DNA viruses, of which over 150 types have been identified to date.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> They are also implicated in numerous other conditions, mainly dermatologic, including common warts (100% of cases), genital warts (100% of cases), vaginal, vulvar, and penile cancer (40% of cases), anal cancer (90% of cases), certain cancers of the oral cavity and the oropharynx,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and skin lesions in patients with epidermodysplasia verruciformis and in immunosuppressed individuals, including organ transplant recipients.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8–10</span></a> This begs the question: might some of these patients thus also benefit from HPV vaccines?</p><p id="par0015" class="elsevierStylePara elsevierViewall">Most HPV infections are latent and resolve spontaneously in 1 or 2 years.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> However, a small proportion develop into a persistent infection, which, when caused by oncogenic HPV types, can progress to precancerous lesions of varying severity over the course of years. Some of these precancerous lesions may progress to in situ or invasive carcinomas. It is thus important to prevent HPV-related conditions, not only because of the associated morbidity but also because of their carcinogenic potential.</p><p id="par0020" class="elsevierStylePara elsevierViewall">HPV types 16 and 18 are included in both the bivalent and quadrivalent vaccine because they are high-risk strains responsible for 70% of high-grade precancerous cervical lesions (cervical intraepithelial neoplasia [CIN] grades 2 and 3). They are, however, also responsible for 70% of anogenital cancers (70%–90% of vaginal and anal cancers and 40% of vulvar and penile cancers<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>) and 10% of oral cavity and oropharyngeal cancers.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13,14</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">While types 6 and 11 have low oncogenic potential, they are included in the quadrivalent vaccine because they can cause low-grade precancerous lesions (CIN 1). They are also responsible for the vast majority (90%) of genital warts and cases of oral papillomatosis.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The quadrivalent vaccine thus has enormous potential value in dermatology as it should, in theory, provide indirect protection against numerous conditions other than cervical cancer. Clinical trials have shown this vaccine to offer complete protection against warts caused by HPV types 6 and 11.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Although Spain has a low prevalence of HPV infection (estimated at 4% in women aged 15–74 years), data from other countries suggest that 1 in 8 women will develop genital warts at least once before the age of 50 years and that 10% of the population will have at least 1 episode of genital warts within 25 years of becoming sexually active. Because of the psychological, physical, and economic repercussions associated with the diagnosis and treatment of HPV infection, prevention is very important. The bivalent and quadrivalent HPV vaccines have proven to be safe, minimally reactogenic, and highly immunogenic. Furthermore, because the quadrivalent vaccine induces robust immune memory, its protective effect is likely to last for life.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Both vaccines are currently licensed for the prevention of cervical cancer in girls and women aged 12 to 25 years, essentially because they have been studied for this indication in females in this age group. There is nothing, however, to indicate that they might not also be effective in other skin infections associated with the HPV types contained in these vaccines, or even in males<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and other age groups. In fact, studies are already underway to assess the efficacy of HPV vaccination in males and other age groups. Thus, the bivalent and quadrivalent vaccines have enormous, unexplored potential in the prevention of a range of dermatologic conditions. Hypothetically, they could prevent 90% of genital warts, 40% of penile carcinomas, 70%–90% of anal cancers, and 10% of oral cavity cancers.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Pedragosa-Jové R, Salleras-Redonet M. La vacuna frente al papilomavirus humano, ¿tiene interés en dermatología? Actas Dermosifiliogr. 2012;103:92–93.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ficha técnica de Gardasil (Quadrivalent Human Papillomavirus [types 6,11,16,18] Recombinant Vaccine). Available from: <a class="elsevierStyleInterRef" href="http://www.merck.com/">http://www.merck.com</a>" ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ficha técnica de Cervarix. 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Year/Month | Html | Total | |
---|---|---|---|
2024 November | 8 | 8 | 16 |
2024 October | 63 | 34 | 97 |
2024 September | 58 | 14 | 72 |
2024 August | 97 | 41 | 138 |
2024 July | 80 | 21 | 101 |
2024 June | 90 | 35 | 125 |
2024 May | 71 | 29 | 100 |
2024 April | 86 | 25 | 111 |
2024 March | 71 | 36 | 107 |
2024 February | 52 | 29 | 81 |
2024 January | 52 | 44 | 96 |
2023 December | 56 | 17 | 73 |
2023 November | 74 | 29 | 103 |
2023 October | 66 | 17 | 83 |
2023 September | 52 | 31 | 83 |
2023 August | 43 | 14 | 57 |
2023 July | 46 | 32 | 78 |
2023 June | 67 | 15 | 82 |
2023 May | 55 | 26 | 81 |
2023 April | 50 | 20 | 70 |
2023 March | 70 | 23 | 93 |
2023 February | 60 | 22 | 82 |
2023 January | 60 | 28 | 88 |
2022 December | 56 | 37 | 93 |
2022 November | 28 | 23 | 51 |
2022 October | 39 | 34 | 73 |
2022 September | 36 | 31 | 67 |
2022 August | 24 | 31 | 55 |
2022 July | 29 | 26 | 55 |
2022 June | 20 | 22 | 42 |
2022 May | 36 | 24 | 60 |
2022 April | 51 | 51 | 102 |
2022 March | 47 | 56 | 103 |
2022 February | 52 | 23 | 75 |
2022 January | 44 | 36 | 80 |
2021 December | 35 | 48 | 83 |
2021 November | 56 | 33 | 89 |
2021 October | 41 | 46 | 87 |
2021 September | 37 | 40 | 77 |
2021 August | 57 | 27 | 84 |
2021 July | 29 | 30 | 59 |
2021 June | 39 | 31 | 70 |
2021 May | 50 | 40 | 90 |
2021 April | 109 | 42 | 151 |
2021 March | 70 | 25 | 95 |
2021 February | 52 | 32 | 84 |
2021 January | 39 | 23 | 62 |
2020 December | 26 | 17 | 43 |
2020 November | 27 | 22 | 49 |
2020 October | 34 | 9 | 43 |
2020 September | 38 | 14 | 52 |
2020 August | 30 | 24 | 54 |
2020 July | 28 | 18 | 46 |
2020 June | 36 | 21 | 57 |
2020 May | 22 | 18 | 40 |
2020 April | 30 | 19 | 49 |
2020 March | 31 | 17 | 48 |
2020 February | 4 | 1 | 5 |
2020 January | 0 | 2 | 2 |
2019 December | 4 | 3 | 7 |
2019 November | 0 | 3 | 3 |
2019 September | 4 | 0 | 4 |
2019 July | 0 | 8 | 8 |
2019 June | 2 | 5 | 7 |
2019 May | 1 | 18 | 19 |
2019 April | 0 | 1 | 1 |
2019 March | 2 | 5 | 7 |
2019 January | 2 | 0 | 2 |
2018 December | 4 | 0 | 4 |
2018 October | 6 | 0 | 6 |
2018 September | 2 | 0 | 2 |
2018 July | 0 | 1 | 1 |
2018 May | 0 | 2 | 2 |
2018 March | 2 | 0 | 2 |
2018 February | 28 | 1 | 29 |
2018 January | 43 | 8 | 51 |
2017 December | 44 | 8 | 52 |
2017 November | 43 | 3 | 46 |
2017 October | 49 | 7 | 56 |
2017 September | 42 | 2 | 44 |
2017 August | 71 | 7 | 78 |
2017 July | 63 | 11 | 74 |
2017 June | 51 | 16 | 67 |
2017 May | 44 | 10 | 54 |
2017 April | 39 | 7 | 46 |
2017 March | 24 | 7 | 31 |
2017 February | 22 | 13 | 35 |
2017 January | 26 | 12 | 38 |
2016 December | 41 | 6 | 47 |
2016 November | 58 | 4 | 62 |
2016 October | 44 | 19 | 63 |
2016 September | 49 | 6 | 55 |
2016 August | 64 | 13 | 77 |
2016 July | 44 | 11 | 55 |
2016 June | 11 | 16 | 27 |
2016 May | 4 | 0 | 4 |
2016 April | 4 | 7 | 11 |
2016 March | 9 | 1 | 10 |
2016 February | 12 | 2 | 14 |
2016 January | 7 | 4 | 11 |
2015 December | 11 | 0 | 11 |
2015 November | 14 | 2 | 16 |
2015 October | 15 | 3 | 18 |
2015 September | 9 | 1 | 10 |
2015 August | 8 | 2 | 10 |
2015 July | 38 | 7 | 45 |
2015 June | 44 | 4 | 48 |
2015 May | 77 | 6 | 83 |
2015 April | 65 | 9 | 74 |
2015 March | 64 | 9 | 73 |
2015 February | 47 | 11 | 58 |
2015 January | 39 | 11 | 50 |
2014 December | 48 | 8 | 56 |
2014 November | 41 | 8 | 49 |
2014 October | 47 | 19 | 66 |
2014 September | 39 | 10 | 49 |
2014 August | 54 | 17 | 71 |
2014 July | 67 | 23 | 90 |
2014 June | 72 | 12 | 84 |
2014 May | 69 | 12 | 81 |
2014 April | 56 | 10 | 66 |
2014 March | 68 | 23 | 91 |
2014 February | 18 | 7 | 25 |
2014 January | 19 | 6 | 25 |
2013 December | 31 | 8 | 39 |
2013 November | 21 | 10 | 31 |
2013 October | 26 | 9 | 35 |
2013 September | 22 | 4 | 26 |
2013 August | 11 | 3 | 14 |
2013 July | 10 | 11 | 21 |
2013 June | 10 | 13 | 23 |
2013 May | 13 | 9 | 22 |
2013 April | 18 | 9 | 27 |
2013 March | 12 | 7 | 19 |
2013 February | 30 | 5 | 35 |
2013 January | 18 | 4 | 22 |
2012 December | 14 | 5 | 19 |
2012 November | 0 | 2 | 2 |
2012 October | 3 | 5 | 8 |