Assessment of the impact of nonavalent human papillomavirus vaccine on disease clearance time in women with active infection.

Abstract

Objective: Human papillomavirus (HPV) is a leading cause of cervical cancer (CC) worldwide. There is growing interest in the potential role of HPV vaccination as adjuvant measure in patients with active infection. This study aimed to assess whether the nonavalent HPV vaccine (9vHPV) promotes faster disease clearance in women with low-grade (LGD) and high-grade disease (HGD).

Methods: Retrospective study including women aged 25-60 years who began follow-up in 2018 at a central Portuguese hospital after referral through organized CC screening. A total of 126 patients with HGD (69 vaccinated, 57 unvaccinated) and 277 with LGD (131 vaccinated, 146 unvaccinated) at baseline were followed with HPV cotesting (HPV test + cervical cytology) at 12, 18, 24, 36, and 48 months. Disease clearance was defined as the first negative cotest result. Kaplan-Meier curves and the Log Rank test were used to compare time to clearance between groups.

Results: Among HGD patients, the vaccinated group showed a shorter mean time to disease clearance (17.4 months; 95% CI: 14.88-19.93) compared to the unvaccinated group (20.2 months; 95% CI: 17.07-23.34), although the difference was not statistically significant (p=0.228). In the LGD group, both vaccinated and unvaccinated patients had similar mean clearance times (25.9 months; 95% CI: 23.44-28.43 vs. 26.9 months; 95% CI: 24.41-29.37), also lacking statistical significance (p=0.637).

Conclusion: Main findings suggest a negligible effect of 9vHPV in significantly reducing time to clearance in patients with active infection. Further research is needed to clarify its role in secondary prevention strategies.