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Prävention HPV-induzierter Erkrankungen durch prophylaktische Impfung

Prevention of HPV-induced diseases by prophylactic vaccination

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best practice onkologie Aims and scope

Zusammenfassung

Infektionen mit humanen Papillomviren (HPV) gehören zu den häufigsten Virusinfektionen des Menschen. HPV können neben gutartigen vulgären Warzen auch benigne und maligne Läsionen der Kopf-Hals-Region sowie anogenitale Dysplasien und Karzinome verursachen. Seit dem Jahr 2007 sind effektive und sichere prophylaktische HPV-Impfstoffe in Europa zugelassen. In Deutschland sind derzeitig ein bivalenter (HPV16 und 18) und ein nonavalenter HPV-Impfstoff (HPV6, 11, 16, 18, 31, 33, 45, 52 und 58) erhältlich. Von der Ständigen Impfkommission (STIKO) wird aktuell die geschlechtsneutrale prophylaktische HPV-Impfung im Alter von 9 bis 14 Jahren empfohlen mit der Möglichkeit einer Nachholimpfung bis zum Alter von 17 Jahren. Der nonavalente HPV-Impfstoff schützt sowohl vor einem Großteil HPV-induzierter Dysplasien und Karzinome als auch effektiv vor Genitalwarzen. Auch iatrogen immunsupprimierte Patienten, die älter als 17 Jahre sind, sollten eine prophylaktische HPV-Impfung erhalten, insbesondere bis zum Alter von 26 Jahren. Bei bereits bestehender HPV-Infektion bzw. HPV-induzierten Läsionen führen prophylaktische HPV-Impfstoffe nicht zu einer beschleunigten HPV-Elimination bzw. Abheilung.

Abstract

Human papillomavirus (HPV) infections belong to the most frequent viral infections. Besides benign common warts and benign and malignant lesions of the head and neck area, HPV can induce anogenital dysplasias and cancers. Since the year 2007, effective and safe prophylactic HPV vaccines are licensed in Europe. To date, a bivalent (HPV16 and 18) and a nonavalent HPV vaccine (HPV6, 11, 16, 18, 31, 33, 45, 52, and 58) are commercially available in Germany. The German standing committee on vaccination (STIKO) currently recommends gender-neutral prophylactic HPV-vaccination between 9 and 14 years of age, with the possibility of catch-up vaccination until the age of 17 years. Besides a large proportion of HPV-induced anogenital dysplasias and carcinomas, the nonavalent HPV vaccine also prevents anogenital warts. Iatrogenically immunocompromised patients older than 17 years of age should also receive prophylactic HPV vaccination, preferrably by the age of 26 years. In case of already acquired HPV infection or existing HPV-induced lesions prophylactic vaccination does not lead to accelerated HPV elimination or clearance of lesions.

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  1. Institut für Virologie, Nationales Referenzzentrum für Papillom- und Polyomaviren, Universitätsklinikum Köln, Universität zu Köln, Köln, Deutschland

    Ulrike Wieland

  2. Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Josefstr. 3, 46045, Oberhausen, Deutschland

    Alexander Kreuter

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U. Wieland gibt an, dass kein Interessenkonflikt besteht. A. Kreuter hat Referentenhonorare von MSD Sharp & Dohme GmbH erhalten und war im Advisory Board von MSD Sharp & Dohme GmbH tätig.

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Dieser Beitrag erschien zuerst in Der Hautarzt 2021 · 72:106–113. https://doi.org/10.1007/s00105-020-04739-4.

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Wieland, U., Kreuter, A. Prävention HPV-induzierter Erkrankungen durch prophylaktische Impfung. best practice onkologie 17, 160–168 (2022). https://doi.org/10.1007/s11654-022-00372-w

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