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Minerva Pediatrica 2007 June;59(3):165-82


language: Italian

Human papillomavirus vaccination. Consensus Conference in pediatric age

Bartolozzi G. 1, Bona G. 2, Ciofi M. 3, De Martino M. 1, Di Pietro P. 4, Duse M. 5, Esposito S. 6, Gasparini R. 7, Mariani L. 8, Marostica G. 9, Paravati F. 10, Plebani A. 11, Principi N. 6, Zuccotti G. V. 12, Tovo P. A. 13

1 Dipartimento di Pediatria, Università degli Studi di Firenze, Firenze 2 Clinica Pediatrica, Dipartimento di Scienze Mediche, Università del Piemonte Orientale “Amedeo Avogadro”, Novara 3 Istituto Superiore di Sanità, Roma 4 Medicina d’Urgenza, DEA Pediatrico, Istituto Scientifico “G. Gaslini”, Genova 5 Clinica Pediatrica, Policlinico “Umberto I”, Università degli Studi “La Sapienza”, Roma 6 Istituto di Pediatria, Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milano 7 Dipartimento di Scienze della Salute, Università di Genova, Genova 8 Istituto Regina Elena, IRCCS, Roma 9 Federazione Italiana Medici Pediatri, Torino 10 Unità Operativa di Pediatria, Presidio Ospedaliero di Crotone, Crotone 11 Clinica Pediatrica and Istituto di Medicina Molecolare “A. Nocivelli”, Università di Brescia, Brescia 12 Clinica Pediatrica, Ospedale L. Sacco, Università di Milano, Milano 13 Dipartimento di Scienze Pediatriche e dell’Adolescenza, Università di Torino, Torino


Genital human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide. Spontaneous clearance of HPV infection occurs in most cases, but chronic infection with high risk genotypes is associated with the development of cervical cancer. In particular, HPV 16 and 18 are responsible for 70% of cancers of the cervix and, in variable proportions, for cancers of the vagina, vulva, anus, penis and oropharinx. Low risk HPV genotypes, such as HPV 6 and 11, cause genital warts. Two prophylactic vaccines using virus like particles (VLPs) of L1 capside protein of HPV 16 and 18 have been developed. Of these, one also containing VLPs of HPV 6 and 11, has been approved by FDA, EMEA and AIFA for use in 9-26 year-old females. Large scale studies have shown that these vaccines are safe, well tolerated, elicits high levels of neutralizing antibodies, prevent chronic HPV infections due to genotypes present in the vaccine, and associated cervical lesions (and genital wars for the quadrivalent vaccine). To be effective the vaccines should be given prior to sexual debut. In Italy, the vaccination will be offered to 12 year-old girls. This article is the result of a targeted Consensus Conference by a panel of experts, which reviews the cornerstones of HPV infection, its association with cervical cancer, the advances in prophylactic vaccines, and the primary role of the paediatrician for the optimal adoption of this new preventive strategy.

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