Erkrankungen durch humane Papillomviren

Zusammenfassung

Humane Papillomviren können die Haut infizieren und sowohl gut- als auch bösartige Tumoren induzieren. HPV 6 und 11 sind die Ursache von bis zu 90 % der Genitalwarzen. Fast jedes Zervixkarzinom ist mit HPV assoziiert. HPV 16 und 18 induzieren bis zu 70 % der zervikalen Neoplasien. Die HPV-Impfung ist eine international anerkannte Routineimpfung, die laut STIKO für alle Mädchen von 12 – 17 empfohlen wird. Sie birgt die Chance, ca. 70 % der Zervixkarzinome und ca. 50 % der Vorstufen zu verhindern. Umfangreiche Studien zeigen die gute Wirksamkeit und Verträglichkeit der beiden verfügbaren Impfstoffe. Gardasil^® richtet sich gegen HPV 6, 11, 16 und 18, Cervarix^® gegen HPV 16 und 18. Durch die tetravalente HPV-Impfung können mehr als 90 % der Genitalwarzen verhindert werden. Die bivalente HPV-Vakzine weist durch die Kreuzprotektion (gegen 16, 18, 31, 33, 45) einen breiten Schutz vor höhergradigen CIN-Läsionen auf. Die Herstellung von VLPs stellt eine innovative Technologie in der Impfstoffproduktion dar. Eine Vergleichstudie der beiden Impfstoffe ergab eine signifikant höhere Immugenität bei Cervarix^®. Die jährliche Krebsfrüherkennungsuntersuchung bleibt essentiell als sekundäre Präventionsmaßnahme. Im internationalen Vergleich ist die HPV-Impfrate in Deutschland niedrig. Persönliche Beratung und Empfehlung sind maßgebliche Kriterien für die Impfentscheidung.

Abstract

Human papilloma viruses are responsible for a large number of benign and malignant lesions of the skin. HPV 6 and 11 cause up to 90 % of condylomata. Almost each cervical cancer is associated with HPV. HPV 16 und 18 induce up to 70 % of cervical neoplasias. The vaccination against HPV is internationally implemented and should be applied to young girls aged 12 to 17 according to STIKO criteria. The vaccination may reduce the rate of cervical cancer by 70 % and the rate of cervical intraepithelial neoplasia by 50 %. Many studies demonstrated the efficacy and safetyness of both vaccines. Gardasil^® offers protection against HPV 6, 11, 16 and 18, Cervarix^® against HPV 16 and 18. Protection against condylomata is offered by the quadrivalent vaccine in 90 %. The bivalent vaccine has demonstrated type-specific protection against the five most frequent cancer inducing types (16, 18, 31, 33, 45). The production of VLPs is an innovative technology. A comparison of both vaccines, Cervarix^® and Gardasil^®, showed a higher immunogenicity for Cervarix^®. In Germany the immunization rates are still low comparing to other countries. As a method for secondary prevention of cervical cancer the PAP smear is still an effective method.

Schlüsselwörter

HPV-Vakzine - zervikale intraepitheliale Neoplasie (CIN) - CIN-Läsionen - humane Papillomviren - Zervixkarzinom

Key words

HPV vaccine - cercical intraepithelial neoplasia (CIN) - CIN lesions - human papilloma virus - cervical cancer

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