Efficacy and impact of quadrivalent human papillomavirus vaccine in male : a systematic review

Objective: Toanalyze the clinical efficacy of quadrivalent human papillomavirus vaccine (QHPV)in preventing human papillomavirus (HPV) related diseases in males and to evaluate the potential epidemiological impact of the vaccine in males. Methods: All published studies were searched using specified keywords via EMBASE, PubMed, Cochrane Library and ClinicalTrials.gov to review systematically the efficacy of QHPV in males. Studies that modeled the impact of QHPV in males were also searched using specified keywords from PubMed, EMBASE and Cochrane Library to evaluate the vaccine impact on males. Results: A total of 5 studies were selected for the systematic review of QHPV efficacy in males. Observed efficacy of QHPV in preventing genital warts(GW)due to HPV types 6 and 11 in males is found to be statistically significant. Efficacies of QHPV in preventing anal intraepithelial neoplasia (AIN), HPV-related cancers in males are yet to be confirmed. A total of 9 studies were selected for the review of modeled impact of QHPV vaccination in males. QHPV vaccination in girls is predicted to reduce the incidence of HPV infections and GW in males. Inclusion of males in the vaccination program could only produce limited additional benefit if vaccination coverage of girls is high. Discussion: Analysis and implications of clinical efficacy of QHPV in males are discussed. The approved indications of QHPV vaccine in various countries were not fully substantiated by clinical evidence. Factors affecting the epidemiological impact of QHPV in males were also discussed. Questionable efficacy of QHPV in males casts doubt on the vaccine’s impact. Conclusion: Clinical efficacy of QHPV in males is basically unclear, except against GW. Impact of the vaccine in males is greatly limited by its efficacy. More research should be conducted in order to obtain a clearer picture on the efficacy and impact of QHPV in males.published_or_final_versionPublic HealthMasterMaster of Public Healt