자궁경부암과 HPV 백신
Human Papillomavirus Vaccine
김 미 경·노 재 홍·송 용 상 | 서울의대 산부인과 | Mi-Kyung Kim, MD·Jae Hong No, MD·Yong -Sang Song, MD
Department of Obstetrics and Gynecology, Seoul National University College of Medicine
E – mail : yssong@snu.ac.kr
J Korean Med Assoc 2009; 52(12): 1180 – 1186
http://synapse.koreamed.org/Synapse/Data/PDFData/0119JKMA/jkma-52-1180.pdf
Abstract
Cervical cancer is the second most common cancer affecting women worldwide. Cervical
cancer is caused by persistent infection with high-risk types of human papillomavirus (HPV).
The most common oncogenic HPV genotypes are 16 and 18, causing approximately 70% of all cervical cancers. Recently, two HPV vaccines, quadrivalent (HPV 6, 11, 16, 18) and bivalent
(HPV 16, 18) vaccines, have been licensed and are now marketed in Korea. HPV vaccines are
prepared from virus-like particles (VLPs) produced by recombinant technology. Clinical trials
have confirmed that both vaccines have high efficiency against persistent infection of HPV 16 or 18 and moderate to severe precancerous lesions. In women who have no evidence of past or current infection with the HPV genotypes in the vaccine, both vaccines show > 90% protection against persistent HPV infection for up to 5 years after vaccination. In addition, vaccine efficacy against precancerous lesions associated with HPV 16/18 was reported to be 100%. Although most clinical trials to date have investigated the effectiveness of HPV vaccines in young females, elderly females and males may also be candidates for HPV vaccines. Since HPV vaccines are prophylactic, the largest impact of vaccination is expected to result from high coverage of young adolescents before exposure to HPV. Cervical cancer screening will still be required, even after HPV vaccines are introduced, although the screening program may need to be adapted to achieve cost-effective reductions in the burden of cervical cancer prevention strategies.
Keywords: Cervical cancer; Human papillomavirus; Vaccination; Prevention
핵 심 용 어: 자궁경부암; 인유두종바이러스; 백신; 예방
결 론
HPV 백신의 도입으로 향후 자궁경부암의 발생 및 사망
률의 감소로 인한 사회적인 부담이 줄어들 것으로 예상하고
있다. HPV 백신의 효과를 극대화시키기 위해선 백신에 대
한 적극적인 권장과 교육이 필요할 것이다. 향후 백신 효과
의 지속기간, 추가접종의 필요성, 면역원성과 백신효능의
관계, 안전성, 비용효과 분석, 한정된 사회적 재원에서의 백
신 투여 전략 등에 대한 추가 연구가 필요하다. 무엇보다 중
요한 것은 백신으로 모든 자궁경부암이 예방되는 것이 아니
므로 지속적인 자궁경부암 선별검사의 중요성을 주지시키
는 것이다.
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