The Medical Letter on Drugs and Therapeutics
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1241
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A Human Papillomavirus Vaccine

A recombinant quadrivalent human-papillomavirus-like particle vaccine, Gardasil (Merck), has been approved by the FDA for use in girls and women 9-26 years old to prevent diseases associated with infection with human papillomavirus (HPV) types 6, 11, 16, and 18, including genital warts, precancerous cervical, vaginal or vulvar lesions, and cervical cancer.

BACKGROUND — HPV is sexually transmitted; it is acquired by young women soon after initiation of sexual activity, with a cumulative incidence of 40% within 16 months.1 Although most HPV infections are cleared without clinical sequelae, persistent infection can cause abnormalities in the cervical epithelium that may progress to cancer.

More than 30 types of HPV can infect the genital tract. Types 16 and 18 are responsible for more than 70% of cervical cancers and high-grade cervical intraepithelial neoplasia (CIN), a precursor of ... more      

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