Uso terapêutico de vacinas contra HPV em mulheres com lesão de colo de útero

Abstract

Cancer of the cervix is the second most common tumor in the female population and the second cause of death from cancer among women. Persistent infection by HPV is a necessary condition for the onset of the disease and its precursor lesions. The use of prophylactic vaccination against HPV has been shown to be effective in preventing disease and mechanism of cancer development from the viral infection, new particle vaccine have been developed with the aim of therapeutic use, in other words, in the presence of injuries. This study aimed to perform a systematic review of the literature on the use of therapeutic vaccines against HPV and the new particles used for this purpose. Was made a query to the databases MEDLINE, PUBMED and LILACS, SciELO and the collections COCHRANE LIBRARY, using the key words "human papillomavirus", "" HPV "," vaccine "," vaccination "," therapeutic " and "immunotherapy" in different combinations, without a time limit. Of the 713 articles found initially, 352 were excluded because they were repeated in different databases, 217 to be review articles, 86 were conducted in animals, 24 published in other languages than English, Portuguese and Spanish, 15 other anatomical locations than the cervix, 2 in HIV-positive patients, 1 in men, 2 whose patients had only infection, but not injury lap and 1 conducted in vitro. One last item was deleted because the vaccine used after removal of the lesion of the cervix patients. Thus 12 articles were selected for this systematic review. These articles are phase I and II, realized with few patients and only two of them are randomized and blinded. We were unable to assign any statistical measure the results, since the heterogeneity of publications. The analyzed studies used particle vaccine based on proteins E6 and E7 of HPV E2, concluding that the E7 protein is the most promising for use in therapeutic vaccines. This review concluded that the use of vaccines based on HPV E7 protein is potentially beneficial in the treatment of lesions of the cervix, being a promising field of study, but this finding should be considered with caution due to the lack of studies with larger numbers of patients and strict methodological criteria.