Human Papillomavirus Virus Vaccine

Cervarix, Nine Valent Vaccine

Mechanism :

The HPV vaccines are based on hollow virus-like particles (VLPs) assembled from recombinant HPV coat proteins. The virus possesses circular double stranded DNA and a viral shell that is composed of 72 capsomeres. Every subunit of the virus is composed of two proteins molecules, L1 and L2. The reason why this virus has the capability to affect the skin and the mucous layers is due to its structure. The primary structures expressed in these areas are E1 and E2, these proteins are responsible for the replication of the virus. E1 is a highly conserved protein in the virus, E1 is in charge of the production of viral copies is also involved in every step of replication process. The second component of this process is E2 ensures that non-specific interaction occur while interacting with E1. As a result of these proteins working together is assures that numerous amounts of copies are made within the host cell. The vaccines are designed to elicit virus-neutralizing antibody responses that prevent initial infection with the HPV types represented in the vaccine. The vaccines have been shown to offer 100 percent protection against the development of cervical pre-cancers and genital warts caused by the HPV types in the vaccine, with few or no side effects. The protective effects of the vaccine are expected to last a minimum of 4.5 years after the initial vaccination.

Indication :

• In girls, prevention of the precancerous conditions (cervical, vulvar, vaginal and anal) caused by HPV types 6, 11, 16, 18,31, 33, 45, 52, 58.
• In boys, prevention of anal cancer caused by HPV types 16, 18, 31, 33, 45, 52, 58 and genital warts (HPV 6,11).

Contraindications :

Hypersensitivity to drug/class/component.

Caution if hypersensitivity to latex (prefilled syringe form).

Caution if immunocompromised or acute illness.

Dosing :

In females, age group 15-45 years and in males, age group is 9-14 years.

0.5 mL three doses given IM on a schedule of 0, 2, 6 months.

Adverse Effect :

Common Reactions: Injection site reaction, erythema and swelling, diarrhea, fatigue, headache, abdominal pain, myalgia, nausea, arthralgia, fever, vomiting, rash, urticaria.

Serious Reactions: Hypersensitivity reaction, anaphylaxis, erythema multiforme.

Interaction :

Monitor/Modify Treatment:

Fingolimod, Rituximab.

Caution Advised:

Abatacept, Adalimumab, Aldesleukin, Alefacept, Alemtuzumab, Altretamine, Anakinra, Antithymocyte Globulin, Azacitidine, Azathioprine, Basiliximab, Belatacept, Belimumab, Bendamustine, Betamethasone, Bleomycin, Busulfan, Cabazitaxel, Capecitabine, Carboplatin, Carmustine, Certolizumab Pegol, Chlorambucil, Cisplatin, Cladribine, Cortisone, Cyclophosphamide, Cyclosporine, Cytarabine, Dacarbazine, Dactinomycin, Dasatinib, Daunorubicin, Decitabine, Dexamethasone, Docetaxel, Doxorubicin, Efalizumab, Epirubicin, Eribulin, Etanercept, Etoposide, Everolimus, Floxuridine, Fludarabine, Fluorouracil, Gemcitabine, Gemtuzumab ozogamicin, Golimumab, Hydrocortisone, Hydroxyurea, Ibritumomab tiuxetan, Ibrutinib, Idarubicin, Ifosfamide, Infliximab, Irinotecan, Ixabepilone, Leflunomide, Lenalidomide, Lomustine, Lymphocyte Immune Globulin, Antithymocyte Globulin, Mechlorethamine, Melphalan, Mercaptopurine, Methotrexate, Methylprednisolone, Mitomycin, Mitoxantrone, Muromonab-Cd3, Mycophenolate Mofetil, Mycophenolic Acid, Natalizumab, Nelarabine, Obinutuzumab, Ofatumumab, Omacetaxine mepesuccinate, Oxaliplatin, Paclitaxel, Pemetrexed, Pentostatin, Pralatrexate, Prednisolone, Prednisone, Ruxolitinib, Sirolimus, Tacrolimus, Temozolomide, Temsirolimus, Teniposide, Teriflunomide, Thioguanine, Thiotepa, Tocilizumab, Tofacitinib, Topotecan, Tositumomab, Triamcinolone, Ustekinumab, Vinblastine, Vincristine, Vinorelbine.

Hepatic Dose :