Genital warts in the post-HPV vaccination era: An eradicated condition among young women? A systematic review

Abstract

Human Papillomavirus (HPV) is responsible for the most prevalent sexually transmitted infection among young women. Notably, ten or more years after HPV vaccination programs it will be of the utmost importance to review the real-world evidence about the incidence of anogenital warts (GWs) among young women vaccinated during childhood. Three databases were searched for studies published between January 2008 to September 2023. Nine cohort studies were included. A total of 890 320 HPV vaccinated women and 1 922 033 unvaccinated women were evaluated. All the studies but one evaluated the 4vHPV vaccine. The incidence rate of GWs in women vaccinated ranged from 0.0 to 1650 per 100 000 person-years. The highest incidences were found in one-dose vaccinated women at age 17-19 years old, in women fully vaccinated only after 19 years of age. A similar incidence values were reported among unvaccinated women. The incidence of GWs is lower when age at first dose was 9-11 years old. This systematic review supports that the incidence of GWs among HPV vaccinated women is related to the age of vaccination and to the number of vaccine doses received. In the post-vaccination era epidemiological surveillance on incidence of GWs and its genotypes is crucial.