男性に対する4価ヒトパピローマウイルスワクチンの接種勧告－Advisory Committee on Immunization Practices (ACIP)、2011年12月28日

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ホーム IMICライブラリ MMWR抄訳 2011年（Vol.60)男性に対する4価ヒトパピローマウイルスワクチンの接･･･

MMWR抄訳

2011/12/23Vol. 60 / No. 50

MMWR60(50):1705－1708
Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males － Advisory Committee on Immunization Practices (ACIP), 2011

男性に対する4価ヒトパピローマウイルスワクチンの接種勧告－Advisory Committee on Immunization Practices (ACIP)、2011年12月28日

2011年10月25日、Advisory Committee on Immunization Practices (ACIP)は11または12歳の男児に対し、4価ヒトパピローマウイルス(HPV)ワクチン(HPV4)の接種勧告を出した。FDAは2006年6月、女性を対象に6、11、16、18型HPVに対してHPV4の使用を認可し、2009年10月には16、18型HPVに対し2価HPVワクチン(HPV2)を認可している。ACIPは11または12歳の女児への定期的な接種を推奨しているが、2009年に男性を対象に性器疣贅の予防に対する使用が認可され、さらに2010年12月、男女ともに肛門癌の予防が追加承認されている。接種率は2010年、13～17歳の女児にて48.7%(3回接種率は32.0%)、男児では2%未満と低い。男性では主にHPV16により肛門癌、陰茎癌、口咽頭癌などが誘発される。年間の発症数は7,000例と推定され、発症率は1973～2007年にて口咽頭癌:1%/年、肛門癌:3%/年である。16～26歳の男性(4,055例)を対象に性器疣贅予防に対する有効性を検討した第3相試験では、3回接種での有効率は89.3%、1回接種では68.1%であった。また、16～26歳の男性同性愛者(MSM)598例を対象に肛門上皮内腫瘍(AIN)予防に対する有効性を検討した第3相試験では、grade1/2/3 AINに対する有効率は77.5%、grade2/3 AINに対しては74.9%であった。安全性に関しては(分析対象:約5,300例)、軽度～中等度の投与部位反応、全身反応は頭痛および発熱が多く認められている。ACIPが推奨する11～12歳の男児へのHPV4の3回接種は9歳より接種可能としており、13～21歳に対しては未接種または不完全接種の場合は接種を推奨し、22～26歳に対しては接種してもよいとしている。また、MSM、HIV感染例に対しては26歳までに接種を完了するよう推奨している。

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