VACUNACIÓN CONTRA EL VIRUS DEL PAPILOMA HUMANO Y AUTOINMUNIDAD
Palabras clave:
Virus del papiloma humano VPH, vacunación, autoinmunidad, efectos colaterales, Human papillomavirus, vaccination, autoimmunity, side effectsResumen
RESUMEN
El desarrollo de enfermedades autoinmunes es un tema de suma importancia cuando de vacunas se trata, dado el riesgo que pueden tener éstas de favorecer fenómenos de autoinmunidad en individuos susceptibles. La relación riesgo/beneficio de desarrollar enfermedades autoinmunes luego de la vacunación contra el virus del papiloma humano (VPH) aún no se ha resuelto. Los datos disponibles son limitados para ofrecer conclusiones definitivas. Dado el aumento reciente de reporte de efectos adversos, se espera que estudios con suficiente tamaño muestral, en diversas poblaciones, confirmen la seguridad de la vacunación contra el VPH en niñas con enfermedades autoinmunes. Un análisis personalizado de cada paciente, que incluya la evaluación de autoinmunidad personal y familiar, podría ser sugerido, aunque no hay estudios que demuestren que sea costo-efectivo. Por lo tanto, la farmacovigilancia permanente de esta vacuna sigue siendo de suma importancia.
Palabras clave: Virus del papiloma humano VPH, vacunación, autoinmunidad, efectos colaterales.
VACCINATION AGAINST HUMAN PAPILLOMAVIRUS AND AUTOIMMUNITY
ABSTRACT
Development of autoimmune diseases is a very important issue in relation to vaccines, because there is a risk that they might promote autoimmune phenomena in susceptible individuals. The risk: benefit ratio of developing autoimmune diseases after human papillomavirus (HPV) vaccination has not yet been resolved. Data available are limited to provide definitive conclusions. Given the recent increase of adverse effect reports, studies with sufficient sample size are expected in various populations, aimed to confirm the safety of HPV vaccination in children with autoimmune diseases. A personalized analysis of each individual, including evaluation of personal and familial autoimmunity, may be suggested; however, there are no studies showing that this policy is cost-effective. Therefore, permanent pharmacovigilance of this vaccine is of paramount importance.
Key words: Human papillomavirus, vaccination, autoimmunity, side effects.
Biografía del autor/a
Juan-Manuel Anaya, Academia Nacional de Medicina
Referencias bibliográficas
http://www.cdc.gov/vaccines/vac-gen/side-effects. htm
http://vacunasaep.org/profesionales/reacciones- adversas-de-las-vacunas-descripcion
Markowitz LE, Dunne EF, Saraiya M, Chesson HW, Curtis CR, Gee J, et al. Human papillomavirus vac- cination. MMWR Recomm Rep. 2014; 63:1-30.
Gonçalves AK, Cobucci RN, Rodrigues HM, de Melo AG, Giraldo PC. Safety, tolerability and side effects of human papillomavirus vaccines: a systematic quantitative review. Braz J Infect Dis. 2014 Apr 27.
Anaya JM, Rojas-Villarraga A, Shoenfeld Y, Levy R, Cervera R. Autoimunity. From bench to bedside. Bogotá: Editorial Universidad del Rosario. 2013.
Cooper GS, Stroehla BC. The epidemiology of au- toimmune diseases. Autoimmun Rev. 2003; 2:119-25.
Chao C, Klein NP, Velicer CM, Sy LS, Slezak JM, Takhar H, et al. Surveillance of autoimmune conditions following routine use of quadrivalent human papillo- mavirus vaccine. J Intern Med. 2012; 271:193-203.
Arnheim-Dahlström L, Pasternak B, Svanström H, Sparén P, Hviid A. Autoimmune, neurological and venous thromboembolic adverse events after immu- nisation of adolescent girls with quadrivalent human papillomavirus vaccine in Denmark and Sweden: cohort study. BMJ. 2013; 347:f5906.
Grimaldi-Bensouda L, Guillemot D, Godeau B, Béni- chou J, Lebrun-Frenay C, Papeix C, et al. Autoimmune disorders and quadrivalent human papillomavirus vaccination of young female subjects. J Intern Med.
; 275:398-408.
Mok CC, Ho LY, Fong LS, To CH. Immunogenicity and safety of a quadrivalent human papillomavirus vaccine in patients with systemic lupus erythema- tosus: a case-control study. Ann Rheum Dis. 2013;
:659-64.
Soybilgic A, Onel KB, Utset T, Alexander K, Wagner-Weiner L. Safety and immunogenicity of the quadrivalent HPV vaccine in female systemic lupus erythematosus patients aged 12 to 26 years. Pediatr Rheumatol Online J. 2013; 11:29.
Pellegrino P, Carnovale C, Perrone V, Salvati D, Gentili M, Antoniazzi S, et al. Human papillomavirus vaccine in patients with systemic lupus erythematosus. Epidemiology. 2014; 25:155-6.
Heijstek MW, Scherpenisse M, Groot N, Tacke C, Schepp RM, Buisman AM, et al. Immunogenicity and safety of the bivalent HPV vaccine in female patients with juvenile idiopathic arthritis: a prospective controlled observational cohort study. Ann Rheum Dis.
; 73:1500-7.
Heijstek MW, Ott de Bruin LM, Bijl M, Borrow R, van der Klis F, Koné-Paut I, et al. EULAR recommendations for vaccination in paediatric patients with rheumatic diseases. Ann Rheum Dis. 2011; 70:1704-12.
Brenol CV, da Mota LM, Cruz BA, Pileggi GS, Pereira IA, Rezende LS, et al. 2012 Brazilian Society of Rheumatology Consensus on vaccination of patients with rheumatoid arthritis. Rev Bras Reumatol. 2013;
:4-23.
Gatto M, Agmon-Levin N, Soriano A, Manna R, Maoz- Segal R, Kivity S, et al. Human papillomavirus vaccine and systemic lupus erythematosus. Clin Rheumatol.
; 32:1301-7.
Shoenfeld Y, Agmon-Levin N. 'ASIA' - autoimmune/ inflammatory syndrome induced by adjuvants. J Autoimmun. 2011; 36:4-8.
Perricone C, Colafrancesco S, Mazor RD, Soriano A, Agmon-Levin N, Shoenfeld Y. Autoimmune/inflam- matory syndrome induced by adjuvants (ASIA) 2013: Unveiling the pathogenic, clinical and diagnostic aspects. J Autoimmun. 2013; 47:1-16.
Clements CJ. Mass psychogenic illness after vacci- nation. Drug Saf. 2003; 26:599-604.
Pellegrino P, Carnovale C, Pozzi M, Antoniazzi S, Perrone V, Salvati D, et al. On the relationship bet- ween human papilloma virus vaccine and autoimmune diseases. Autoimmun Rev. 2014; 13:736-41
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