{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:14:40Z","timestamp":1792293280100,"version":"4.4.0"},"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011447","name":"Science and Technology Department of Henan Province","doi-asserted-by":"crossref","award":["112102310306"],"award-info":[{"award-number":["112102310306"]}],"id":[{"id":"10.13039\/501100011447","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The prophylactic vaccines available to protect against infections by human papillomavirus (HPV) are well tolerated and highly immunogenic. This systematic review and meta-analysis aimed to explore the efficacy of HPV vaccination on the risk of HPV infection and recurrent diseases related to HPV infection in individuals undergoing local surgical treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A literature search was performed using PubMed\/MEDLINE, Embase, the Cochrane Library, Scopus, Web of Science, and bioRxiv\/medRxiv from inception to July 15, 2024. Randomized controlled trials (RCTs) reporting the effect of HPV vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment vs no HPV vaccination were included. The primary outcome measure was risk of recurrence cervical high-grade squamous intraepithelial lesion (HSIL) after local surgical treatment, with follow-up as reported by individual studies. Included studies were assessed for risk of bias using the Revised Cochrane risk-of-bias (RoB 2.0 tool). Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated. No restrictions were applied on language, the date of publication, age, sex, and country. All analyses were carried out using the Review Manager 5 software (version 5.4).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Eight RCTs (n = 3068) met the inclusion criteria. The risk of cervical HSIL recurrence was not reduced in individuals who were vaccinated compared with those who were not vaccinated (RR 0.92, 95% CI: 0.66\u20131.27; <jats:italic>I<\/jats:italic><jats:sup><jats:italic>2<\/jats:italic><\/jats:sup> = 40%). However, HPV vaccination reduced the risk of recurrence of cervical HSIL related to the HPV types HPV16\/18, but uncertainty was large (RR 0.57, 95% CI: 0.18\u20131.84; <jats:italic>I<\/jats:italic><jats:sup><jats:italic>2<\/jats:italic><\/jats:sup> = 29%).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Adjuvant HPV vaccination after surgical excision is not associated with a reduced risk of recurrent HSIL overall or a reduced risk of recurrent lesions caused by the most oncogenic strains (HPV16\/18). Therefore, HPV vaccination should not be considered for adjuvant treatment in patients undergoing surgical excision.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0312128","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T18:52:30Z","timestamp":1735671150000},"page":"e0312128","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Effect of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment: A systematic review and 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Viechtbauer","year":"2007","journal-title":"Stat Med"},{"key":"pone.0312128.ref034","doi-asserted-by":"crossref","first-page":"d4002","DOI":"10.1136\/bmj.d4002","article-title":"Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials","volume":"343","author":"JA Sterne","year":"2011","journal-title":"BMJ"},{"issue":"2","key":"pone.0312128.ref035","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3390\/vaccines8020245","article-title":"HPV Vaccination as Adjuvant to Conization in Women with Cervical Intraepithelial Neoplasia: A Study under Real-Life Conditions","volume":"8","author":"M Del Pino","year":"2020","journal-title":"Vaccines (Basel)."},{"issue":"2","key":"pone.0312128.ref036","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.ygyno.2013.04.050","article-title":"Is vaccination with quadrivalent HPV vaccine after loop electrosurgical excision procedure effective in preventing recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN2-3)?","volume":"130","author":"WD Kang","year":"2013","journal-title":"Gynecol Oncol"},{"issue":"7","key":"pone.0312128.ref037","doi-asserted-by":"crossref","first-page":"e2211","DOI":"10.1093\/cid\/ciaa1456","article-title":"Human Papillomavirus Vaccination Prior to Loop Electroexcision Procedure Does Not Prevent Recurrent Cervical High-grade Squamous Intraepithelial Lesions in Women Living With Human Immunodeficiency Virus: A Randomized, Double-blind, Placebo-controlled Trial","volume":"73","author":"C Firnhaber","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"12","key":"pone.0312128.ref038","doi-asserted-by":"crossref","first-page":"2812","DOI":"10.1002\/ijc.30391","article-title":"Prior human papillomavirus-16\/18 AS04-adjuvanted vaccination prevents recurrent high grade cervical intraepithelial neoplasia after definitive surgical therapy: Post-hoc analysis from a randomized controlled 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non-vaccine-preventable HPV types after vaccination with the bivalent AS04-adjuvanted HPV vaccine: an analysis of the long-term follow-up study from the randomised Costa Rica HPV Vaccine Trial","volume":"23","author":"JZ Shing","year":"2022","journal-title":"Lancet Oncol"},{"issue":"4","key":"pone.0312128.ref042","doi-asserted-by":"crossref","first-page":"428","DOI":"10.3390\/vaccines12040428","article-title":"Therapeutic Vaccines for HPV-Associated Cervical Malignancies: A Systematic Review.","volume":"12","author":"S Alouini","year":"2024","journal-title":"Vaccines (Basel)."},{"key":"pone.0312128.ref043","doi-asserted-by":"crossref","first-page":"k499","DOI":"10.1136\/bmj.k499","article-title":"Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis","volume":"360","author":"K Tainio","year":"2018","journal-title":"BMJ"},{"issue":"6","key":"pone.0312128.ref044","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1111\/1471-0528.16081","article-title":"Conservative management of women with cervical intraepithelial neoplasia grade 2 in Denmark: a cohort study.","volume":"127","author":"M Skorstengaard","year":"2020","journal-title":"Bjog"},{"issue":"5","key":"pone.0312128.ref045","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1097\/AOG.0000000000003833","article-title":"Adjuvant Human Papillomavirus Vaccine to Reduce Recurrent Cervical Dysplasia in Unvaccinated Women: A Systematic Review and Meta-analysis.","volume":"135","author":"K Lichter","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"41","key":"pone.0312128.ref046","doi-asserted-by":"crossref","first-page":"6402","DOI":"10.1016\/j.vaccine.2020.07.055","article-title":"Prophylactic HPV vaccination after conization: A systematic review and 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