Vaccine (2008) 26, 2669—2679 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/vaccine REVIEW Prospects and prejudices of human papillomavirus vaccines in India Bhudev C. Das a,* , Showket Hussain a , Vilas Nasare b , Mausumi Bharadwaj b,** a Division of Molecular Oncology, Institute of Cytology & Preventive Oncology (ICMR), I-7, Sector-39, Noida 201301, India b Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), I-7, Sector-39, Noida 201301, India Received 13 October 2007; received in revised form 5 March 2008; accepted 12 March 2008 Available online 14 April 2008 KEYWORDS Human papilomavirus; Cervical cancer; Vaccine Summary Cervical cancer is the most common cancer and a leading cause of cancer deaths among women in developing countries. The disease is caused due to persistent infection of one or more of about 15 high-risk human papillomaviruses (HR-HPVs), most commonly by HPV types 16/18. In India, over 98% of cervical cancer cases harbor HPV infection and HPV 16 is the type exclusively (80—90%) prevalent. Unlike the West, HPV infection is most common in women in their third decade (26—35 years) of sexual activity and invasive cancer also arises much later with a peak at about 45—55 years of age. Recently, two successful prophylactic HPV vaccines, a quadrivalent (HPV16/18/6/11) ‘Gardasil’ by Merck and a bivalent (HPV16/18) ‘Cervarix’ by GSK have been developed. Several other approaches including plant-based edible, pentameric capsomere-based intranasal and DNA-based vaccines have also been employed to develop prophylactic vaccines. Also, several therapeutic vaccines either protein/peptide based or DNA based are in clinical trials but are yet to establish their efficacy. Though there are several issues regarding implementation of the already developed vaccines in resource limited countries, efforts are being made to develop cost-effective second-generation vaccines. If cost minimized, HPV related new technologies involved in screening tests and vaccines are expected to reduce incidence of cervical cancer and deaths it causes in women from developing countries. © 2008 Elsevier Ltd. All rights reserved. Contents Introduction ............................................................................................................ 2670 Papillomaviruses and cancer ............................................................................................ 2670 Cervical cancer and human papillomavirus infection .................................................................... 2670 * Corresponding author. Tel.: +91 120 2578837; fax: +91 120 2579473/8838. ** Corresponding author. Tel.: +91 120 2501490; fax: +91 120 2579473/8838. E-mail addresses: bcdas48@hotmail.com (B.C. Das), bharadwajm@icmr.org.in, mausumi02@yahoo.com (M. Bharadwaj). 0264-410X/$ — see front matter © 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.vaccine.2008.03.056