인간유두종바이러스 감염에 대한 예방 백신
Prophylactic Vaccines Against HPV Infection
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초록
자궁경부암의 예방법은 변하고 있으며 자궁경부 세포검사법은 여전히 중요한 예방법으로 지속되어야 한다. HPV 감염이 자궁경부암을 비롯한 생식기 암의 발생에 기여하므로 최근에는 HPV 백신이 자궁경부암의 발생을 낯추는 중요한 전략이 되고 있다. HPV 백신 접종으로 생식기 사마귀와 자궁경부의 고등급 상피내 병변의 뚜렷한 감소가 보고되고 있다. 자궁경부암뿐 아니라 HPV 백신은 HPV 관련질환인 항문암, 음경암, 외음부암, 구강/인후암의 발생도 감소시킬 것으로 기대되어 진다. 백신에 의한 자궁경부암의 예방이 우선 대상이 되는 이유는 발생빈도가 높아 비용효율면에 잇점이 있기 때문인데, 자궁경부암이 구강암의 78배, 인후암의 60배, 음경암의 47배, 외음부와 질암의 30배, 항문암의 17배로 흔하다. 두 백신 모두 접종 당시 HPV 감염이 없던 여성들에서 HPV의 지속감염이나 이로 인한 상피내 병변 2/3의 예방에 우수한 예방효과가 있다. 여성에서의 접종은 이미 승인되어 권고되고 있으며, 남성에서도 HPV와 연관된 암 발생이 증가하고 있어 접종이 중요한 예방책으로 받아들여지고 있다. 항문암은 적절한 선별검사법이 없으며 백신접종으로 남성 자신에게 뿐아니라 여성에게 HPV의 전파를 차단하므로 접종 효과를 넓힐 수 있다. 또한 최근 증가 추세에 있는 구강/인후암에서 아직까지는 연구결과가 없으나 백신을 통한 HPV 감염 예방이 중요한 암 예방법이 될 것으로 기대된다.
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