Systematic review and meta analysis of the preventive effect of HPV vaccine in anal squamous intraepithelial lesions in MSM

Abstract Objective : To systematically review and appraise published data, to determine efficacy and safety of the quadrivalent human papillomavirus (qHPV) vaccine in preventing anal intraepithelial neoplasia (AIN) incidence in men who have sex with men(MSM); Design : Systematic review and meta-analysis; Data sources : PubMed, Embase, Cochrane Library and Web of Science; Results : The qHPV vaccine-group showed a decresed risk of AIN incidence close to a half as compared to the placebo group.(OR=0.49,95%CI 0.22-1.11, P=0.09, I²= 97.9%). For the subgroup analysis, the AIN incidence of the HIV-positive group showed no meaningful difference between vaccine group and placebo group(pooled OR=1.07, 95%CI 0.74-1.53; P=0.73), and the AIN incidence of vaccine group in the HIV-negative group reduced by a factor of four (pooled OR=0.20, 95%CI 0.15-0.28; P<0.00001) in contrast with the placebo group. Test for subgroup differences: P<0.00001, I²= 97.9%; Conclusions : MSM who received qHPV vaccine had a decreased risk of AIN incidence compared with those who did not receive the vaccine. The subgroup analysis suggested that HIV-positive MSM may not be protected from AIN by vaccination; Clinical PROSPERO : registration number (CRD42022301994).