Murillo Raúl, Molano Mónica, Martínez Gilberto, Mejía Juan-Carlos, Gamboa Oscar
Subdirección Investigaciones, Instituto Nacional de Cancerología de Colombia, Bogota, Colombia.
Infect Dis Obstet Gynecol. 2009;2009:653598. doi: 10.1155/2009/653598. Epub 2009 Dec 20.
Human Papillomavirus (HPV) vaccines have been considered potentially cost-effective for the reduction of cervical cancer burden in developing countries; their effectiveness in a public health setting continues to be researched. We conducted an HPV prevalence survey among Colombian women with invasive cancer. Paraffin-embedded biopsies were obtained from one high-risk and one low-middle-risk regions. GP5+/GP6+ L1 primers, RLB assays, and E7 type specific PCR were used for HPV-DNA detection. 217 cases were analyzed with 97.7% HPV detection rate. HPV-16/18 prevalence was 63.1%; HPV-18 had lower occurrence in the high-risk population (13.8% versus 9.6%) allowing for the participation of less common HPV types; HPV-45 was present mainly in women under 50 and age-specific HPV type prevalence revealed significant differences. Multiple high-risk infections appeared in 16.6% of cases and represent a chance of replacement. Age-specific HPV prevalence and multiple high-risk infections might influence vaccine impact. Both factors highlight the role of HPVs other than 16/18, which should be considered in cost-effectiveness analyses for potential vaccine impact.
人乳头瘤病毒(HPV)疫苗已被认为对于减轻发展中国家宫颈癌负担具有潜在成本效益;其在公共卫生环境中的有效性仍在研究中。我们对患有浸润性癌症的哥伦比亚女性进行了HPV患病率调查。从一个高风险地区和一个低中风险地区获取石蜡包埋活检样本。使用GP5+/GP6+ L1引物、RLB检测和E7型特异性PCR进行HPV-DNA检测。对217例病例进行分析,HPV检测率为97.7%。HPV-16/18患病率为63.1%;HPV-18在高风险人群中的发生率较低(13.8%对9.6%),这使得不太常见的HPV类型也能参与研究;HPV-45主要出现在50岁以下女性中,且特定年龄的HPV类型患病率存在显著差异。16.6%的病例出现多重高危感染,这意味着存在替代的可能性。特定年龄的HPV患病率和多重高危感染可能会影响疫苗效果。这两个因素凸显了16/18型以外的HPV的作用,在对潜在疫苗效果进行成本效益分析时应予以考虑。