The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia.
BMC Infect Dis. 2013 Mar 18;13:140. doi: 10.1186/1471-2334-13-140.
There has been a rapid decline in the number of young heterosexuals diagnosed with genital warts at outpatient sexual health services since the national human papillomavirus (HPV) vaccination program started in Australia in 2007. We assessed the impact of the vaccination program on the number of in-patient treatments for genital warts.
Data on in-patient treatments of genital warts in all private hospitals were extracted from the Medicare website. Medicare is the universal health insurance scheme of Australia. In the vaccine period (2007-2011) and pre-vaccine period (2000-2007) we calculated the percentage change in treatment numbers and trends in annual treatment rates in private hospitals. Australian population data were used to calculate rates. Summary rate ratios of average annual trends were determined.
Between 2000 and 2011, 6,014 women and 936 men aged 15-44 years underwent in-patient treatment for genital warts in private hospitals. In 15-24 year old women, there was a significant decreasing trend in annual treatment rates of vulval/vaginal warts in the vaccine period (overall decrease of 85.3% in treatment numbers from 2007 to 2011) compared to no significant trend in the pre-vaccine period (summary rate ratio (SRR) = 0.33, p < 0.001). In 25-34 year old women, declining trends were seen in both vaccine and pre-vaccine periods (overall decrease of 33% vs. 24.3%), but the rate of change was greater in the vaccine period (SRR = 0.60, p < 0.001). In 35-44 year old women, there was no significant change in both periods (SRR = 0.91, p = 0.14). In 15-24 year old men, there was a significant decreasing trend in annual treatment rates of penile warts in the vaccine period (decrease of 70.6%) compared to an increasing trend in the pre-vaccine period (SRR = 0.76, p = 0.02). In 25-34 year old men there was a significant decreasing trend in the vaccine period compared to no change in the pre-vaccine period (SRR = 0.81, p = 0.04) and in 35-44 year old men there was no significant change in rates of penile warts both periods, but the rate of change was greater in the vaccine period (SRR = 0.70, p = 0.02).
The marked decline in in-patient treatment of vulval/vaginal warts in the youngest women is probably attributable to the HPV vaccine program. The moderate decline in in-patient treatments for penile warts in men probably reflects herd immunity.
自 2007 年澳大利亚启动全国人乳头瘤病毒（HPV）疫苗接种计划以来，在门诊性健康服务中被诊断患有生殖器疣的年轻异性恋者人数迅速下降。我们评估了疫苗接种计划对生殖器疣住院治疗人数的影响。
从医疗保险网站提取所有私立医院生殖器疣住院治疗数据。医疗保险是澳大利亚全民健康保险计划。在疫苗接种期（2007-2011 年）和疫苗接种前（2000-2007 年），我们计算了治疗人数的百分比变化和私立医院年度治疗率的趋势。使用澳大利亚人口数据计算发病率。确定平均年度趋势的汇总率比。
2000 年至 2011 年间，6014 名 15-44 岁的女性和 936 名 15-44 岁的男性在私立医院接受了生殖器疣的住院治疗。在 15-24 岁的女性中，与疫苗接种前时期相比，疫苗接种时期（2007 年至 2011 年治疗数量总体减少 85.3%）中外阴/阴道疣的年度治疗率呈显著下降趋势（无显著趋势）。（SRR=0.33，p<0.001）。在 25-34 岁的女性中，疫苗接种和疫苗接种前时期均出现下降趋势（总体减少 33%与 24.3%），但疫苗接种期的变化速度更快（SRR=0.60，p<0.001）。在 35-44 岁的女性中，两个时期均无显著变化（SRR=0.91，p=0.14）。在 15-24 岁的男性中，疫苗接种期阴茎疣的年度治疗率呈显著下降趋势（下降 70.6%），而疫苗接种前时期则呈上升趋势（SRR=0.76，p=0.02）。在 25-34 岁的男性中，疫苗接种期呈显著下降趋势，而疫苗接种前时期则无变化（SRR=0.81，p=0.04），在 35-44 岁的男性中，两个时期阴茎疣的发病率均无显著变化，但疫苗接种期的变化速度更快（SRR=0.70，p=0.02）。
最年轻女性外阴/阴道疣住院治疗人数的显著下降可能归因于 HPV 疫苗接种计划。男性阴茎疣住院治疗人数的适度下降可能反映了群体免疫。
