Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Vaccine. 2013 Dec 31;31 Suppl 7:H59-70. doi: 10.1016/j.vaccine.2013.03.029.
We present a review of current cervical cancer screening practices, the implementation status of vaccination against human papillomaviruses (HPV) and available data concerning the burden of HPV infection and HPV type-specific distribution in 16 Central and Eastern European countries: Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia and the Former Yugoslav Republic (FYR) of Macedonia. Since published data were relatively scarce, two detailed surveys were conducted during August-October 2011 and in January 2013 to obtain relevant and updated information. The mean prevalence of HPV infection in 8610 women with normal cervical cytology from the region was 12.6%, with HPV16 being the most frequent HPV type. The overall HPV DNA prevalence in women with high-grade cervical lesions was 78.1%. HPV DNA was found in 86.6% of cervical cancers; the combined prevalence of HPV16/18 among HPV positive cases was 87.5%. The overall HPV DNA prevalence in genital warts and laryngeal papillomas was 94.8% and 95.2%, respectively, with HPV6 and HPV11 being the most frequent types. Opportunistic and organized cervical screening, mainly based on conventional cytology, is performed in nine and seven countries in the region, respectively, with the proposed age of the start of screening ranging from 20 to 30 years and the estimated coverage ranging from a few percent to over 70%. At least one of the current HPV prophylactic vaccines is registered in all Central and Eastern European countries except Montenegro. Only Bulgaria, Czech Republic, FYR Macedonia, Latvia, Romania and Slovenia have actually integrated HPV vaccination into their national immunization programme and currently provide routine vaccination free of charge to the primary target population. The key reasons for lack of implementation of HPV vaccination into the national immunization programme are high vaccine cost and negative public perception. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Central and Eastern Europe and Central Asia Region" Vaccine Volume 31, Supplement 7, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.
我们回顾了当前在 16 个中东欧国家（阿尔巴尼亚、波斯尼亚和黑塞哥维那、保加利亚、克罗地亚、捷克共和国、爱沙尼亚、匈牙利、拉脱维亚、立陶宛、黑山、波兰、罗马尼亚、塞尔维亚、斯洛伐克、斯洛文尼亚和前南斯拉夫的马其顿共和国）实施的宫颈癌筛查实践、人乳头瘤病毒（HPV）疫苗接种的实施情况以及 HPV 感染负担和 HPV 型别分布的现有数据。由于发表的数据相对较少，我们于 2011 年 8 月至 10 月和 2013 年 1 月进行了两项详细调查，以获取相关和最新信息。该地区 8610 名宫颈细胞学正常的女性 HPV 感染的平均流行率为 12.6%，HPV16 是最常见的 HPV 型别。高级别宫颈病变女性的 HPV DNA 总流行率为 78.1%。HPV DNA 在前宫颈癌中检出率为 86.6%；HPV 阳性病例中 HPV16/18 的联合流行率为 87.5%。生殖器疣和喉乳头状瘤的 HPV DNA 总流行率分别为 94.8%和 95.2%，HPV6 和 HPV11 是最常见的型别。该地区有 9 个国家和 7 个国家分别实施机会性和有组织的宫颈癌筛查，筛查起始年龄分别为 20 岁至 30 岁，估计覆盖率从百分之几到 70%以上不等。除了黑山之外，所有中东欧国家都注册了至少一种当前的 HPV 预防性疫苗。只有保加利亚、捷克共和国、前南斯拉夫的马其顿共和国、拉脱维亚、罗马尼亚和斯洛文尼亚实际上将 HPV 疫苗接种纳入了国家免疫规划，并目前免费向主要目标人群提供常规疫苗接种。未将 HPV 疫苗接种纳入国家免疫规划的主要原因是疫苗费用高和公众负面看法。本文是题为“中东欧和中亚地区人乳头瘤病毒感染及相关疾病综合防治”的区域报告的一部分，该报告发表在 2013 年《疫苗》第 31 卷增刊 7 期。另一篇题为“人乳头瘤病毒感染及相关疾病综合防治”的专题论文则介绍了该领域的最新进展，该论文发表在 2012 年《疫苗》第 30 卷增刊 5 期。
