Orlando Giovanna, Fasolo Michela, Mazza Francesca, Ricci Elena, Esposito Susanna, Frati Elena, Zuccotti Gian Vincenzo, Cetin Irene, Gramegna Maria, Rizzardini Giuliano, Tanzi Elisabetta
STD Unit; Infectious Diseases I; L Sacco University Hospital; Milan, Italy.
Infectious Diseases I; L Sacco University Hospital; Milan, Italy.
Hum Vaccin Immunother. 2014;10(4):986-94. doi: 10.4161/hv.27682. Epub 2014 Jan 15.
HPV vaccination is expected to reduce the incidence of cervical cancer. The greatest and the earliest health gains will be ensured by high vaccine coverage among all susceptible people. The high costs and the risk of a reduced cost/effectiveness ratio in sexually active girls still represent the main obstacles for a more widespread use of HPV vaccination in many countries. Data on the rate, risk factors, and HPV types in sexually active women could provide information for the evaluation of vaccination policies extended to broader age cohorts. Sexually active women aged 13-26 years enrolled in an Italian cohort study were screened for cervical HPV infections; HPV-DNA positive samples were genotyped by InnoLipa HPV Genotyping Extra or by RFLP genotype analysis.: Among the 796 women meeting the inclusion criteria, 10.80% (95% CI 8.65-12.96) were HPV-DNA infected. Age>18 years, lifetime sexual partners>1, and history of STIs were associated to higher risk of HPV infection in the multivariable models adjusted for age, lifetime sexual partners, and time of sexual exposure. The global prevalence of the four HPV vaccine-types was 3.02% (95% CI 1.83-4.20) and the cumulative probability of infection from at least one vaccine-type was 12.82% in 26-years-old women and 0.78% in 18-years-old women.: Our data confirm most of the previously reported findings on the risk factors for HPV infections. The low prevalence of the HPV vaccine-types found may be useful for the evaluation of the cost/efficacy and the cost/effectiveness of broader immunization programs beyond the 12-years-old cohort.
人乳头瘤病毒(HPV)疫苗接种有望降低宫颈癌的发病率。在所有易感人群中实现高疫苗接种覆盖率,将确保获得最大且最早的健康收益。在许多国家,高昂的成本以及性活跃女孩中成本效益比降低的风险,仍是更广泛使用HPV疫苗的主要障碍。性活跃女性中HPV感染率、风险因素及HPV类型的数据,可为评估扩大至更广泛年龄组的疫苗接种政策提供信息。对纳入一项意大利队列研究的13至26岁性活跃女性进行了宫颈HPV感染筛查;HPV-DNA阳性样本通过InnoLipa HPV基因分型额外检测法或限制性片段长度多态性(RFLP)基因分型分析进行基因分型。在796名符合纳入标准的女性中,10.80%(95%置信区间8.65 - 12.96)感染了HPV-DNA。在针对年龄、性伴侣数量及性接触时间进行调整的多变量模型中,年龄>18岁、性伴侣数量>1以及有性传播感染病史与HPV感染风险较高相关。四种HPV疫苗型的总体流行率为3.02%(95%置信区间1.83 - 4.20),26岁女性中至少感染一种疫苗型的累积概率为12.82%,18岁女性为0.78%。我们的数据证实了先前报道的关于HPV感染风险因素的大部分研究结果。所发现的HPV疫苗型低流行率,可能有助于评估12岁以上人群更广泛免疫计划的成本效益和成本效果。