Guo Fangjian, Hirth Jacqueline M, Berenson Abbey B
a Department of Obstetrics & Gynecology ; Center for Interdisciplinary Research in Women's Health; The University of Texas Medical Branch ; Galveston , TX USA.
Hum Vaccin Immunother. 2015;11(10):2337-44. doi: 10.1080/21645515.2015.1066948.
There is some concern about the effectiveness of the HPV vaccine among young adult women due to the risk of prior HPV infection. This study used National Health and Nutrition Examination Survey (NHANES) 2007-2012 data to evaluate the effectiveness of HPV vaccination among women 20-26 years of age who were vaccinated after 12 years of age. This cross-sectional study examined 878 young adult women (20-26 years) with complete information on HPV prevalence and HPV vaccination status from NHANES 2007-2012. Vaginal swab specimens were analyzed for HPV DNA by L1 consensus polymerase chain reaction followed by type-specific hybridization. Multivariate logistic regression models controlling for sociodemographic characteristics and sexual behaviors were used to compare type-specific HPV prevalence between vaccinated and unvaccinated women. A total of 21.4% of young adult women surveyed through NHANES between 2007 and 2012 received the HPV vaccine. Vaccinated women had a lower prevalence of vaccine types than unvaccinated women (7.4% vs 17.1%, prevalence ratio 0.43, 95% CI 0.21-0.88). The prevalence of high-risk nonvaccine types was higher among vaccinated women than unvaccinated women (52.1% vs 40.4%, prevalence ratio 1.29, 95% CI 1.06-1.57), but this difference was attenuated after adjusting for sexual behavior variables (adjusted prevalence ratio 1.19, 95% CI 0.99-1.43). HPV vaccination was effective against all 4 vaccine types in young women vaccinated after age 12. However, vaccinated women had a higher prevalence of high-risk nonvaccine types, suggesting that they may benefit from newer vaccines covering additional types.
由于存在既往感染人乳头瘤病毒(HPV)的风险,年轻成年女性中对HPV疫苗的有效性存在一些担忧。本研究使用2007 - 2012年美国国家健康与营养检查调查(NHANES)数据,评估12岁后接种疫苗的20 - 26岁女性中HPV疫苗接种的有效性。这项横断面研究检查了878名20 - 26岁的年轻成年女性,她们来自2007 - 2012年NHANES,具备HPV流行率和HPV疫苗接种状况的完整信息。通过L1共识聚合酶链反应分析阴道拭子标本中的HPV DNA,随后进行型特异性杂交。使用控制社会人口统计学特征和性行为的多变量逻辑回归模型,比较接种疫苗和未接种疫苗女性之间型特异性HPV流行率。2007年至2012年通过NHANES调查的年轻成年女性中,共有21.4%接种了HPV疫苗。接种疫苗的女性中疫苗型别的流行率低于未接种疫苗的女性(7.4%对17.1%,流行率比0.43,95%可信区间0.21 - 0.88)。接种疫苗的女性中高危非疫苗型别的流行率高于未接种疫苗的女性(52.1%对40.4%,流行率比1.29,95%可信区间1.06 - 1.57),但在调整性行为变量后,这种差异有所减弱(调整后的流行率比1.19,95%可信区间0.99 - 1.43)。HPV疫苗接种对12岁后接种疫苗的年轻女性中的所有4种疫苗型别均有效。然而,接种疫苗的女性中高危非疫苗型别的流行率较高,这表明她们可能会从覆盖更多型别的新型疫苗中受益。