Sudenga Staci L, Torres B Nelson, Botha Matthys H, Zeier Michele, Abrahamsen Martha E, Glashoff Richard H, Engelbrecht Susan, Schim Van der Loeff Maarten F, Van der Laan Louvina E, Kipping Siegfried, Taylor Douglas, Giuliano Anna R
Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA.
Department of Obstetrics and Gynaecology and Unit for Gynaecological Oncology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa.
J Infect. 2016 Jan;72(1):60-9. doi: 10.1016/j.jinf.2015.10.001. Epub 2015 Oct 19.
The objective of this analysis was to assess human papillomavirus (HPV) infection persistence and incidence 7-months post-enrollment by HPV vaccine study arm (vaccine or placebo).
HIV-negative, sexually active women aged 16-24 years in the Western Cape, South Africa, were enrolled in the EVRI Trial and were randomized to receive 4-valent HPV vaccine or placebo. Cervical specimens were collected at enrollment and at the 7-month visit and were genotyped for HPV. HPV prevalence, persistence, and incidence were calculated. Prevalence ratios and odds ratios were calculated to assess factors associated with a prevalent and incident HPV infection.
HPV incidence rates were marginally higher for the placebo group (n = 163) compared to the vaccine group (n = 169). A large proportion of the prevalent high-risk (HR-HPV) HPV types (49%) persisted over the 7-month period in both arms. Prevalent HR-HPV infection was significantly associated with a prevalent gonorrhea infection and detection of Herpes simplex type 2 antibodies. Incident HR-HPV infection was significantly associated with abnormal cervical cytology at enrollment and younger age.
Women living in geographic areas, such as southern Africa, at high-risk for HPV need to receive HPV vaccination at a very young age to maximally prevent infection and subsequent disease.
本分析的目的是按人乳头瘤病毒（HPV）疫苗研究组（疫苗或安慰剂）评估入组7个月后的HPV感染持续情况和发病率。
南非西开普省16至24岁的HIV阴性、有性行为的女性参加了EVRI试验，并被随机分配接受四价HPV疫苗或安慰剂。在入组时和7个月随访时收集宫颈标本，并对HPV进行基因分型。计算HPV患病率、持续率和发病率。计算患病率比和比值比以评估与HPV现患感染和新发感染相关的因素。
与疫苗组（n = 169）相比，安慰剂组（n = 163）的HPV发病率略高。在7个月期间，两个组中很大一部分现患高危（HR-HPV）HPV类型（49%）持续存在。现患HR-HPV感染与现患淋病感染和单纯疱疹病毒2型抗体检测显著相关。新发HR-HPV感染与入组时宫颈细胞学异常和年龄较小显著相关。
生活在如非洲南部等HPV高风险地理区域的女性需要在非常年轻时接种HPV疫苗，以最大程度预防感染及后续疾病。
