Oliphant Jeannie, Stewart Joanna, Saxton Peter, Lo Min, Perkins Nicky, Ward Daniel
Auckland Sexual Health Service, Greenlane Clinical Centre, Auckland.
School of Population Health, University of Auckland, Auckland.
N Z Med J. 2017 Mar 24;130(1452):9-16.
To investigate whether changes in rates of genital warts diagnosis at Auckland Sexual Health Service (ASHS), pre and post the quadrivalent human papillomavirus (4vHPV) vaccine introduction in late 2008, differed between clients vaccine-eligible and not eligible.
All new clients attending ASHS from 2007 to 2013 were categorised as having genital warts or not. Generalised linear mixed models were used to compare differences in rates of change in diagnoses.
Overall, 43,480 were seen with genital warts diagnosed in 13.1%. The difference in rate of change over time in diagnosis pre- to post-vaccine differed in females vaccine-eligible to not (p=0.004). The relative risk of diagnosis per year pre-vaccine was 0.98 (0.84, 1.13) and post-vaccine 0.77 (0.74, 0.81) in those eligible compared to 0.87 (0.80, 0.95) and 0.95 (0.91, 0.98), respectively, in those not eligible. This difference in change, between vaccine eligible or not, differed between males and females (p=0.02), with males considered eligible if the same aged female would have been. In males, no difference in rate change pre- to post-vaccine could be shown in those eligible or not (p=0.53).
In this study a population effect for women of the 4vHPV vaccine was demonstrated.
调查在2008年末四价人乳头瘤病毒（4vHPV）疫苗引入奥克兰性健康服务中心（ASHS）前后，符合疫苗接种条件和不符合疫苗接种条件的客户之间，尖锐湿疣诊断率的变化是否存在差异。
将2007年至2013年期间前往ASHS的所有新客户分为患有尖锐湿疣和未患尖锐湿疣两类。使用广义线性混合模型比较诊断率变化的差异。
总体而言，共诊治43480例患者，其中13.1%被诊断为尖锐湿疣。疫苗接种前后诊断率随时间的变化差异在符合疫苗接种条件和不符合疫苗接种条件的女性中有所不同（p = 0.004）。符合疫苗接种条件者在疫苗接种前每年诊断的相对风险为0.98（0.84，1.13），接种后为0.77（0.74，0.81），而不符合疫苗接种条件者分别为0.87（0.80，0.95）和0.95（0.91，0.98）。符合疫苗接种条件与否的这种变化差异在男性和女性之间也有所不同（p = 0.02），如果同年龄女性符合条件，则男性也被视为符合条件。在男性中，符合或不符合疫苗接种条件者在疫苗接种前后的率变化没有差异（p = 0.53）。
本研究证明了4vHPV疫苗对女性的群体效应。
