Microbiology Department, Institute of Biomedical Research of Vigo, University Hospital of Vigo, Vigo, Spain.
Gynecology Department, University Hospital of Vigo, Vigo, Spain.
Virol J. 2017 Nov 6;14(1):214. doi: 10.1186/s12985-017-0879-1.
Human papillomavirus (HPV) bivalent and quadrivalent vaccines have been widely implemented in worldwide organized immunization programs. A nonavalent HPV vaccine is now available in several countries. The objective was to describe the fraction of squamous non-invasive high-grade cervical intraepithelial lesions attributable to genotypes targeted by bi-quadrivalent vaccines and by nonavalent vaccine according to age and diagnosis in women living in the city of Vigo (Galicia, Spain).
Cervical scrapings (2009-2014) of women with histological diagnosis of cervical intraepithelial neoplasia grade 2 (CIN2, n = 145) and grade 3-carcinoma in situ (CIN3-CIS, n = 244) were tested with Linear Array HPV Genotyping test (Roche diagnostics, Mannheim, Germany). Hierarchical estimation of the fraction attributable to HPV 16/18 or HPV 31/33/45/52/58 detected alone or in combination was calculated. Absolute additional fraction attributable to genotypes targeted by nonavalent vaccine compared to genotypes targeted by bi-quadrivalent vaccines was calculated as the increment of attributable cases with respect to all studied cases. Age group 1, 2 and 3 included women 18 to 34, 35-44 and ≥45 years old, respectively. EPIDAT 3.1 was used.
Fraction attributable to genotypes targeted by bi-quadrivalent vaccines was 59% CIN2 vs. 69% CIN3-CIS (p < 0.001). It was 63/51/50% of CIN2 and 78/66/45% of CIN3-CIS in age group 1, 2, 3, respectively. Fraction attributable to genotypes targeted by nonavalent vaccine was 86% CIN2 and 86% CIN3-CIS. It was 87/91/75% of CIN2 and 90/86/76% of CIN3-CIS in age group 1, 2, 3, respectively. Fraction attributable to genotypes targeted by these vaccines tended to decrease as age increased (p-trend <0.05). Globally, absolute additional attributable fraction was 16%, 26% and 29% in age group 1, 2 and 3, respectively (p < 0.005).
Absolute additional fraction of CIN2 and CIN3-CIS attributable to genotypes targeted by nonavalent vaccine was observed in women of any age, especially in those over 35 years old.
人乳头瘤病毒（HPV）二价和四价疫苗已在全球范围内的有组织免疫计划中广泛实施。目前，已有几种九价 HPV 疫苗可供使用。本研究的目的是描述在加利西亚维哥市（西班牙）居住的女性中，根据年龄和诊断，二价和四价疫苗针对的基因型以及九价疫苗针对的基因型分别归因于鳞柱交界区高级别宫颈上皮内瘤变的比例。
对 2009 年至 2014 年间组织学诊断为宫颈上皮内瘤变 2 级（CIN2，n=145）和 3 级原位癌（CIN3-CIS，n=244）的女性的宫颈刮片进行检测，采用线性阵列 HPV 基因分型检测（罗氏诊断公司，德国曼海姆）。采用分层估计方法计算单独或联合检测到的 HPV 16/18 或 HPV 31/33/45/52/58 所致病变的归因分数。与二价疫苗针对的基因型相比，九价疫苗针对的基因型的绝对附加归因分数，计算方法为相对于所有研究病例，归因病例的增量。年龄组 1、2 和 3 分别包括 18 至 34、35-44 和≥45 岁的女性。使用 EPIDAT 3.1 软件进行数据分析。
二价疫苗针对的基因型的归因比例为 59%的 CIN2 与 69%的 CIN3-CIS（p<0.001）。在年龄组 1、2、3 中，CIN2 为 63/51/50%，CIN3-CIS 为 78/66/45%。九价疫苗针对的基因型的归因比例为 86%的 CIN2 和 86%的 CIN3-CIS。在年龄组 1、2、3 中，CIN2 为 87/91/75%，CIN3-CIS 为 90/86/76%。随着年龄的增长，这些疫苗针对的基因型的归因比例有下降的趋势（p 趋势<0.05）。总体而言，年龄组 1、2 和 3 的 CIN2 和 CIN3-CIS 归因于九价疫苗针对的基因型的绝对附加归因比例分别为 16%、26%和 29%（p<0.005）。
在任何年龄段的女性中，均可观察到九价 HPV 疫苗针对的基因型归因于 CIN2 和 CIN3-CIS 的绝对附加比例，特别是在 35 岁以上的女性中。
