国家 HPV 疫苗接种计划实施后青少年复发性呼吸道乳头瘤病发病率的前瞻性研究。

A Prospective Study of the Incidence of Juvenile-Onset Recurrent Respiratory Papillomatosis After Implementation of a National HPV Vaccination Program.

机构信息

University of Sydney Medical School, University of Sydney and Kids Research Institute, Sydney Children's Hospitals Network (Westmead).

ENT Department, Children's Hospital Westmead, University of Sydney and Kids Research Institute, Sydney Children's Hospitals Network (Westmead).

出版信息

J Infect Dis. 2018 Jan 4;217(2):208-212. doi: 10.1093/infdis/jix498.

DOI:10.1093/infdis/jix498

PMID:29136168

Abstract

BACKGROUND

Recurrent respiratory papillomatosis is a rare but morbid disease caused by human papillomavirus (HPV) types 6 and 11. Infection is preventable through HPV vaccination. Following an extensive quadrivalent HPV vaccination program (females 12-26 years in 2007-2009) in Australia, we established a method to monitor incidence and demographics of juvenile-onset recurrent respiratory papillomatosis (JORRP) cases.

METHODS

The Australian Paediatric Surveillance Unit undertakes surveillance of rare pediatric diseases by contacting practitioners monthly. We enrolled pediatric otorhinolaryngologists and offered HPV typing. We report findings for 5 years to end 2016.

RESULTS

The average annual incidence rate was 0.07 per 100000. The largest number of cases was reported in the first year, with decreasing annual frequency thereafter. Rates declined from 0.16 per 100000 in 2012 to 0.02 per 100000 in 2016 (P = .034). Among the 15 incident cases (60% male), no mothers were vaccinated prepregnancy, 20% had maternal history of genital warts, and 60% were first born; 13/15 were born vaginally. Genotyped cases were HPV-6 (n = 4) or HPV-11 (n = 3).

CONCLUSION

To our knowledge, this is the first report internationally documenting decline in JORRP incidence in children following a quadrivalent HPV vaccination program.

摘要

背景

复发性呼吸道乳头瘤病是一种罕见但严重的疾病，由人乳头瘤病毒（HPV）型 6 和 11 引起。通过 HPV 疫苗接种可以预防感染。在澳大利亚广泛开展四价 HPV 疫苗接种计划（2007-2009 年为 12-26 岁女性）后，我们建立了一种监测青少年复发性呼吸道乳头瘤病（JORRP）病例发病率和人口统计学特征的方法。

方法

澳大利亚儿科监测单位每月与医生联系，开展罕见儿科疾病监测。我们招募了儿科耳鼻喉科医生，并提供 HPV 分型。我们报告了截至 2016 年底的 5 年发现结果。

结果

平均年发病率为每 10 万人 0.07 例。报告的病例数量最多的是第一年，此后每年的频率逐渐降低。发病率从 2012 年的每 10 万人 0.16 例降至 2016 年的每 10 万人 0.02 例（P =.034）。在 15 例新发病例（60%为男性）中，没有母亲在妊娠前接种疫苗，20%的母亲有生殖器疣病史，60%为第一胎，13/15 为阴道分娩。HPV 型别为 HPV-6（n = 4）或 HPV-11（n = 3）。