WHO HPV LabNet Global Reference Laboratory, Dept. of Clinical Microbiology, Skåne University Hospital, Malmö and Center for Cervical Cancer Prevention, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
Dept. of Research, Cancer Registry of Norway, Oslo, Norway.
Vaccine. 2018 Jun 18;36(26):3820-3829. doi: 10.1016/j.vaccine.2018.05.019. Epub 2018 May 31.
To monitor the changes in prevalence of human papillomavirus (HPV) infections in women <50 years of age, participating in cervical screening programs of Denmark, Norway, and Sweden, before and after introduction of quadrivalent HPV (qHPV) vaccination.
Liquid-based cytology samples were collected from 6538 women who attended cervical screening in Denmark, Norway, and Sweden in 2006-2008 and from 6332 similarly enrolled women in 2012-2013. Denmark started organized qHPV vaccination in 2008, Norway in 2009, and Sweden in 2012. All HPV testing and genotyping was performed using identical enrollment and analysis methods, by accredited general primer polymerase chain reaction methods with typing using the Luminex system.
Overall HPV positivity declined slightly from 36.5% in 2006-2008 to 34.5% in 2012-2013. The decline was most pronounced among women 18-26 years of age: from 54.4% to 48.1% (P < 0.001). The decline was substantial for vaccine HPV types (HPV6/11/16/18: decline from 22.3% to 16.6%; P < 0.001) and was seen for both low-risk vaccine types (HPV6/11 declined from 5.0% to 2.5%) and high-risk vaccine types (HPV16/18 declined from 18.9% to 14.9%). Among women 27-50 years of age, there was no change between the time periods (22.5% and 21.6%, respectively). The significant decline in the younger age group was different in the 3 countries.
This population-based study enrolling >12,000 women participating in cervical screening in the 3 Nordic countries before and after introduction of organized qHPV vaccination demonstrated a marked decline in HPV infection in the younger population in the 2 countries where qHPV vaccination programs started in 2008-2009, suggesting that organized HPV vaccination programs resulted in a decrease of HPV types circulating in the general population.
监测丹麦、挪威和瑞典参加宫颈癌筛查项目的 <50 岁女性中 HPV 感染流行率在引入四价 HPV（qHPV）疫苗前后的变化。
2006-2008 年期间，从丹麦、挪威和瑞典参加宫颈癌筛查的 6538 名女性中采集了液基细胞学样本，2012-2013 年期间从同样参加筛查的 6332 名女性中采集了样本。丹麦于 2008 年开始有组织地接种 qHPV 疫苗，挪威于 2009 年，瑞典于 2012 年。所有 HPV 检测和基因分型均采用相同的入组和分析方法，使用经过认证的通用引物聚合酶链反应方法进行，通过 Luminex 系统进行分型。
总体 HPV 阳性率从 2006-2008 年的 36.5%略有下降至 2012-2013 年的 34.5%。18-26 岁女性的降幅最为显著：从 54.4%降至 48.1%（P<0.001）。疫苗 HPV 型别（HPV6/11/16/18：从 22.3%降至 16.6%；P<0.001）的降幅显著，低危型疫苗 HPV 型别（HPV6/11 从 5.0%降至 2.5%）和高危型疫苗 HPV 型别（HPV16/18 从 18.9%降至 14.9%）均出现了降幅。27-50 岁女性在这两个时间段之间没有变化（分别为 22.5%和 21.6%）。年轻组的显著下降在这 3 个国家有所不同。
这项基于人群的研究在丹麦、挪威和瑞典的 3 个国家入组了 >12000 名参加宫颈癌筛查的女性，在引入有组织的 qHPV 疫苗接种前后进行了研究，结果显示在 2008-2009 年开始 qHPV 疫苗接种项目的 2 个国家，年轻人群的 HPV 感染显著下降，表明有组织的 HPV 疫苗接种项目降低了人群中流行的 HPV 型别。
