Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Department of Obstetrics Gynaecology, University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Vaccine. 2019 Oct 31;37(46):6907-6914. doi: 10.1016/j.vaccine.2019.09.052. Epub 2019 Sep 24.
Australia introduced a school-based human papillomavirus (HPV) vaccination program for females aged 12-13 years in 2007, with a three-year catch-up to age 26; and for boys aged 12-13 from 2013, with a two-year catch-up to age 15. This study aimed to compare the prevalence of penile HPV between teenage heterosexual males in cohorts eligible or non-eligible for the school-based male vaccination program.
Between 2014 and 2017, sexually active heterosexual males aged 17-19 were recruited from sexual health centres and community sources across Australia. Males provided a self-collected penile swab for 37 HPV genotypes using Roche Linear Array and completed a questionnaire. We calculated adjusted prevalence ratios (aPR) of HPV between males in two periods: 2014-2015 (preceding implementation of school-based male vaccination) and 2016-2017 (eligible for school-based male vaccination). Self-reported vaccine doses were confirmed with doses reported to the National HPV Vaccination Program Register.
Overall, 152 males were recruited in 2014-2015 and 146 in 2016-2017. Numbers of female sex partners and condom use did not differ between the two periods. The prevalence of quadrivalent vaccine-preventable [4vHPV] genotypes (6/11/16/18) was low in both periods (2.6% [2014-15] versus 0.7% [2016-17]; p = 0.371; aPR 0.28 [95% CI: 0.03-2.62]). Compared with men in 2014-2015, men in 2016-2017 had a lower prevalence of any of the 37 HPV genotypes tested (21.7% versus 11.6%; aPR 0.62 [95% CI: 0.36-1.07]) and any of the 13 high-risk genotypes tested (15.8% versus 7.5%; aPR 0.59 [95% CI: 0.30-1.19]). Prevalence of low-risk HPV genotypes did not differ between the two periods. Of the males recruited in 2016-2017, 55% had received ≥1 vaccine dose.
The prevalence of 4vHPV genotypes among teenage heterosexual males in both cohorts was low, presumably due to herd protection from the female-only vaccination program. Further studies are required to determine the impact of universal HPV vaccination on HPV prevalence in males.
澳大利亚于 2007 年为 12-13 岁的女性推出了基于学校的人乳头瘤病毒（HPV）疫苗接种计划，并为 26 岁以下的女性提供了为期三年的补种机会；2013 年开始为 12-13 岁的男性接种疫苗，并为 15 岁以下的男性提供了为期两年的补种机会。本研究旨在比较符合和不符合学校男童疫苗接种计划的青少年异性恋男性中阴茎 HPV 的流行率。
2014 年至 2017 年期间，从澳大利亚各地的性健康中心和社区招募了 17-19 岁的有性活动的异性恋男性。男性使用罗氏线性阵列自我采集阴茎拭子，检测 37 种 HPV 基因型，并完成一份问卷。我们计算了两个时期男性 HPV 的调整患病率比（aPR）：2014-2015 年（学校男童疫苗接种实施前）和 2016-2017 年（有资格接种学校男童疫苗）。通过国家 HPV 疫苗接种计划登记处报告的疫苗剂量来确认自我报告的疫苗剂量。
总体而言，2014-2015 年期间招募了 152 名男性，2016-2017 年期间招募了 146 名男性。两个时期男性的女性性伴侣数量和 condom 使用情况没有差异。两种四价疫苗可预防（4vHPV）基因型（6/11/16/18）的流行率均较低（2014-15 年为 2.6%，2016-17 年为 0.7%；p=0.371；aPR 0.28 [95%CI：0.03-2.62]）。与 2014-2015 年相比，2016-2017 年男性中任何一种 37 种 HPV 基因型的流行率均较低（21.7%对 11.6%；aPR 0.62 [95%CI：0.36-1.07]）和任何一种 13 种高危基因型的流行率也较低（15.8%对 7.5%；aPR 0.59 [95%CI：0.30-1.19]）。两个时期低危 HPV 基因型的流行率没有差异。2016-2017 年招募的男性中，55%至少接种了一剂疫苗。
两个队列中青少年异性恋男性中 4vHPV 基因型的流行率较低，这可能是由于女性专用疫苗接种计划产生的群体保护作用。需要进一步研究以确定普遍 HPV 疫苗接种对男性 HPV 流行率的影响。
