Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, The Netherlands.
Clin Infect Dis. 2021 Jul 15;73(2):291-297. doi: 10.1093/cid/ciaa582.
There is ongoing debate about the possible protective effect of the bivalent human papillomavirus (2vHPV) vaccine, targeting oncogenic types HPV-16/18, against anogenital warts (AGWs), commonly attributed to HPV-6/11. We performed a retrospective registry-based open cohort study to assess the effect of 2vHPV vaccination on AGWs.
We linked general practice (ie, primary care) data from women born between 1993 and 2002, who had been eligible for HPV vaccination in the Netherlands, to the Dutch national immunization registry on an individual level. Women were followed until their first AGW diagnosis or end of follow-up. Adjusted incidence rate ratios (aIRRs) were estimated using Poisson regression with vaccination status as a time-dependent exposure.
We linked data of 96 468 women with a total of 328 019 years observation time and 613 AGW diagnoses (incidence: 1.87/1000 person-years). At the end of follow-up, 61% were 2vHPV vaccinated (≥ 1 dose) of whom 91% were fully vaccinated. The AGW incidence was lower among those with ≥ 1 dose vs 0 doses (aIRR, 0.75 [95% confidence interval {CI}, .64-.88]). The effect of vaccination was stronger after full vaccination (aIRR, 0.72 [95% CI, .61-.86]) and for women who were offered vaccination at 12-13 years of age (aIRR, 0.69 [95% CI, .51-.93]) vs those at 13-16 years of age (aIRR, 0.77 [95% CI, .64-.93]).
This is the largest population-based study so far to examine the effect of 2vHPV vaccination on AGWs, with reliable individual information on AGW diagnoses and vaccination status. The results indicate that 2vHPV vaccination partially protects against AGWs, especially when administered in early adolescence.
目前，人们对于二价人乳头瘤病毒（HPV）疫苗（针对致癌性 HPV-16/18 型）针对肛门生殖器疣（AGW）的可能保护作用存在争议，AGW 通常归因于 HPV-6/11 型。我们进行了一项回顾性基于登记的开放性队列研究，以评估二价 HPV 疫苗接种对 AGW 的影响。
我们将出生于 1993 年至 2002 年之间、有资格在荷兰接种 HPV 疫苗的女性的一般实践（即初级保健）数据与荷兰国家免疫登记处按个人进行了关联。女性随访至首次 AGW 诊断或随访结束。使用泊松回归，将疫苗接种状态作为时间依赖性暴露，估计调整发病率比（aIRR）。
我们共关联了 96468 名女性的数据，总计 328019 人年的观察时间和 613 例 AGW 诊断（发病率：1.87/1000 人年）。随访结束时，61%的女性接种了二价 HPV 疫苗（≥1 剂），其中 91%的女性完成了全程接种。与 0 剂相比，≥1 剂的 AGW 发病率较低（aIRR，0.75[95%置信区间{CI}，0.64-0.88]）。完全接种疫苗后的疫苗效果更强（aIRR，0.72[95%CI，0.61-0.86]），以及 12-13 岁时接种疫苗的女性（aIRR，0.69[95%CI，0.51-0.93]）与 13-16 岁时接种疫苗的女性（aIRR，0.77[95%CI，0.64-0.93]）相比。
这是迄今为止规模最大的基于人群的研究，旨在检查二价 HPV 疫苗接种对 AGW 的影响，具有关于 AGW 诊断和疫苗接种状态的可靠个人信息。结果表明，二价 HPV 疫苗接种对 AGW 有一定的保护作用，尤其是在青少年早期接种时。
