疫苗对男男性行为者中流行的肛门和口腔人乳头瘤病毒感染的有效性-美国，2016-2018 年。
Vaccine Effectiveness Against Prevalent Anal and Oral Human Papillomavirus Infection Among Men Who Have Sex With Men-United States, 2016-2018.
机构信息
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Department of Epidemiology, University of Washington, Seattle, Washington, USA.
出版信息
J Infect Dis. 2020 Nov 13;222(12):2052-2060. doi: 10.1093/infdis/jiaa306.
BACKGROUND
In the United States, human papillomavirus (HPV) vaccination has been recommended for young adult men who have sex with men (MSM) since 2011.
METHODS
The Vaccine Impact in Men study surveyed MSM and transgender women aged 18-26 years in 3 US cities during 2016-2018. Self-collected anal swab and oral rinse specimens were assessed for 37 types of HPV. We compared HPV prevalence among vaccinated and unvaccinated participants and determined adjusted prevalence ratios (aPR) and 95% confidence intervals (CI).
RESULTS
Among 1767 participants, 704 (39.8%) self-reported receiving HPV vaccine. Median age at vaccination (18.7 years) was older than age at first sex (15.7 years). Quadrivalent vaccine-type HPV was detected in anal or oral specimens from 475 (26.9%) participants. Vaccine-type HPV prevalence was lower among vaccinated (22.9%) compared with unvaccinated (31.6%) participants; aPR for those who initiated vaccination at age ≤18 years was 0.41 (CI, 0.24-0.57) and at age >18 years was 0.82 (CI, 0.67-0.98). Vaccine effectiveness of at least 1 HPV vaccine dose at age ≤18 years or >18 years was 59% and 18%, respectively.
CONCLUSIONS
Findings suggest real-world effectiveness of HPV vaccination among young adult MSM. This effect was stronger with younger age at vaccination.
背景
在美国，自 2011 年以来，性活跃的男男性接触者（MSM）中的年轻成年男性就被推荐接种人乳头瘤病毒（HPV）疫苗。
方法
2016 年至 2018 年期间，疫苗对男性的影响研究在 3 个美国城市中调查了 18-26 岁的 MSM 和跨性别女性。参与者自行采集肛门拭子和口腔冲洗样本，检测 37 种 HPV 类型。我们比较了接种疫苗和未接种疫苗参与者的 HPV 流行率，并确定了调整后的流行率比（aPR）和 95%置信区间（CI）。
结果
在 1767 名参与者中，有 704 人（39.8%）自我报告接种了 HPV 疫苗。接种疫苗的中位年龄（18.7 岁）大于首次性行为年龄（15.7 岁）。475 名（26.9%）参与者的肛门或口腔样本中检测到四价疫苗型 HPV。与未接种疫苗的参与者（31.6%）相比，接种疫苗的参与者（22.9%）疫苗型 HPV 的流行率较低；18 岁及以下开始接种疫苗的参与者的比值比（aPR）为 0.41（95%CI，0.24-0.57），18 岁以上的参与者为 0.82（95%CI，0.67-0.98）。18 岁及以下或 18 岁以上接种至少 1 剂 HPV 疫苗的疫苗有效性分别为 59%和 18%。
结论
研究结果表明，在年轻的 MSM 中，HPV 疫苗具有实际效果。接种年龄越小，效果越强。
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