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HPV 疫苗接种后五年哥伦比亚年轻女性(18-25 岁)中 HPV 型别感染减少。

Reduction in Vaccine HPV Type Infections in a Young Women Group (18-25 Years) Five Years after HPV Vaccine Introduction in Colombia.

机构信息

Grupo de Investigación en Biología del Cáncer, Instituto Nacional de Cancerología (INC), Bogotá, Colombia.

Departamento de Microbiología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.

出版信息

Cancer Prev Res (Phila). 2022 Jan;15(1):55-66. doi: 10.1158/1940-6207.CAPR-21-0063. Epub 2021 Oct 5.

Abstract

In Colombia, the human papillomavirus (HPV) vaccine was launched in 2012 in the context of a school-based national vaccination program targeting girls ages 9 to 14 and offering catch-up vaccination for girls ages 14 to 17. In this study, we evaluated the program's impact on type-specific HPV infection by comparing HPV cervical prevalence among vaccinated and nonvaccinated women. This is a comparative cross-sectional study conducted 5 years after the quadrivalent HPV vaccination implementation in a sentinel Colombian City. This study included young women (18-25 years old) who had been vaccinated in the catch-up group and were attending universities and technical institutions, and women who attended primary health care facilities for Pap smear screening. The HPV prevalence of 1,287 unvaccinated women was compared with the prevalence of 1,986 vaccinated women. The prevalence of HPV16/18 infections was significantly lower in vaccinated compared with unvaccinated women (6.5% vs. 15.4%; < 0.001), whereas for HPV6/11 infections, a decrease of 63.7% in vaccinated women (1.02% vs. 2.81%) was observed. The adjusted effectiveness to HPV16/18 was 61.4%; 95% CI, 54.3%-67.6%. However, the effectiveness against HPV16/18 was significantly higher among women vaccinated before their sexual debut 91.5%; 95% CI, 86.8-94.5, compared with effectiveness for vaccination after their sexual debut, 36.2%; 95% CI, 23.6-46.7. Five years after the introduction of HPV vaccines in Colombia, high effectiveness of HPV to prevent HPV16/18 infections is observed in the catch-up cohorts including virgin and sexually active women. PREVENTION RELEVANCE: Monitoring HPV vaccines post-licensure plays an important role in assessing the progress of immunization programs, demonstrating the impact of vaccines on the population, and providing data for policy needs. In Colombia, HPV vaccines showed effectiveness when administered before start of sexual activity, and two doses are sufficient to achieve good protection.

摘要

在哥伦比亚,人乳头瘤病毒(HPV)疫苗于 2012 年在全国疫苗接种计划的背景下推出,该计划针对 9 至 14 岁的女孩,并为 14 至 17 岁的女孩提供补种疫苗。在这项研究中,我们通过比较已接种和未接种疫苗的女性中 HPV 宫颈患病率,评估了该计划对特定 HPV 感染的影响。这是在四价 HPV 疫苗接种实施五年后在哥伦比亚一个有代表性的城市进行的一项比较性横断面研究。这项研究包括参加大学和技术机构的 18-25 岁的年轻女性,她们属于补种组,并包括参加巴氏涂片筛查的初级保健机构的女性。对 1287 名未接种疫苗的女性和 1986 名接种疫苗的女性的 HPV 流行率进行了比较。与未接种疫苗的女性相比,接种疫苗的女性 HPV16/18 感染的流行率显著降低(6.5%比 15.4%;<0.001),而 HPV6/11 感染的流行率下降了 63.7%(1.02%比 2.81%)。HPV16/18 的调整有效性为 61.4%;95%CI,54.3%-67.6%。然而,在性行为开始前接种疫苗的女性中,HPV16/18 的有效性明显更高(91.5%;95%CI,86.8-94.5),而性行为开始后接种疫苗的女性,HPV16/18 的有效性为 36.2%;95%CI,23.6-46.7。在 HPV 疫苗在哥伦比亚推出五年后,在包括处女和有性行为的女性在内的补种组中观察到 HPV 预防 HPV16/18 感染的高有效性。预防相关性:疫苗接种后监测 HPV 疫苗在评估免疫规划进展、证明疫苗对人群的影响以及为政策需求提供数据方面发挥着重要作用。在哥伦比亚,HPV 疫苗在开始性行为前接种时有效,两剂疫苗足以实现良好的保护。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f880/9662904/89bcb072d2d6/55fig1.jpg

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