Ye Ze-Hao, Liu Zhao-Zhen, Cui Si-Tong, Chu Zhen-Xing, Jiang Yong-Jun, Xu Jun-Jie, Hu Qing-Hai, Shang Hong
National Health Commission Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.
Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.
Front Med (Lausanne). 2021 Nov 19;8:763564. doi: 10.3389/fmed.2021.763564. eCollection 2021.
Despite the insupportable burden caused by the human papillomavirus (HPV) and high vaccine acceptability, vaccination programs are not currently available for men who have sex with men (MSM). We aimed to assess HPV infection by examining the willingness for vaccination among MSM and cost-effectiveness of the Chinese 2-valent HPV vaccine. We recruited MSM in Shenyang, China between July and December 2020 to conduct anal HPV testing and an online survey regarding HPV-related knowledge and vaccine acceptability. We performed a cost-effectiveness analysis to evaluate the incremental cost-effectiveness ratios (ICERs) of the Chinese 2-valent HPV vaccine. A total of 234 participants completed the online survey; of those, 203 were successfully tested for HPV. The median age was 30 years [interquartile range (IQR): 23-38 years]. Most participants had at least undergraduate education (136/234, 58.1%). The acceptability rate for the free HPV vaccine was 57.7% (135/234). The prevalence of HPV types 16 and 18 was 14.9% (18/121) and 26.8% (22/82) in the willing and unwilling to vaccinate groups, respectively ( > 0.05). The prevalence of high-risk HPV among participants aged <30 and ≥50 years was 48.6 and 38.9%, respectively. Using the Chinese per capita gross domestic product (GDP) as a threshold, the Chinese 2-valent HPV vaccine would be a "very cost-effective" strategy, with an ICER value of USD 4,411. This evidence showed that the Chinese 2-valent HPV vaccine was more cost-effective than other imported vaccines. Targeted strategies should be utilized in MSM with different rates of vaccine acceptability. A pilot HPV vaccination program based on the Chinese 2-valent HPV vaccine for MSM is urgently warranted to reduce the burden of HPV and anal cancer.
尽管人乳头瘤病毒（HPV）造成了难以承受的负担且疫苗可接受性较高，但目前针对男男性行为者（MSM）尚无疫苗接种项目。我们旨在通过调查MSM的疫苗接种意愿以及中国二价HPV疫苗的成本效益来评估HPV感染情况。2020年7月至12月期间，我们在中国沈阳招募了MSM，进行肛门HPV检测以及关于HPV相关知识和疫苗可接受性的在线调查。我们进行了成本效益分析，以评估中国二价HPV疫苗的增量成本效益比（ICER）。共有234名参与者完成了在线调查；其中，203人成功进行了HPV检测。中位年龄为30岁[四分位间距（IQR）：23 - 38岁]。大多数参与者至少拥有本科学历（136/234，58.1%）。免费HPV疫苗的可接受率为57.7%（135/234）。在愿意接种和不愿意接种的组中，16型和18型HPV的患病率分别为14.9%（18/121）和26.8%（22/82）（P>0.05）。年龄<30岁和≥50岁的参与者中高危HPV的患病率分别为48.6%和38.9%。以中国人均国内生产总值（GDP）作为阈值，中国二价HPV疫苗将是一种“非常具有成本效益”的策略，ICER值为4411美元。这一证据表明，中国二价HPV疫苗比其他进口疫苗更具成本效益。对于疫苗可接受率不同的MSM应采用有针对性的策略。迫切需要开展一项基于中国二价HPV疫苗的MSM HPV疫苗接种试点项目，以减轻HPV和肛门癌的负担。
