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人乳头瘤病毒疫苗接种后的自身和性伴侣保护:HPV 疫苗接种减少传播和预防研究的初步分析。

Protection to Self and to One's Sexual Partner After Human Papillomavirus Vaccination: Preliminary Analysis From the Transmission Reduction And Prevention with HPV Vaccination Study.

机构信息

From the Division of Cancer Epidemiology, McGill University, Montreal, Quebec.

Department of Family Medicine, McGill University.

出版信息

Sex Transm Dis. 2022 Jun 1;49(6):414-422. doi: 10.1097/OLQ.0000000000001620. Epub 2022 Mar 2.

DOI:10.1097/OLQ.0000000000001620
PMID:35235550
Abstract

BACKGROUND

It is unknown whether recently human papillomavirus (HPV)-vaccinated individuals confer protection against vaccine-preventable HPV types to their partners.

METHODS

Participants 18 to 45 years old who were living in Montreal, Canada, and in a heterosexual relationship of 6 months or less were randomly assigned to receive the intervention HPV vaccine, Gardasil or Gardasil 9, or active control (AC), Avaxim, a hepatitis A vaccine. Couples attended a maximum of 6 clinic visits (baseline and at 2, 4, 6, 9, and 12 months) and provided genital samples for detection of 36 HPV genotypes. Participants were vaccinated at baseline and at 2 and 6 months. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between the administered vaccine and infections at the HPV episode level.

RESULTS

We restricted analyses to 273 participants (intervention: n = 141, AC: n = 132) who had at least 2 visits with valid HPV data. The HR of becoming positive for a given vaccine-preventable HPV type in the intervention group among those who received at least 1 dose compared with AC was 0.47 (95% CI, 0.23-0.97). Comparing individuals with HPV-vaccinated versus AC-vaccinated partners, there was no difference in risk of becoming positive for a given vaccine-preventable HPV type among those whose partners received at least 1 (HR, 1.46; 95% CI, 0.73-2.94) or 2 (HR, 0.78; 95% CI, 0.31-1.96) doses.

CONCLUSIONS

Our study provides inconclusive evidence that individuals whose partner recently received an HPV vaccine are protected from vaccine-preventable types but demonstrates that vaccinated individuals are at a lower risk of incident infections.Trial Registration Number: NCT01824537.

摘要

背景

目前尚不清楚最近接种人乳头瘤病毒(HPV)疫苗的个体是否会为其伴侣提供针对可预防 HPV 类型的保护。

方法

18 至 45 岁的参与者居住在加拿大蒙特利尔,且伴侣关系持续时间不超过 6 个月,他们被随机分配接受干预性 HPV 疫苗(加德西或加德西 9)或活性对照(AC)疫苗(甲型肝炎疫苗)。伴侣最多参加 6 次就诊(基线和 2、4、6、9 和 12 个月),并提供生殖器样本以检测 36 种 HPV 基因型。参与者在基线和 2 个月和 6 个月时接种疫苗。我们使用 Cox 比例风险回归模型估计接种疫苗与 HPV 发作水平感染之间的关联的风险比(HR)和 95%置信区间(CI)。

结果

我们将分析限制在至少有 2 次具有有效 HPV 数据的 273 名参与者(干预组:n = 141,AC 组:n = 132)。与 AC 相比,至少接受 1 剂疫苗的干预组中某一疫苗可预防 HPV 类型呈阳性的 HR 为 0.47(95%CI,0.23-0.97)。比较 HPV 疫苗接种者和 AC 疫苗接种者,其伴侣至少接受 1 剂(HR,1.46;95%CI,0.73-2.94)或 2 剂(HR,0.78;95%CI,0.31-1.96)疫苗的参与者,HPV 疫苗预防的特定类型呈阳性的风险没有差异。

结论

我们的研究提供了不确定的证据表明,最近其伴侣接种 HPV 疫苗的个体可以预防疫苗可预防的类型,但也表明接种疫苗的个体感染新发病例的风险较低。

试验注册号

NCT01824537。

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