Sierra Mónica S, Tsang Sabrina H, Porras Carolina, Herrero Rolando, Sampson Joshua N, Cortes Bernal, Schussler John, Wagner Sarah, Carvajal Loretto, Quint Wim, Kreimer Aimée R, Hu Shangying, Rodriguez Ana Cecilia, Romero Byron, Hildesheim Allan
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
Sex Transm Infect. 2022 Jul 16;99(3):180-6. doi: 10.1136/sextrans-2022-055434.
Human papillomavirus (HPV) vaccines protect against incident HPV infections, which cause cervical cancer.
We estimated the prevalence and incidence of HPV infections in young adult women to understand the impact of an HPV vaccination programme in this population.
We collected cervical specimens from 6322 unvaccinated women, aged 18-37 years, who participated in the Costa Rica Vaccine Trial and its long-term follow-up. Women were followed for (median) 4.8 years and had (median) 4.0 study visits. Cervical specimens were tested for the presence/absence of 25 HPV genotypes. For each age band, we estimated the percentage of women with 1+ prevalent or 1+ incident HPV infections using generalised estimating equations. We also estimated the prevalence and incidence of HPV as a function of time since first sexual intercourse (FSI).
The model estimated HPV incident infections peaked at 28.0% (95% CI 25.3% to 30.9%) at age 20 years then steadily declined to 11.8% (95% CI 7.6% to 17.8%) at age 37 years. Incident oncogenic HPV infections (HPV16/18/31/33/35/39/45/51/52/56/58/59) peaked and then declined from 20.3% (95% CI 17.9% to 22.9%) to 7.7% (95% CI 4.4% to 13.1%); HPV16/18 declined from 6.4% (95% CI 5.1% to 8.1%) to 1.1% (95% CI 0.33% to 3.6%) and HPV31/33/45/52/58 declined from 11.0% (95% CI 9.3% to 13.1%) to 4.5% (95% CI 2.2% to 8.9%) over the same ages. The percentage of women with 1+ incident HPV of any, oncogenic, non-oncogenic and vaccine-preventable (HPV16/18, HPV31/33/45, HPV31/33/45/52/58, and HPV6/11) types peaked <1 year after FSI and steadily declined with increasing time since FSI (p for trends <0.001). We observed similar patterns for model estimated HPV prevalences.
Young adult women may benefit from HPV vaccination if newly acquired vaccine-preventable oncogenic infections lead to cervical precancer and cancer. HPV vaccination targeting this population may provide additional opportunities for primary prevention.
NCT00128661.
人乳头瘤病毒（HPV）疫苗可预防导致宫颈癌的HPV感染。
我们评估了年轻成年女性中HPV感染的患病率和发病率，以了解HPV疫苗接种计划对该人群的影响。
我们收集了参加哥斯达黎加疫苗试验及其长期随访的6322名18-37岁未接种疫苗女性的宫颈样本。女性随访时间（中位数）为4.8年，进行（中位数）4.0次研究访视。检测宫颈样本中25种HPV基因型的存在与否。对于每个年龄组，我们使用广义估计方程估计有1种或以上HPV感染的现患或新发感染女性的百分比。我们还估计了自首次性交（FSI）以来HPV的患病率和发病率。
模型估计HPV新发感染在20岁时达到峰值28.0%（95%CI 25.3%至30.9%），然后在37岁时稳步下降至11.8%（95%CI 7.6%至17.8%）。致癌性HPV新发感染（HPV16/18/31/33/35/39/45/51/52/56/58/59）达到峰值后下降，从20.3%（95%CI 17.9%至22.9%）降至7.7%（95%CI 4.4%至13.1%）；HPV16/18从6.4%（95%CI 5.1%至8.1%）降至1.1%（95%CI 0.33%至3.6%），HPV31/33/45/52/58在相同年龄范围内从11.0%（95%CI 9.3%至13.1%）降至4.5%（95%CI 2.2%至8.9%）。任何类型、致癌性、非致癌性和疫苗可预防（HPV16/18、HPV31/33/45、HPV31/33/45/52/58和HPV6/11）的1种或以上新发HPV感染女性的百分比在FSI后<1年达到峰值，并随着自FSI以来时间的增加而稳步下降（趋势p<0.001）。我们观察到模型估计的HPV患病率有类似模式。
如果新获得的疫苗可预防致癌性感染导致宫颈上皮内瘤变和癌症，年轻成年女性可能会从HPV疫苗接种中受益。针对该人群的HPV疫苗接种可能为一级预防提供更多机会。
NCT00128661。
