Bowden Sarah J, Ellis Laura Burney, Kyrgiou Maria, Fiander Alison N, Hibbitts Samantha
IRDB, Imperial College London, London W12 0NN, UK.
School of Medicine, Cardiff University, Cardiff CF14 4XN, UK.
Vaccines (Basel). 2022 Oct 20;10(10):1754. doi: 10.3390/vaccines10101754.
Human papillomavirus (HPV) is detected in 99.7% of cervical cancers. Current vaccines target types 16 and 18. Prior to vaccination implementation, a prospective cohort study was conducted to determine baseline HPV prevalence in unvaccinated women in Wales; after HPV16 and HPV18, HPV 51 was found to be most prevalent. This study aimed to re-assess the unexpected high prevalence of HPV 51 and consider its potential for type-replacement. Two hundred HPV 51 positive samples underwent re-analysis by repeating the original methodology using HPV 51 GP5+/6+ PCR-enzyme immunoassay, and additionally a novel assay of HPV 51 E7 PCR. Data were correlated with age, social deprivation and cytology. Direct repeat of HPV 51 PCR-EIA identified 146/195 (75.0%) samples as HPV 51 positive; E7 PCR identified 166/195 (85.1%) samples as HPV 51 positive. HPV 51 prevalence increased with cytological grade. The prevalence of HPV 51 in the pre-vaccinated population was truly high. E7 DNA assays may offer increased specificity for HPV genotyping. Cross-protection of current vaccines against less-prevalent HPV types warrants further study. This study highlights the need for longitudinal investigation into the prevalence of non-vaccine HPV types, especially those phylogenetically different to vaccine types for potential type-replacement. Ongoing surveillance will inform future vaccines.
99.7%的宫颈癌中可检测到人乳头瘤病毒（HPV）。目前的疫苗针对16型和18型。在疫苗接种实施之前，进行了一项前瞻性队列研究以确定威尔士未接种疫苗女性的HPV基线流行率；在HPV16和HPV18之后，发现HPV 51最为流行。本研究旨在重新评估HPV 51意外的高流行率，并考虑其进行型别替代的可能性。通过使用HPV 51 GP5+/6+ PCR酶免疫测定重复原始方法，对200份HPV 51阳性样本进行重新分析，此外还采用了一种新的HPV 51 E7 PCR检测方法。数据与年龄、社会剥夺程度和细胞学相关。HPV 51 PCR-EIA的直接重复检测确定146/195（75.0%）份样本为HPV 51阳性；E7 PCR确定166/195（85.1%）份样本为HPV 51阳性。HPV 51流行率随细胞学分级增加。疫苗接种前人群中HPV 51的流行率确实很高。E7 DNA检测可能会提高HPV基因分型的特异性。目前疫苗对较不流行的HPV型别的交叉保护值得进一步研究。本研究强调需要对非疫苗HPV型别的流行率进行纵向调查，尤其是那些在系统发育上与疫苗型别不同的型别，以了解其进行型别替代的可能性。持续的监测将为未来的疫苗提供信息。
