Su Yingying, Zheng Tingquan, Bi Zhaofeng, Jia Xinhua, Li Yufei, Kuang Xuefeng, Yang Yuan, Chen Qi, Lin Hongyan, Huang Yue, Huang Shoujie, Qiao Youlin, Wu Ting, Zhang Jun, Xia Ningshao
State Key Laboratory of Vaccines for Infectious Diseases, Xiang an Biomedicine Laboratory, School of Public Health, Xiamen University, Xiamen, China.
National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, Xiamen University, Xiamen, China.
Hum Vaccin Immunother. 2024 Dec 31;20(1):2334474. doi: 10.1080/21645515.2024.2334474. Epub 2024 Apr 15.
To assess the pattern of multiple human papillomavirus infection to predict the type replacement postvaccination. A total of 7372 women aged 18-45y from a phase III trial of an -produced HPV-16/18 vaccine were analyzed at enrollment visit before vaccination. Hierarchical multilevel logistic regression was used to evaluate HPV vaccine type and nonvaccine-type interactions with age as a covariate. Binary logistic regression was construed to compare multiple infections with single infections to explore the impact of multiple-type infections on the risk of cervical disease. Multiple HPV infections were observed in 25.2% of HPV-positive women and multiple infections were higher than expected by chance. Statistically significant negative associations were observed between HPV16 and 52, HPV18 and HPV51/52/58, HPV31 and HPV39/51/52/53/54/58, HPV33 and HPV52/58, HPV58 and HPV52, HPV6 and HPV 39/51/52/53/54/56/58. Multiple HPV infections increased the risk of CIN2+ and HSIL+, with the ORs of 2.27(95%CI: 1.41, 3.64) and 2.26 (95%CI: 1.29, 3.95) for multiple oncogenic HPV infection separately. However, no significant evidence for the type-type interactions on risk of CIN2+ or HSIL+. There is possibility of type replacement between several pairs of vaccine and nonvaccine HPV type. Multiple HPV infection increased the risk of cervical disease, but coinfection HPV types seem to follow independent disease processes. Continued post-vaccination surveillance for HPV 51/52/58 types and HPV 39/51 types separately was essential after the first and second generation of HPV vaccination implementation in China.
评估多重人乳头瘤病毒感染模式，以预测接种疫苗后的型别替代情况。对来自一种国产HPV-16/18疫苗III期试验的7372名18至45岁女性在接种疫苗前的入组访视时进行了分析。采用分层多级逻辑回归，以年龄作为协变量，评估HPV疫苗型别和非疫苗型别之间的相互作用。构建二元逻辑回归以比较多重感染与单一感染，探讨多重型别感染对宫颈疾病风险的影响。在25.2%的HPV阳性女性中观察到多重HPV感染，且多重感染高于偶然预期。在HPV16与52、HPV18与HPV51/52/58、HPV31与HPV39/51/52/53/54/58、HPV33与HPV52/58、HPV58与HPV52、HPV6与HPV 39/51/52/53/54/56/58之间观察到具有统计学意义的负相关。多重HPV感染增加了CIN2+和HSIL+的风险，多重致癌性HPV感染的OR分别为2.27(95%CI: 1.41, 3.64)和2.26(95%CI: 1.29, 3.95)。然而，没有显著证据表明型别间相互作用对CIN2+或HSIL+风险有影响。在几对疫苗型和非疫苗型HPV型别之间存在型别替代的可能性。多重HPV感染增加了宫颈疾病的风险，但合并感染的HPV型别似乎遵循独立的疾病进程。在中国第一代和第二代HPV疫苗接种实施后，分别持续对接种后HPV 51/52/58型别和HPV 39/51型别进行监测至关重要。
