Santos Ana Carolina da Silva, Silva Nayara Nascimento Toledo, da Silva Ismael Dale Cotrim Guerreiro, Carneiro Mariângela, Coura-Vital Wendel, Lima Angélica Alves
Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto (UFOP), Campus Universitário, Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35402-163, Brazil.
Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, Minas Gerais, Brazil.
BMC Infect Dis. 2025 Jan 20;25(1):88. doi: 10.1186/s12879-024-10284-5.
Globally, cervical cancer is an increasing public health issue, and vaccination against HPV has proven to be an effective strategy to reduce this neoplasia. The purpose of this study was to assess the effectiveness of the quadrivalent vaccine in reducing the prevalence and incidence of HPV infection in women, aged 18 to 24 years old, in the cities of Ouro Preto and Mariana, Minas Gerais, Brazil.
A concurrent cohort study was performed, with an initial follow-up of 12 to 18 months. The selected young women were interviewed and divided into two groups: vaccinated and unvaccinated. Participants underwent a Pap smear and cervical sample collection for HPV detection, genotyping performed by PCR-RFLP, type-specific PCR, and using the PapilloCheck®. The prevalence of HPV infection was analyzed using the compare proportions test. Poisson and Cox multivariate regression models were used to estimate vaccine effectiveness.
There was no significant difference in the overall prevalence of HPV infection between vaccinated and unvaccinated groups (23.6% vs. 18.7%; p = 0.364). However, the prevalence of infection by HPV 6/11, 16 and 18 types in vaccinated young women (1.1%) was lower than in unvaccinated ones (7.5%; p = 0.030). Regarding non-vaccine types, a higher prevalence was identified among vaccinated women (22.5% vs. 11.2%; p = 0.018). The overall incidence of HPV infection was 15.75/100 young women/year in non-immunized women compared to 9.12/100 young women/year among those immunized. The effectiveness of the vaccine was 64.0%, regardless of the viral type, and no vaccinated woman was detected with the specific vaccine HPV-type in follow-up. HPV33/45, related to cross-protection, were detected in 12.3% of vaccinated women and 1.2% of unvaccinated ones (p < 0.001) at baseline. These viral types were identified at follow-up in 2.03/100 young women/year of vaccinated participants and 4.24/100 young women/year of unvaccinated ones.
The results showed that the quadrivalent HPV vaccine was effective in reducing the prevalence of vaccine-type HPV and the incidence of infection by any HPV type. Public health policies must encourage vaccination to prevent HPV infection. However, surveillance of HPV infection should be continued to assess the prevalence of different genotypes and the impact of the vaccination program.
在全球范围内，宫颈癌是一个日益严重的公共卫生问题，而人乳头瘤病毒（HPV）疫苗接种已被证明是降低这种肿瘤发生的有效策略。本研究的目的是评估四价疫苗在巴西米纳斯吉拉斯州欧鲁普雷图市和马里亚纳市18至24岁女性中降低HPV感染患病率和发病率的有效性。
进行了一项同期队列研究，初始随访时间为12至18个月。对选定的年轻女性进行访谈并分为两组：接种疫苗组和未接种疫苗组。参与者接受巴氏涂片检查和宫颈样本采集以检测HPV，通过聚合酶链反应-限制性片段长度多态性（PCR-RFLP）、型特异性PCR以及使用PapilloCheck®进行基因分型。使用比较比例检验分析HPV感染的患病率。采用泊松和Cox多变量回归模型估计疫苗有效性。
接种疫苗组和未接种疫苗组之间HPV感染的总体患病率无显著差异（23.6%对18.7%；p = 0.364）。然而，接种疫苗的年轻女性中HPV 6/11、16和18型感染的患病率（1.1%）低于未接种疫苗的女性（7.5%；p = 0.030）。关于非疫苗型，接种疫苗的女性中患病率更高（22.5%对11.2%；p = 0.018）。未免疫女性中HPV感染的总体发病率为15.75/100名年轻女性/年，而免疫女性中为9.12/100名年轻女性/年。无论病毒类型如何，疫苗的有效性为64.0%，且在随访中未检测到接种疫苗的女性感染特定的疫苗HPV型。在基线时，与交叉保护相关的HPV33/45在12.3%的接种疫苗女性和1.2%的未接种疫苗女性中被检测到（p < 0.001）。在随访中，这些病毒类型在接种疫苗参与者中以2.03/100名年轻女性/年的比例被识别，在未接种疫苗者中以4.24/100名年轻女性/年的比例被识别。
结果表明，四价HPV疫苗在降低疫苗型HPV的患病率和任何HPV型感染的发病率方面是有效的。公共卫生政策必须鼓励接种疫苗以预防HPV感染。然而，应继续监测HPV感染，以评估不同基因型的患病率和疫苗接种计划的影响。
