do Nascimento Glauciane Resende, da Silva Santos Ana Carolina, Silva Nayara Nascimento Toledo, Guilmarães Nathalia Sernizon, Lima Angélica Alves, Coura-Vital Wendel
Programa de Pós-graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil.
BMC Infect Dis. 2025 Jan 28;25(1):131. doi: 10.1186/s12879-025-10520-6.
Human Papillomavirus (HPV) is the most common sexually transmitted lower genital tract infection worldwide and the main etiological factor of cervical cancer (CC). Since 2006, vaccines have been implemented to reduce CC-related morbidity and mortality. This systematic review and meta-analysis aimed to evaluate the prevalence of cervical infections by non-vaccine high-risk HPV (HR-HPV) types in women vaccinated against types 16 and 18.
This systematic review and meta-analysis used independent electronic databases - Lilacs, WHO, BDENF, State Department of Health SP, Health Information Locator, IRIS, Coleciona Sistema Único de Saúde, BINACIS, IBECS, CUMED and SciELO, on July 14, 2023. Observational studies that evaluated vaccinated and unvaccinated women against HR-HPV and the prevalence of cervical infection by types of HR-HPV were included. Intervention effects were expressed as prevalence ratios (PR). Forest plots were used to visualize vaccination effects. The study protocol was previously registered in PROSPERO, under code CRD42023440610.
Of the 7,051 studies, 31 met the analysis criteria. A total of 59,035 women were eligible for this systematic review. The results showed a high prevalence of non-vaccine HR-HPV types, regardless of vaccination status. For HPV 31/33/45 (PR = 0.60 [0.40-0.91]), HPV31 (PR = 0.47 [0.31-0.72]), and HPV 45 (PR = 0.38 [0.22-0.69]), a positive random effect was found.
The prevalence of non-vaccine HR-HPV cervical infection was high in women, regardless of vaccination status. For HPV types 31 and 45 and 31/33/45, the prevalence was lower in vaccinated women, suggesting a cross-protective effect of vaccines for these viral types.
人乳头瘤病毒（HPV）是全球最常见的性传播下生殖道感染，也是宫颈癌（CC）的主要病因。自2006年以来，已实施疫苗接种以降低与CC相关的发病率和死亡率。本系统评价和荟萃分析旨在评估接种16型和18型疫苗的女性中未接种疫苗的高危HPV（HR-HPV）类型引起的宫颈感染患病率。
本系统评价和荟萃分析于2023年7月14日使用独立的电子数据库——Lilacs、世界卫生组织、巴西数字健康图书馆、圣保罗州卫生部、健康信息定位器、IRIS、统一卫生系统文献数据库、巴西综合卫生信息系统、巴西卫生经济与成本效益分析信息库、巴西电子健康记录信息系统、CUMED和科学电子图书馆在线。纳入评估接种和未接种HR-HPV疫苗的女性以及按HR-HPV类型划分的宫颈感染患病率的观察性研究。干预效果以患病率比（PR）表示。森林图用于直观显示疫苗接种效果。该研究方案先前已在国际前瞻性系统评价注册库（PROSPERO）中注册，注册号为CRD42023440610。
在7051项研究中，31项符合分析标准。共有59035名女性符合本系统评价的条件。结果显示，无论疫苗接种状况如何，未接种疫苗的HR-HPV类型的患病率都很高。对于HPV 31/33/45（PR = 0.60 [0.40 - 0.91]）、HPV31（PR = 0.47 [0.31 - 0.72]）和HPV 45（PR = 0.38 [0.22 - 0.69]），发现有正向随机效应。
无论疫苗接种状况如何，女性中未接种疫苗的HR-HPV宫颈感染患病率都很高。对于HPV 31型和45型以及31/33/45型，接种疫苗的女性患病率较低，这表明疫苗对这些病毒类型有交叉保护作用。
