2018 - 2020年，华盛顿州西雅图市男男性行为者中按年龄、接种疫苗时的年龄以及接种疫苗时间相对于首次性行为年龄的HPV疫苗有效性

HPV Vaccine Effectiveness by Age, Age at Vaccination, and Timing of Vaccination Relative to Age at First Sex among Men who Have Sex with Men - Seattle, Washington, 2018-2020.

作者信息

Buchbinder Stephanie A, Lin John, Markowitz Lauri E, Hughes James P, Querec Troy D, Unger Elizabeth R, Dada Damilola, Iqbal Alfred, Golden Matthew R, Meites Elissa, DeSisto Carla L, Winer Rachel L

机构信息

Department of Epidemiology, University of Washington, Seattle, WA.

Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA.

出版信息

Sex Transm Dis. 2025 Jun 2. doi: 10.1097/OLQ.0000000000002192.

DOI:10.1097/OLQ.0000000000002192

PMID:40454692

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12258699/

Abstract

BACKGROUND

We evaluated human papillomavirus (HPV) vaccine effectiveness (VE) against prevalent anal HPV among men who have sex with men (MSM) by age, age at vaccination, and age at vaccination relative to age at first sex.

METHODS

Residual anal specimens from 1092 MSM ages 18-45 years attending a Seattle, Washington sexual health clinic in 2018-2020 were tested for 28 HPV types. Demographic, clinical, sexual behavioral, and HPV vaccination data were extracted from clinic and electronic medical records. We calculated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between vaccination (≥1 dose of any HPV vaccine) and quadrivalent HPV vaccine (4vHPV)-type infection, by age group (18-26, 27-35, 36-45 years), vaccination age (among age groups 18-26, 27-35 years) and vaccination age relative to first sex (among those 18-26 years). Analyses were adjusted for race and ethnicity, pre-exposure prophylaxis use for HIV prevention, and lifetime number of sex partners. VE was calculated as (1-aPR)x100.

RESULTS

Among persons aged 18-26 years, 4vHPV-type HPV prevalence was lower among those vaccinated before first sex (aPR = 0.12[95%CI:0.02-0.87]; VE = 88%) or at <18 years of age (aPR = 0.22[95%CI:0.07-0.68]; VE = 78%) versus unvaccinated, but no VE was observed in those vaccinated at 18-26 years. Among persons aged 27-35 years, 4vHPV-type HPV prevalence was lower among those vaccinated at 18-26 years versus unvaccinated (aPR = 0.56[95%CI:0.36-0.87]; VE = 44%). No VE was observed in persons aged 27-35 or 36-45 years who were vaccinated at >26 years.

CONCLUSIONS

Results highlight the importance of routine HPV vaccination in adolescence and support efforts to increase catch-up vaccination among MSM.

摘要

背景

我们根据年龄、接种疫苗时的年龄以及接种疫苗时的年龄相对于首次性行为时的年龄，评估了人乳头瘤病毒（HPV）疫苗对男男性行为者（MSM）中普遍存在的肛门HPV的有效性（VE）。

方法

对2018 - 2020年在华盛顿州西雅图一家性健康诊所就诊的1092名年龄在18 - 45岁的男男性行为者的剩余肛门标本进行了28种HPV类型的检测。从诊所和电子病历中提取了人口统计学、临床、性行为和HPV疫苗接种数据。我们计算了按年龄组（18 - 26岁、27 - 35岁、36 - 45岁）、接种疫苗年龄（在18 - 26岁、27 - 35岁年龄组中）以及接种疫苗年龄相对于首次性行为的年龄（在18 - 26岁人群中）划分的接种疫苗（任何HPV疫苗≥1剂）与四价HPV疫苗（4vHPV）型感染之间关联的调整患病率比（aPRs）和95%置信区间（CIs）。分析对种族和族裔、用于预防HIV的暴露前预防措施的使用情况以及性伴侣的终身数量进行了调整。VE计算为（1 - aPR）×100。

结果

在18 - 26岁的人群中，在首次性行为前接种疫苗者（aPR = 0.12[95%CI：0.02 - 0.87]；VE = 88%）或18岁之前接种疫苗者（aPR = 0.22[95%CI：0.07 - 0.68]；VE = 78%）中，4vHPV型HPV患病率低于未接种疫苗者，但在18 - 26岁接种疫苗者中未观察到VE。在27 - 35岁的人群中，18 - 26岁接种疫苗者的4vHPV型HPV患病率低于未接种疫苗者（aPR = 0.56[95%CI：0.36 - 0.87]；VE = 44%）。在27 - 35岁或36 - 45岁且在26岁之后接种疫苗的人群中未观察到VE。