Song Heekyoung, Lee Sanha, Choi Suein, Hur Soo Young
Department of Obstetrics and Gynecology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 21431, Republic of Korea.
Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Cancers (Basel). 2025 Aug 3;17(15):2561. doi: 10.3390/cancers17152561.
BACKGROUND/OBJECTIVES: This study evaluated the real-world effectiveness of prophylactic Human Papillomavirus (HPV) vaccination in Korean women aged over 26 years, focusing on its impact on persistent HPV infection and disease progression.
This multicenter prospective study analyzed data from the Korea HPV Cohort (2010-2021). After applying exclusion criteria, the final analytical cohort included 1,231 women aged ≥ 27 years with cytologic findings of atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions and HPV infection. Propensity score matching was used to compare vaccinated ( = 340) and unvaccinated ( = 891) participants. After matching, 273 vaccinated and 273 unvaccinated individuals were included in the final analysis. The primary outcomes were persistent HPV infection and progression to biopsy-confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Logistic and Cox regression models were employed, with additional age-stratified analyses.
Among women aged 27-39 years, vaccination was significantly associated with a 54% reduction in the odds of persistent HPV infection (odds ratio = 0.46; 95% CI: 0.22-0.96; = 0.040). In the full cohort, vaccinated participants had a 62% lower risk of progression to CIN2+ compared with unvaccinated participants (hazard ratio = 0.38; 95% CI: 0.18-0.81; = 0.011). Body mass index had a notable impact on HPV persistence in HPV 16/18 genotype groups.
HPV vaccination effectively reduced persistent infection and progression to CIN2+ in Korean women, particularly those vaccinated before age 40. These findings support the age-extended HPV vaccination policies in South Korea.
背景/目的：本研究评估了预防性人乳头瘤病毒（HPV）疫苗接种在26岁以上韩国女性中的实际效果，重点关注其对持续性HPV感染和疾病进展的影响。
这项多中心前瞻性研究分析了韩国HPV队列（2010 - 2021年）的数据。应用排除标准后，最终分析队列包括1231名年龄≥27岁、细胞学检查结果为意义不明确的非典型鳞状细胞/低级别鳞状上皮内病变且伴有HPV感染的女性。采用倾向得分匹配法比较接种疫苗（n = 340）和未接种疫苗（n = 891）的参与者。匹配后，273名接种疫苗者和273名未接种疫苗者纳入最终分析。主要结局为持续性HPV感染以及进展为活检确诊的宫颈上皮内瘤变2级或更严重病变（CIN2+）。采用逻辑回归和Cox回归模型，并进行额外的年龄分层分析。
在27 - 39岁的女性中，接种疫苗与持续性HPV感染几率降低54%显著相关（优势比 = 0.46；95%置信区间：0.22 - 0.96；P = 0.040）。在整个队列中，与未接种疫苗的参与者相比，接种疫苗的参与者进展为CIN2+的风险低62%（风险比 = 0.38；95%置信区间：0.18 - 0.81；P = 0.011）。体重指数对HPV 16/18基因型组中的HPV持续性有显著影响。
HPV疫苗接种有效降低了韩国女性的持续性感染和进展为CIN2+的风险，尤其是40岁之前接种疫苗的女性。这些发现支持了韩国扩大年龄范围的HPV疫苗接种政策。
