Reduction in HPV 16/18 prevalence among young women following HPV vaccine introduction in a highly vaccinated district, Japan, 2008-2017.
Reduction in HPV 16/18 prevalence among young women following HPV vaccine introduction in a highly vaccinated district, Japan, 2008-2017.
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DOI：
10.2185/jrm.2986
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发表时间：
2019-05-01
期刊：
影响因子：
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通讯作者：
Nagao, Daisuke
中科院分区：
文献类型：
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作者：
Karube, Akihiro;Saito, Fumiko;Nagao, Daisuke
目的：人乳头状瘤病毒(HPV)疫苗接种作为针对12-16岁女孩的国家免疫计划于2013年4月在日本推出，2010年作为一项针对13-16岁女孩的公共援助计划首次引入。由于最初的公共援助计划，2017年，Yuri-Honjo区在17-51岁女性中的疫苗覆盖率最高。这项研究的目的是评估2008-2012年(疫苗前时代)和2013-2017年(疫苗时代)HPV16/18感染疫苗类型的差异。材料和方法：我们评估了接种HPV疫苗是否与降低HPV16/18和高危HPV的患病率以及HPV相关宫颈病变的发生率有关。2008年6月至2017年12月，共有1,342名年龄在18-49岁之间、涵盖疫苗前和疫苗接种时代的女性来到Yuri Kumiai综合医院接受HPV基因测试。结果：在接种疫苗覆盖率较高的18-24岁妇女中(68.2%)，HPV16/18和高危HPV16/18和高危HPV的流行率分别从接种前的36.7%和69.4%下降到接种前的5.8%和50.0%(p=0.00013和p=0.047)。在宫颈上皮内瘤变2级和2+级患者中，HPV16/18感染率分别从30.0%降至2.7%(p=0.0018)和从81.8%降至36.4%(p=0.030)。在这一年龄段中，HPV16/18阳性率显著下降。在疫苗覆盖率较低的年龄组中，两个时代的HPV流行率没有显著差异。结论：18~24岁女性中HPV16/18和高危型HPV的感染率显著下降，且大多数女性接种了疫苗。接种HPV疫苗有效地降低了Yuri-Honjo区HPV16/18感染的流行率。
Objective: Human papillomavirus (HPV) vaccination was introduced in Japan in April 2013, as a national immunization program for girls aged 12-16 years, after an initial introduction in 2010 as a public-aid program for girls aged 13-16 years. The Yuri-Honjo district had the highest vaccine coverage among women aged 17-51 years in 2017, due to the original public-aid program. The aim of this study was to evaluate the differences in the vaccine types of HPV16/18 infections between 2008-2012 (pre-vaccine era) and 2013-2017 (vaccine era). Materials and Methods: We evaluated whether HPV vaccination was associated with a decrease in the prevalence of HPV16/18 and high-risk HPV and the incidence of HPV-associated cervical lesions. A total of 1,342 women aged 18-49 years, covering both the pre-vaccine and vaccine eras, who visited Yuri Kumiai General Hospital and underwent HPV genotype tests from June 2008 to December 2017 were compared. Results: Among women aged 18-24 years with higher vaccine coverage (68.2%), the prevalence of HPV16/18 and high-risk HPV decreased from 36.7% and 69.4%, respectively, in the pre-vaccine era to 5.8% and 50.0%, respectively, in the vaccine era (p=0.00013 and p=0.047, respectively). Among those with cervical intraepithelial neoplasia grade 2- and grade 2+, HPV16/18 prevalence decreased from 30.0% to 2.7% (p=0.0018) and from 81.8% to 36.4% (p=0.030), respectively. In this age group, the rate of HPV16/18 positivity decreased significantly. Among age groups with lower vaccine coverage, HPV prevalence did not significantly differ between the two eras. Conclusion: The prevalence of HPV16/18 and high-risk HPV significantly decreased in women aged 18-24 years, most of whom were vaccinated. HPV vaccination effectively reduced the prevalence of HPV16/18 infections in the Yuri-Honjo district.