Changes in Cervical Human Papillomavirus (HPV) Prevalence at a Youth Clinic in Stockholm, Sweden, a Decade After the Introduction of the HPV Vaccine
Changes in Cervical Human Papillomavirus (HPV) Prevalence at a Youth Clinic in Stockholm, Sweden, a Decade After the Introduction of the HPV Vaccine
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DOI：
10.3389/fcimb.2019.00059
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发表时间：
2019-03-20
影响因子：
5.7
通讯作者：
Du, Juan
中科院分区：
文献类型：
--
作者：
Ahrlund-Richter, Andreas;Cheng, Liqin;Du, Juan
目的：本研究旨在跟踪2008-2018年间斯德哥尔摩市中心一家青年诊所中HPV感染和接种对妇女宫颈HPV高感染率的影响。背景：2008-2010年，斯德哥尔摩一家青年诊所未接种HPV的妇女宫颈HPV感染率(69.5%)和HPV16感染率(34.7%)都很高。2013-2015年，在引入四价Gardasil(R)HPV疫苗后，HPV16和HPV6的流行率有所下降。材料和方法：2017-2018年间，对来自15-23岁女性的178份宫颈拭子进行了27种HPV型别的检测。将2008年至2010年的615份样本和2013至2015年的338份样本的HPV感染数据与接种状况和年龄相关，以及与2003-2008年斯托克霍尔市143例宫颈癌病例的HPV类型进行比较。结果：接种疫苗的妇女比例从2008-2010年的10.7%上升到2017-2018年的82.1%。与未接种的女性相比，接种疫苗的女性所有27种HPV、所有高危HPV(HR-HPV)以及四价Gardasil(R)型HPV16、18、6和11型的患病率较低(分别为67.4vs.93.3%，p=0.0031，60.1vs.86.7%，p=0.0057和5.8vs.26.7%，p=0.002)。此外，2017年至2018年未接种疫苗的女性的HPV16型感染率低于2008年至2010年(分别为16.7%和34.7%，p=0.0471)，HPV18型和11型的趋势相似。在接种疫苗和未接种疫苗的女性中，最常见的非四价Gardasil(R)疫苗HR-HPV型为HPV39、51、52、56和59。2003-2008年间，四价Gardasil(R)疫苗共占斯德哥尔摩宫颈癌病例的9.8%，2017-2018年间其患病率较2008-2010年间有上升趋势。结论：四价Gardasil(R)疫苗接种显著降低了HPV疫苗类型的患病率。然而，斯德哥尔摩一家青年诊所的潜在高危女性中，非疫苗HR-HPV类型仍然很高。
Aim: This study aimed to follow the impact of human papillomavirus (HPV) catch-up and vaccination on the very high cervical HPV-prevalence in women at a youth clinic in central Stockholm during the period 2008-2018.Background: 2008-2010, cervical HPV-prevalence (69.5%) and HPV16 prevalence (34.7%) were high in non-vaccinated women at a youth clinic in Stockholm. 2013-2015, after the introduction of the quadrivalent-Gardasil (R) HPV-vaccine, HPV16 and HPV6 prevalence had decreased. Here, cervical HPV-prevalence was investigated 10 years after primary sampling.Material and Methods: 2017-2018, 178 cervical swabs, from women aged 15-23 years old, were tested for 27 HPV types by a bead-based multiplex method. HPV-prevalence data were then related to vaccination status and age and compared to HPV-prevalence in 615 samples from 2008 to 2010 and 338 samples from 2013 to 2015 from the same clinic, and to HPV types in 143 cervical cancer cases during 2003-2008 in Stockholm.Results: The proportion of vaccinated women increased from 10.7% (2008-2010) to 82.1%(2017-2018). The prevalence of all 27 HPVs, all high-risk HPVs (HR-HPVs) and the combined presence of the quadrivalent-Gardasil (R) types HPV16, 18, 6, and 11, was lower in vaccinated compared to unvaccinated women (67.4 vs. 93.3%, p = 0.0031, 60.1 vs. 86.7%, p = 0.0057 and 5.8 vs. 26.7%, p = 0.002, respectively). Furthermore, HPV16 prevalence in non-vaccinated women 2017-2018 was lower than that in 2008-2010 (16.7 and 34.7%, respectively, p = 0.0471) and similar trends were observed for HPV18 and 11. In both vaccinated and non-vaccinated women, the most common non-quadrivalent-Gardasil (R) vaccine HR-HPV types were HPV39, 51, 52, 56, and 59. Together they accounted for around 9.8% of cervical cancer cases in Stockholm during 2003-2008, and their prevalence tended to have increased during 2017-2018 compared to 2008-2010.Conclusion: Quadrivalent-Gardasil (R) vaccination has decreased HPV-vaccine type prevalence significantly. However, non-vaccine HR-HPV types remain high in potentially high-risk women at a youth clinic in Stockholm.