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Roteli-Martins CM, Magno V, Santos ALF, Teixeira JC, Nilma AN, Fialho SCAV. Human papillomavirus vaccination for adult women. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:631-635. [PMID: 35820426 PMCID: PMC9948262 DOI: 10.1055/s-0042-1751331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Valentino Magno
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Batmunkh T, Dalmau MT, Munkhsaikhan ME, Khorolsuren T, Namjil N, Surenjav U, Toh ZQ, Licciardi PV, Russell FM, Garland SM, Mulholland K, von Mollendorf C. A single dose of quadrivalent human papillomavirus (HPV) vaccine is immunogenic and reduces HPV detection rates in young women in Mongolia, six years after vaccination. Vaccine 2020; 38:4316-4324. [PMID: 32387009 PMCID: PMC7254061 DOI: 10.1016/j.vaccine.2020.04.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/13/2020] [Accepted: 04/16/2020] [Indexed: 12/12/2022]
Abstract
Background Emerging observational evidence suggests a single-dose of human papillomavirus (HPV) vaccine may be protective against vaccine-targeted HPV infection and associated cervical dysplasia. We aimed to demonstrate whether a single dose of quadrivalent HPV (4vHPV) vaccine was immunogenic and reduced HPV detection rates in young women in Mongolia. We also assessed knowledge and attitudes regarding HPV and the HPV vaccine. Methods A retrospective paired cohort study was undertaken to evaluate the effect of a single dose of 4vHPV, given at age 11–17 years in 2012, on HPV detection rates, when compared with unvaccinated women. Real time PCR was performed on self-administered vaginal swabs for HPV detection. An immunological analysis detecting neutralising antibodies (NAb) to high-risk HPV (HRHPV) genotypes 16 and 18 was performed on sera from a subset of 58 participants. Questionnaires evaluated knowledge, attitudes and self-swab acceptability. Findings A total of 475 women (mean age 20.4 years ± 1.6) were recruited; 118 vaccinated and 357 unvaccinated women. The prevalence of vaccine-targeted HRHPV16 and 18 was reduced by 92% (95%CI 44–99%) in the vaccinated (1·1%) compared with the unvaccinated (15.4%) group. The percentage of non-vaccine HPV genotypes was similar between vaccinated (26.5%) and unvaccinated (26.7%) groups. Approximately 90% and 58% of vaccinated women remained seropositive after six years for HRHPV16 and 18, respectively, with neutralising antibody levels 5- and 2-fold higher than unvaccinated women (p < 0.001). Interpretation One dose of 4vHPV vaccine reduces vaccine-targeted HPV genotypes, six years following vaccination, with high levels of HR genotype seropositivity among young Mongolian women.
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Affiliation(s)
- Tsetsegsaihan Batmunkh
- National Cancer Council of Mongolia, #101, Oyutnii khotkhon 68/1, Bayanzurkh district, Ulaanbaatar, Mongolia.
| | - Marguerite T Dalmau
- National Cancer Council of Mongolia, #101, Oyutnii khotkhon 68/1, Bayanzurkh district, Ulaanbaatar, Mongolia
| | - Margad-Erdene Munkhsaikhan
- National Cancer Council of Mongolia, #101, Oyutnii khotkhon 68/1, Bayanzurkh district, Ulaanbaatar, Mongolia
| | - Tungalagtuya Khorolsuren
- National Cancer Council of Mongolia, #101, Oyutnii khotkhon 68/1, Bayanzurkh district, Ulaanbaatar, Mongolia
| | - Narantuya Namjil
- Onoshmed Laboratory, Khatagtai Hospital, Sukhbaatar District, Ulaanbaatar, Mongolia
| | | | - Zheng Quan Toh
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia
| | - Paul V Licciardi
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia
| | - Fiona M Russell
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia
| | - Suzanne M Garland
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Centre for Women's Infectious Diseases Research, Royal Women's Hospital, Parkville, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Melbourne, Australia
| | - Kim Mulholland
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Claire von Mollendorf
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia
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Batmunkh T, von Mollendorf C, Tulgaa K, Surenjav U, Dalmau MT, Namjil N, Tsedevdamba B, Tsegmed S, Enkhmaa J, Garland SM, Mulholland K. HPV genoprevalence and HPV knowledge in young women in Mongolia, five years following a pilot 4vHPV vaccination campaign. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2019; 8:100175. [PMID: 31276802 PMCID: PMC6658929 DOI: 10.1016/j.pvr.2019.100175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND In a 2012 pilot, 9111 Mongolian girls aged 11-17 years received three doses of the quadrivalent (4vHPV) vaccine, Gardasil®. This is the first study to measure early vaccine effectiveness and assess knowledge and attitudes of young women in Mongolia in relation to the human papillomavirus (HPV), the vaccine and cervical cancer. METHODS A cohort of women vaccinated in 2012 (n = 726) and an unvaccinated cohort (n = 790) provided self-administered vaginal swabs for detection of high-risk HPV genotypes 16, 18/45, 31, 33, 35, 39, 51, 52, 56, 58, 59, 66, 68 five years following vaccination. Participant knowledge and attitudes were assessed through a questionnaire. RESULTS A total of 1882 questionnaires and 1516 self-administered vaginal swabs were analyzed. The prevalence of any HRHPV was 39.5% among both cohorts. The prevalence of vaccine-targeted HPV types was significantly lower in the vaccinated cohort than unvaccinated: 4.8% and 17.2% respectively. The 4vHPV was shown to be protective against HRHPV 16, 18/45 with 75% vaccine effectiveness. Participant knowledge was low. CONCLUSIONS This study demonstrates that the 4vHPV is associated with reduced vaccine-targeted HPV detection rates in young Mongolian women. The questionnaire results highlight a need for awareness-raising initiatives in Mongolia on HPV, the vaccine and cervical cancer.
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Affiliation(s)
- Tsetsegsaikhan Batmunkh
- National Cancer Council of Mongolia, #101, Oyutnii Khotkhon 68/1, Bayanzurkh District, Ulaanbaatar, Mongolia.
| | - Claire von Mollendorf
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia
| | - Khosbayar Tulgaa
- Mongolian National University of Medical Sciences, Jamyan Street 3, Ulaanbaatar, Mongolia
| | | | - Marguerite T Dalmau
- National Cancer Council of Mongolia, #101, Oyutnii Khotkhon 68/1, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Narantuya Namjil
- Onoshmed Laboratory, Khatagtai Hospital, Sukhbaatar District, Ulaanbaatar, Mongolia
| | - Battsetseg Tsedevdamba
- National Cancer Council of Mongolia, #101, Oyutnii Khotkhon 68/1, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Sambuu Tsegmed
- National Center for Public Health, Olympic Street 2, Ulaanbaatar, Mongolia
| | - Jalserd Enkhmaa
- Mongolian National University of Medical Sciences, Jamyan Street 3, Ulaanbaatar, Mongolia
| | - Suzanne M Garland
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Centre for Women's Infectious Diseases Research, Royal Women's Hospital, Parkville, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Melbourne, Australia
| | - Kim Mulholland
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Borgogna JC, Shardell MD, Santori EK, Nelson TM, Rath JM, Glover ED, Ravel J, Gravitt PE, Yeoman CJ, Brotman RM. The vaginal metabolome and microbiota of cervical HPV-positive and HPV-negative women: a cross-sectional analysis. BJOG 2019; 127:182-192. [PMID: 31749298 DOI: 10.1111/1471-0528.15981] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Characterise the vaginal metabolome of cervical HPV-infected and uninfected women. DESIGN Cross-sectional. SETTING The Center for Health Behavior Research at the University of Maryland School of Public Health. SAMPLE Thirty-nine participants, 13 categorised as HPV-negative and 26 as HPV-positive (any genotype; HPV+ ), 14 of whom were positive with at least one high-risk HPV strain (hrHPV). METHOD Self-collected mid-vaginal swabs were profiled for bacterial composition by 16S rRNA gene amplicon sequencing, metabolites by both gas and liquid chromatography mass spectrometry, and 37 types of HPV DNA. MAIN OUTCOME MEASURES Metabolite abundances. RESULTS Vaginal microbiota clustered into Community State Type (CST) I (Lactobacillus crispatus-dominated), CST III (Lactobacillus iners-dominated), and CST IV (low-Lactobacillus, 'molecular-BV'). HPV+ women had higher biogenic amine and phospholipid concentrations compared with HPV- women after adjustment for CST and cigarette smoking. Metabolomic profiles of HPV+ and HPV- women differed in strata of CST. In CST III, there were higher concentrations of biogenic amines and glycogen-related metabolites in HPV+ women than in HPV- women. In CST IV, there were lower concentrations of glutathione, glycogen, and phospholipid-related metabolites in HPV+ participants than in HPV- participants. Across all CSTs, women with hrHPV strains had lower concentrations of amino acids, lipids, and peptides compared with women who had only low-risk HPV (lrHPV). CONCLUSIONS The vaginal metabolome of HPV+ women differed from HPV- women in terms of several metabolites, including biogenic amines, glutathione, and lipid-related metabolites. If the temporal relation between increased levels of reduced glutathione and oxidised glutathione and HPV incidence/persistence is confirmed in future studies, anti-oxidant therapies may be considered as a non-surgical HPV control intervention. TWEETABLE ABSTRACT Metabolomics study: Vaginal microenvironment of HPV+ women may be informative for non-surgical interventions.
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Affiliation(s)
- J C Borgogna
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - M D Shardell
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - E K Santori
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - T M Nelson
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA.,Department of Animal and Range Sciences, Montana State University, Bozeman, MT, USA
| | - J M Rath
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, College Park, MD, USA.,Truth Initiative, Washington, DC, USA
| | - E D Glover
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, College Park, MD, USA
| | - J Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - P E Gravitt
- Department of Global Health, George Washington University, Washington, DC, USA
| | - C J Yeoman
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA.,Department of Animal and Range Sciences, Montana State University, Bozeman, MT, USA
| | - R M Brotman
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
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