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Wang WV, Kothari S, Skufca J, Giuliano AR, Sundström K, Nygård M, Koro C, Baay M, Verstraeten T, Luxembourg A, Saah AJ, Garland SM. Real-world impact and effectiveness of the quadrivalent HPV vaccine: an updated systematic literature review. Expert Rev Vaccines 2022; 21:1799-1817. [PMID: 36178094 DOI: 10.1080/14760584.2022.2129615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Human papillomavirus (HPV) infection, which poses significant disease burden, is decreasing following implementation of vaccination programs. Synthesized evidence on HPV vaccine real-world benefit was published in 2016. However, long-term impact of vaccination, and how vaccination programs influence infection rates and disease outcomes, requires further examination. AREAS COVERED We systematically reviewed observational studies on HPV vaccination within MEDLINE, EMBASE, and Google Scholar from 2016 to 2020, involving 14 years of follow-up data. We identified 138 peer-reviewed publications reporting HPV vaccine impact or effectiveness. Outcomes of interest included rates of infection at different anatomical sites and incidence of several HPV-related disease endpoints. EXPERT OPINION The expansion of HPV vaccination programs worldwide has led to a reduction in genital infection and significant decreases in incidence of HPV-related disease outcomes. Therefore, the WHO has set goals for the elimination of cervical cancer as a public health concern. To track progress toward this requires an understanding of the effectiveness of different vaccination initiatives. However, the impact on males, and potential benefit of gender-neutral vaccination programs have not been fully explored. To present an accurate commentary on the current outlook of vaccination and to help shape policy therefore requires a systematic review of available data.
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Affiliation(s)
- Wei Vivian Wang
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme LLC, Rahway, NJ, USA
| | - Smita Kothari
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme LLC, Rahway, NJ, USA
| | - Jozica Skufca
- Epidemiology & Pharmacovigilance, P95, Leuven, Belgium
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL USA
| | - Karin Sundström
- Department of Laboratory Medicine, Karolinska Institutet, Sweden
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Carol Koro
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme LLC, Rahway, NJ, USA
| | - Marc Baay
- Epidemiology & Pharmacovigilance, P95, Leuven, Belgium
| | | | - Alain Luxembourg
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme LLC, Rahway, NJ, USA
| | - Alfred J Saah
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme LLC, Rahway, NJ, USA
| | - Suzanne M Garland
- Department of Obstetrics and Gynecology, The University of Melbourne, Royal Women's Hospital (RWH), Murdoch Childrens Research Institute, Melbourne, Australia
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Prevalence, Diversity, and Risk Factors for Cervical HPV Infection in Women Screened for Cervical Cancer in Belém, Pará, Northern Brazil. Pathogens 2022; 11:pathogens11090960. [PMID: 36145392 PMCID: PMC9506000 DOI: 10.3390/pathogens11090960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Human papillomavirus (HPV) is the most common viral sexually transmitted infection of the reproductive tract, and cervical cancer is the most common HPV-related disease. This study estimated the prevalence, diversity of HPV genotypes, and associated risk factors in women screened for cervical cancer in northern Brazil. Methods: The cross-sectional study was conducted in Belém, Pará, in the Amazon region of Brazil, and it included 162 women who were spontaneously undergoing a Pap-smear routine. Epidemiological, sexual, and health-related information was collected by interviews, and cervical samples were collected for cytological examination and HPV-DNA detection. HPV genotypes were classified as low risk (LR) and high risk (HR) by nucleotide sequencing. Results: In total, 17.3% (28/162) of the participants had HPV-DNA, and LR-HPV was the most prevalent (71.4%). Among the 13 different types of HPV detected, HPV-11 was found most frequently (12/28; 42.9%), followed by HPV-31 (3/28; 10.7%). Of the participants with cytological alterations, HPV infection was detected in only four: two were diagnosed with low-grade squamous intraepithelial lesions (15.4%), one with atypical squamous cells of undetermined significance (7.7%), and one with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (7.7%). Of the 61 women who presented a normal cytology, 13 (21.3%) had positive tests for HPV infection, 4 (8.2%) of which were positive for a high-risk genotype. Conclusion: The prevalence of HPV was high in Belém, Pará, and especially in women who had normal cytology results, which suggests the need for greater screening for HPV infection in women’s primary health care.
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Wang W, Kothari S, Baay M, Garland SM, Giuliano AR, Nygård M, Velicer C, Tota J, Sinha A, Skufca J, Verstraeten T, Sundström K. Real-world impact and effectiveness assessment of the quadrivalent HPV vaccine: a systematic review of study designs and data sources. Expert Rev Vaccines 2021; 21:227-240. [PMID: 34845951 DOI: 10.1080/14760584.2022.2008243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Vaccine effectiveness and impact studies are typically observational, generating evidence after vaccine launch in a real-world setting. For human papillomavirus (HPV) vaccination studies, the variety of data sources and methods used is pronounced. Careful selection of study design, data capture and analytical methods can mitigate potential bias in such studies. AREAS COVERED We systematically reviewed the different study designs, methods, and data sources in published evidence (1/2007-3/2020), which assessed the quadrivalent HPV vaccine effectiveness and impact on cervical/cervicovaginal, anal, and oral HPV infections, anogenital warts, lesions in anus, cervix, oropharynx, penis, vagina or vulva, and recurrent respiratory papillomatosis. EXPERT OPINION The rapid growth in access to real-world data allows global monitoring of effects of different public health interventions, including HPV vaccination programs. But the use of data which are not collected or organized to support research also underscore a need to develop robust methodology that provides insight of vaccine effects and consequences of different health policy decisions. To achieve the WHO elimination goal, we foresee a growing need to evaluate HPV vaccination programs globally. A critical appraisal summary of methodology used will provide timely guidance to researchers who want to initiate research activities in various settings.
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Affiliation(s)
- Wei Wang
- Center for Observational and Real-world Evidence, Merck & Co. Inc., Kenilworth, NJ, USA
| | - Smita Kothari
- Center for Observational and Real-world Evidence, Merck & Co. Inc., Kenilworth, NJ, USA
| | - Marc Baay
- P95 Epidemiology & Pharmacovigilance, Leuven, Belgium
| | - Suzanne M Garland
- Department Obstetrics and Gynaecology, University of Melbourne, Centre Women's Infectious Diseases Research, Royal Women's Hospital, and Infection & Immunity Murdoch Children's Research Institute, Parkville, Australia
| | - Anna R Giuliano
- Center for Immunizaton and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Christine Velicer
- Center for Observational and Real-world Evidence, Merck & Co. Inc., Kenilworth, NJ, USA
| | - Joseph Tota
- Center for Observational and Real-world Evidence, Merck & Co. Inc., Kenilworth, NJ, USA
| | - Anushua Sinha
- Center for Observational and Real-world Evidence, Merck & Co. Inc., Kenilworth, NJ, USA
| | - Jozica Skufca
- P95 Epidemiology & Pharmacovigilance, Leuven, Belgium
| | | | - Karin Sundström
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden
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Sauvageau C, Gilca V, Ouakki M, Kiely M, Coutlée F, Mathieu-Chartier S, Defay F, Lambert G. Sexual behavior, clinical outcomes and attendance of cervical cancer screening by HPV vaccinated and unvaccinated sexually active women. Hum Vaccin Immunother 2021; 17:4393-4396. [PMID: 34410872 DOI: 10.1080/21645515.2021.1961470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Concerns were raised about HPV vaccination possibly leading to riskier sexual behavior. We assessed sexual behaviors, risk of sexually transmitted infection, and attendance to cervical cancer screening by HPV vaccinated and unvaccinated young women. In this analysis, 1475 questionnaires completed by women aged 17-29 years were included. The majority of respondents (67.9%) were vaccinated against HPV. The proportion of those vaccinated decreased with age: from 93.2% in those aged 17-19 to 72.9% in those aged 20-22, and 21.8% in 23-29-year olds. A higher proportion of unvaccinated respondents had at least one sexual intercourse under the age of 15 when compared to those vaccinated (30% vs. 23%, p < .0001). The number of sexual partners during the last 12 months was similar between vaccinated and unvaccinated participants. Vaccinated participants reported more condom use (45% versus 38%; p = .0002), and less sexually transmitted infections (10% versus 28%; p < .0001), and less anogenital condylomas (2.2% vs. 11.6%; p < .0001). A screening test has been reported by 51% and 77% of vaccinated and unvaccinated participants, respectively (p < .0001). The association between vaccination status and cervical cancer screening disappeared when adjusting for participants' age. The study results consolidate the existing body of data regarding the absence of an impact of HPV vaccination on sexual behavior or use of contraceptives.
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Affiliation(s)
- Chantal Sauvageau
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada, Université Laval, Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du CHU de Quebec, Quebec, Canada
| | - Vladimir Gilca
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada, Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du CHU de Quebec, Quebec, Canada
| | - Manale Ouakki
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada
| | - Marilou Kiely
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada
| | - François Coutlée
- Service de Biologie Moléculaire du Département de Médecine de Laboratoire et Service d'infectiologie du Département de Médecine, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
| | | | - Fannie Defay
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada
| | - Gilles Lambert
- Direction Régionale de Santé Publique, Centre Intégré Universitaire de Santé et de Services Sociauxdu Centre-Sud-de-l'Île-de-Montréal, Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada
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Carvalho NSD, Silva RJDCD, Val ICD, Bazzo ML, Silveira MFD. Brazilian Protocol for Sexually Transmitted Infections 2020: human papillomavirus (HPV) infection. Rev Soc Bras Med Trop 2021; 54:e2020790. [PMID: 34008731 PMCID: PMC8210485 DOI: 10.1590/0037-8682-790-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 11/22/2022] Open
Abstract
This article addresses human papillomavirus (HPV) infection, one of the topics covered by the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health. The Protocol and Guidelines have been developed based on scientific evidence and validated in discussions with specialists. This article presents epidemiological and clinical aspects and guidelines for health service managers and health workers about diagnosing and treating people with papillomavirus infection. This theme is a significant public health issue since it is the most prevalent sexually transmitted infection globally, capable of triggering the oncogenic process of cervical cancer and the possibility of anogenital warts. Important information is presented for gaining knowledge about HPV and action strategies for infection prevention and control, provision of quality care, and effective treatment of the disease. Infection by the human papillomavirus is the sexually transmitted infection of the highest contagion, superior to genital herpes and HIV.
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Affiliation(s)
| | | | | | - Maria Luiza Bazzo
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Farmácia, Florianópolis, SC, Brasil
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Carvalho NSD, Silva RJDCD, Val ICD, Bazzo ML, Silveira MFD. [Brazilian Protocol for Sexually Transmitted Infections 2020: human papillomavirus (HPV) infection]. ACTA ACUST UNITED AC 2021; 30:e2020790. [PMID: 33729414 DOI: 10.1590/s1679-4974202100014.esp1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022]
Abstract
This article addresses human papillomavirus (HPV) infection, this being one of the topics covered by the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health. The Protocol and Guidelines have been developed based on scientific evidence and validated in discussions with specialists. This article presents epidemiological and clinical aspects, as well as guidelines for health service managers and health workers about diagnosing and treating people with papillomavirus infection. This theme is an important public health problem, since it is the most prevalent sexually transmitted infection in the world, capable of triggering the oncogenic process of cervical cancer, as well as the possibility anogenital warts occurring. Important information is presented for gaining knowledge about HPV, as well as action strategies for infection prevention and control, provision of quality care and effective treatment of the disease.
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Affiliation(s)
| | | | | | - Maria Luiza Bazzo
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Farmácia, Florianópolis, SC, Brasil
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Systematic literature review of cross-protective effect of HPV vaccines based on data from randomized clinical trials and real-world evidence. Vaccine 2021; 39:2224-2236. [PMID: 33744051 DOI: 10.1016/j.vaccine.2020.11.076] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/07/2020] [Accepted: 11/30/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The extent of cross-protection provided by currently licensed bivalent and quadrivalent HPV vaccines versus direct protection against HPV 31-, 33-, 45-, 52-, and 58-related disease is debated. A systematic literature review was conducted to establish the duration and magnitude of cross-protection in interventional and observational studies. METHODS PubMed and Embase databases were searched to identify randomized controlled trials (RCT) and observational studies published between 2008 and 2019 reporting on efficacy and effectiveness of HPV vaccines in women against non-vaccine types 31, 33, 45, 52, 58, and 6 and 11 (non-bivalent types). Key outcomes of interest were vaccine efficacy against 6- and 12-month persistent infection or genital lesions, and type-specific genital HPV prevalence or incidence. RCT data were analyzed for the according-to-protocol (bivalent vaccine) or negative-for-14-HPV-types (quadrivalent vaccine) efficacy cohorts. RESULTS Data from 23 RCTs and 33 observational studies evaluating cross-protection were extracted. RCTs assessed cross-protection in post-hoc analyses of small size subgroups. Among fully vaccinated, baseline HPV-naïve women, the bivalent vaccine showed statistically significant cross-protective efficacy, although with wide confidence intervals, against 6-month and 12-month persistent cervical infections and CIN2+ only consistently for HPV 31 and 45, with the highest effect observed for HPV 31 (range 64.6% [95% CI: 27.6 to 83.9] to 79.1% [97.7% CI: 27.6 to 95.9] for 6-month persistent infection; maximal follow-up 4.7 years). No cross-protection was shown in extended follow-up. The quadrivalent vaccine efficacy reached statistical significance for HPV 31 (46.2% [15.3-66.4]; follow-up: 3.6 years). Similarly, observational studies found consistently significant effectiveness only against HPV 31 and 45 with both vaccines. CONCLUSIONS RCTs and observational studies show that cross-protection is inconsistent across non-vaccine HPV types and is largely driven by HPV 31 and 45. Furthermore, existing data suggest that it wanes over time; its long-term durability has not been established.
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Rane MS, Page LC, McVeigh E, Miller K, Baure D, Elizabeth Halloran M, Duchin JS. Improving adolescent human papillomavirus (HPV) immunization uptake in school-based health centers through awareness campaigns. Vaccine 2021; 39:1765-1772. [PMID: 33640146 DOI: 10.1016/j.vaccine.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/17/2020] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study was to measure the effect of a multicomponent human papillomavirus (HPV) vaccine promotion campaign on adolescent HPV vaccine uptake at school-based health centers (SBHCs) in Seattle, WA. METHODS Youth-led HPV vaccine promotion campaigns were introduced in 2016 in 13 schools with SBHCs in Seattle. Five other schools with SBHCs served as controls. Vaccination records for students were obtained from the Washington Immunization Information System from September 2012 to August 2018. We compared increase in HPV vaccine uptake in SBHCs between 1) intervention and control schools, and 2) pre- and post-intervention periods in intervention schools using generalized estimating equations. RESULTS HPV vaccine uptake was high at baseline among students that use SBHCs for vaccines and has steadily increased between 2012 and 2018. Implementing the promotion campaign resulted in 14% higher (95% Confidence Interval (CI): 1%, 30%) HPV vaccine uptake in intervention SBHCs compared to control SBHCs, adjusting for time and confounders. Comparing pre-and post-intervention periods in intervention SBHCs, HPV vaccine uptake was 14% higher (95% CI: -4%, 35%) in the post-intervention period. SBHCs that received more active intervention activities saw 9% higher (95% CI: 1%, 21%) vaccine uptake compared to those that received passive intervention. CONCLUSION The vaccination promotion program implemented in a school-based setting resulted in higher HPV vaccine uptake in the post-intervention period compared to pre-intervention period, but this increase was not statistically significant. Even so, schools that received more intervention activities for longer periods of time had higher HPV vaccine uptake.
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Affiliation(s)
- Madhura S Rane
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Libby C Page
- Public Health, Seattle & King County, Seattle, WA, USA
| | - Emma McVeigh
- Public Health, Seattle & King County, Seattle, WA, USA
| | | | - David Baure
- Public Health, Seattle & King County, Seattle, WA, USA
| | - M Elizabeth Halloran
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Jeffrey S Duchin
- Public Health, Seattle & King County, Seattle, WA, USA; Division of Allergy and Infectious Diseases and School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA
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Carvalho AMCD, Araújo TMED. FACTORS ASSOCIATED WITH ADOLESCENT COMPLIANCE WITH HUMAN PAPILLOMAVIRUS VACCINE: A CROSS-SECTIONAL STUDY. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to identify the factors associated with adolescent compliance with the human papillomavirus vaccine. Method: this is a cross-sectional study, developed through a school survey, in Teresina, Piauí, Brazil, whose data collection occurred in 2018. A scale was used to assess decision-making, attitudes, feelings and knowledge about the human papillomavirus, in addition to a questionnaire to collect sociodemographic, economic and vaccination status data. The variables were submitted to the multivariate model of logistic regression to explain factors associated with vaccination adeforemen. Results: the study sample consisted of 624 adolescents, 15 years old, attending the first year of high school, of which 22.8% received the human papillomavirus vaccine. Being male decreases the chance of complying with the vaccine by 50% (aOR=0.05). Moreover, disagreeing or disagreeing with or disagreeing with parents to make the decision to vaccinate their children also reduced the chances of vaccination by 66% (aOR=0.34), respectively, as well as disagreeing with or disagreeing that men do not take human papillomavirus, minimized the chances of vaccination complying with vaccination by 66% (aOR=0.34), when compared to those who disagreed with this statement. Conclusion: low adolescent compliance with human papillomavirus vaccine was identified. Adolescents remain susceptible to diseases related to the human papillomavirus. Therefore, vaccination strategies need to be rethought, with the offer of vaccination in schools, mediated by educational campaigns.
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Jeannot E, Viviano M, de Pree C, Amadane M, Kabengele E, Vassilakos P, Petignat P. Prevalence of Vaccine Type Infections in Vaccinated and Non-Vaccinated Young Women: HPV-IMPACT, a Self-Sampling Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071447. [PMID: 29987255 PMCID: PMC6069376 DOI: 10.3390/ijerph15071447] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/02/2018] [Accepted: 07/05/2018] [Indexed: 12/15/2022]
Abstract
Background: The human papillomavirus (HPV) vaccination program for young girls aged 11⁻26 years was introduced in Switzerland in 2008. The objective of this study was to evaluate the prevalence of high- and low-risk HPV in a population of undergraduate students using self-sampling for monitoring the HPV vaccination program's effect. METHODS Undergraduate women aged between 18⁻31 years, attending the Medical School and University of Applied Sciences in Geneva, were invited to participate in the study. Included women were asked to perform vaginal self-sampling for HPV testing using a dry cotton swab. RESULTS A total of 409 students participated in the study-aged 18⁻31 years-of which 69% of the participants were vaccinated with Gardasil HPV vaccine and 31% did not received the vaccine. About HPV prevalence, 7.2% of unvaccinated women were HPV 16 or 18 positive, while 1.1% of vaccinated women were infected by HPV 16 or 18 (p < 0.01). Prevalence of HPV 6 and 11 was 8.3% in non-vaccinated women versus 2.1% in vaccinated women (p < 0.02). We observed no cross-protection for the other HPV genotypes of a low- and high-risk strain. CONCLUSIONS Prevalence of HPV 6/11/16/18 was lower in vaccinated women versus unvaccinated women. Continued assessment of HPV vaccine effectiveness in real population is needed.
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Affiliation(s)
- Emilien Jeannot
- Institute of Global Health-Faculty of Medicine, Chemin de Mines 9, 1202 Geneva, Switzerland.
- Community Psychiatric Service, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland.
| | - Manuella Viviano
- Gynecology Division, Department of Obstetrics and Gynecology, Geneva University Hospitals, Boulevard de la Cluse 30, 1205 Geneva, Switzerland.
| | - Charlotte de Pree
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland.
| | - Mona Amadane
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland.
| | - Emmanuel Kabengele
- Institute of Global Health-Faculty of Medicine, Chemin de Mines 9, 1202 Geneva, Switzerland.
| | - Pierre Vassilakos
- Geneva Foundation for Medical Education and Research, Route de Ferney 150, 1211 Geneva 2, Switzerland.
| | - Patrick Petignat
- Gynecology Division, Department of Obstetrics and Gynecology, Geneva University Hospitals, Boulevard de la Cluse 30, 1205 Geneva, Switzerland.
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Bretagne CH, Jooste V, Guenat D, Riethmuller D, Bouvier AM, Bedgedjian I, Prétet JL, Valmary-Degano S, Mougin C. Prevalence and distribution of HPV genotypes and cervical-associated lesions in sexually active young French women following HPV vaccine. J Gynecol Obstet Hum Reprod 2018; 47:525-531. [PMID: 29807205 DOI: 10.1016/j.jogoh.2018.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Despite the availability of safe and effective HPV vaccines in France, more than 80% of girls remain unvaccinated. SETTING A regional university hospital referral center in France. OBJECTIVE To estimate the overall prevalence and distribution of HPV in vaccinated, sexually active young French women who were screened for cervical cancer by cytology and HPV testing. METHODS High-risk HPV (HR-HPV) prevalence, genotype-specific prevalence and extent of multiple infections were assessed in 125 cervical samples from females with available vaccine data using hc2 assay and INNO-LiPA assay. HPV status was analyzed in accordance with cytological data. RESULTS In our series, mean age was 23 years, overall prevalence of HR-HPV was 52% and was correlated with the lesion grade. The diversity of HPV genotypes was broad. Single HR-HPV infections were identified in 11%, 21% and 47% of women with NILM, ASC-US/-H and LSIL respectively. Multiple infections with HR-HPV were detected in 28% of the specimens. Only 24.5% of women with NILM presented infections with 2 genotypes or more, vs 28% of women with ASC-US/-H and 35% of women with LSIL. The overall prevalence of genotypes covered by the quadrivalent vaccine was low (5.9%); with 4.2%, 0%, 0.8% and 0.8% for HPV 16, HPV 18, HPV 6 and HPV 11 respectively. CONCLUSION Among HPV-vaccinated young women, HR-HPV are detected at a high rate, and an association with the grade of cytological abnormalities was observed. However, HPV 16 and 18, both targeted by the vaccines, are remarkably rare among young French women since program implementation.
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Affiliation(s)
- C H Bretagne
- Service d'Anatomie et cytologie pathologiques, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - V Jooste
- Registre Bourguignon des Cancers Digestifs, Hôpital Universitaire Dijon-Bourgogne, 21000 Dijon, France; INSERM, U1231, EPICAD Team, Université Bourgogne-Franche-Comté, 21000 Dijon, France.
| | - D Guenat
- EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France; Centre National de Référence Papillomavirus, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - D Riethmuller
- EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France; Service de gynécologie obstétrique, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - A M Bouvier
- Registre Bourguignon des Cancers Digestifs, Hôpital Universitaire Dijon-Bourgogne, 21000 Dijon, France; INSERM, U1231, EPICAD Team, Université Bourgogne-Franche-Comté, 21000 Dijon, France.
| | - I Bedgedjian
- Service d'Anatomie et cytologie pathologiques, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - J L Prétet
- EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France; Centre National de Référence Papillomavirus, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - S Valmary-Degano
- Service d'Anatomie et cytologie pathologiques, CHU Besançon, Bd Fleming, 25000 Besançon, France; EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France.
| | - C Mougin
- EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France; Centre National de Référence Papillomavirus, CHU Besançon, Bd Fleming, 25000 Besançon, France.
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