HPV genotype-specific prevalence and infection risks: A 10-year population-based study from the United States.

IF 9.9 1区 医学 Q1 ONCOLOGY JNCI Journal of the National Cancer Institute Pub Date : 2024-12-10 DOI:10.1093/jnci/djae327
Cosette M Wheeler, Rachael Adcock, William C Hunt, Michael Robertson, Norah E Torrez-Martinez, Ruth McDonald, Emily Merchasin, Steven Jenison, Debbie Saslow, Nancy E Joste, Philip E Castle, Jane J Kim, Jack Cuzick
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Abstract

Background: Various studies have reported on the impact of human papillomavirus (HPV) vaccines. Here we present the largest population-based investigation of genotype-specific distributions over the decade following implementation of the 4-valent HPV vaccine (HPV6/11/16/18) in the United States.

Methods: Liquid-based cervical cytology samples from individuals aged 15-30 years undergoing cervical screening throughout New Mexico were tested by broad-spectrum HPV genotyping. Weighted relative differences in HPV type-specific prevalence (RDP) and 95% confidence intervals (95%CI) were calculated comparing individuals screened in 2007-2009 (n = 95,915) to those screened in 2013-2016 (n = 103,371). Weighted logistic regression was used to estimate relative risk of type-specific HPV infections. Tests of significance were 2-sided.

Results: Genotype-specific prevalence reduced significantly for HPV16 (RDP=-52.6%, 95%CI -56.9 to -48.3), HPV18 (RDP=-62.1%, 95%CI -68.5 to -55.8), HPV31 (RDP=-34.2%, 95%CI -42.1 to -26.3) and HPV33 (RDP=-31.8%, 95%CI -48.4 to -15.1). The RDP increased for other carcinogenic HPV types by 19.5% (95%CI +14.3 to + 24.6) when excluding HPV16/18. Large reductions in HPV6/11 RDP were observed but overall, non-carcinogenic, non-vaccine types increased. Comparing females born in 1996 to those born in 1989, risk of infection with HPV6/11/16/18 decreased by 80.0% among individuals aged 21-25 years. High-grade squamous intraepithelial lesions or worse (HSIL+) decreased by 49.4% when extending the evaluation from 2007 to 2018.

Conclusion(s): HSIL+ incidence is decreasing with large reductions in the prevalence of 4-valent HPV vaccine types and non-vaccine types HPV31 and 33, reflecting vaccine cross-protection. Increases in non-vaccine HPVs may attenuate anticipated reductions in HPV-related abnormalities including cancers however the benefits of HPV vaccination remain substantial.

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HPV基因型特异性患病率和感染风险:美国一项为期10年的基于人群的研究
背景:各种研究报道了人乳头瘤病毒(HPV)疫苗的影响。在这里,我们提出了在美国实施4价HPV疫苗(HPV6/11/16/18)后的十年中最大规模的基于人群的基因型特异性分布调查。方法:在新墨西哥州接受宫颈筛查的15-30岁个体的液体宫颈细胞学样本进行广谱HPV基因分型检测。比较2007-2009年筛查的个体(n = 95,915)与2013-2016年筛查的个体(n = 103,371),计算HPV类型特异性患病率(RDP)和95%置信区间(95% ci)的加权相对差异。加权逻辑回归用于估计类型特异性HPV感染的相对风险。显著性检验为双侧检验。结果:HPV16 (RDP=-52.6%, 95%CI为-56.9 ~ -48.3)、HPV18 (RDP=-62.1%, 95%CI为-68.5 ~ -55.8)、HPV31 (RDP=-34.2%, 95%CI为-42.1 ~ -26.3)和HPV33 (RDP=-31.8%, 95%CI为-48.4 ~ -15.1)的基因型特异性患病率显著降低。当排除HPV16/18时,其他致癌型HPV的RDP增加了19.5% (95%CI +14.3至+ 24.6)。观察到HPV6/11 RDP大幅下降,但总体而言,非致癌,非疫苗类型增加。与1989年出生的女性相比,1996年出生的女性感染HPV6/11/16/18的风险在21-25岁的个体中降低了80.0%。结论(5):随着4价HPV疫苗型和非疫苗型HPV31和33的患病率大幅下降,HSIL+的发病率呈下降趋势,反映了疫苗的交叉保护作用。非疫苗HPV的增加可能会减弱HPV相关异常(包括癌症)的预期减少,但HPV疫苗接种的好处仍然很大。
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来源期刊
CiteScore
17.00
自引率
2.90%
发文量
203
审稿时长
4-8 weeks
期刊介绍: The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.
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