Exploring monitoring strategies for population surveillance of HPV vaccine impact using primary HPV screening

IF 4.7 Q1 VIROLOGY Tumour Virus Research Pub Date : 2023-06-01 DOI:10.1016/j.tvr.2023.200255
Louiza S. Velentzis , David Hawkes , Michael Caruana , Julia ML. Brotherton , Megan A. Smith , Lara Roeske , Khurram A. Karim , Suzanne M. Garland , C. David Wrede , Jeffery Tan , Cosette Wheeler , Philip E. Castle , Marion Saville , Karen Canfell
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Abstract

Australia's cervical screening program transitioned from cytology to HPV-testing with genotyping for HPV16/18 in Dec’2017. We investigated whether program data could be used to monitor HPV vaccination program impact (commenced in 2007) on HPV16/18 prevalence and compared estimates with pre-vaccination benchmark prevalence. Pre-vaccination samples (2005–2008) (n = 1933; WHINURS), from 25 to 64-year-old women had been previously analysed with Linear Array (LA). Post-vaccination samples (2013-2014) (n = 2989; Compass pilot), from 25 to 64-year-old women, were analysed by cobas 4800 (cobas), and by LA for historical comparability. Age standardised pre-vaccination HPV16/18 prevalence was 4.85% (95%CI:3.81–5.89) by LA; post-vaccination estimates were 1.67% (95%CI:1.21–2.13%) by LA, 1.49% (95%CI:1.05–1.93%) by cobas, and 1.63% (95%CI:1.17–2.08%) for cobas and LA testing of non-16/18 cobas positives (cobas/LA). Age-standardised pre-vaccination oncogenic HPV prevalence was 15.70% (95%CI:13.79–17.60%) by LA; post-vaccination estimates were 9.06% (95%CI:8.02–10.09%) by LA, 8.47% (95%CI:7.47–9.47%) by cobas and cobas/LA. Standardised rate ratios between post-vs. pre-vaccination rates were significantly different for HPV16/18, non-16/18 HPV and oncogenic HPV: 0.34 (95%CI:0.23–0.50), 0.68 (95%CI:0.55–0.84) and 0.58 (95%CI:0.48–0.69), respectively. Additional strategies (LA for all cobas positives; combined cobas and LA results on all samples) had similar results. If a single method is applied consistently, it will provide important data on relative changes in HPV prevalence following vaccination.

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探索使用HPV初级筛查对HPV疫苗影响的人群监测策略
2017年12月,澳大利亚的宫颈筛查项目从细胞学转向HPV检测,并对HPV16/18进行基因分型。我们调查了计划数据是否可用于监测HPV疫苗接种计划(始于2007年)对HPV16/18流行率的影响,并将估计值与疫苗接种前的基准流行率进行了比较。疫苗接种前样本(2005-2008年)(n=1933;WHINURS),来自25至64岁女性,之前曾使用线性阵列(LA)进行过分析。通过cobas 4800(cobas)和LA对25至64岁女性的疫苗接种后样本(2013-2014)(n=2989;Compass试点)进行了历史可比性分析。LA的年龄标准化疫苗接种前HPV16/18患病率为4.85%(95%CI:3.81-5.89);LA的疫苗接种后估计值为1.67%(95%CI:1.21–2.13%),cobas的疫苗接种估计值为1.49%(95%CI:1.05–1.93%),cobas和LA检测非16/18 cobas阳性(cobas/LA)的疫苗接种预测值为1.63%(95%CI:1.17–2.08%)。LA的年龄标准化接种前致癌HPV患病率为15.70%(95%CI:13.79–17.60%);LA的疫苗接种后估计值为9.06%(95%CI:8.02–10.09%),cobas和cobas/LA的估计值为8.47%(95%CI:7.47–9.47%)。后与。HPV16/18、非16/18型HPV和致癌HPV的疫苗接种前率显著不同:分别为0.34(95%CI:0.23–0.50)、0.68(95%CI:0.55–0.84)和0.58(95%CI=0.48–0.69)。其他策略(所有cobas阳性的LA;所有样本的cobas和LA组合结果)具有相似的结果。如果持续应用单一方法,它将提供有关接种疫苗后HPV患病率相对变化的重要数据。
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来源期刊
Tumour Virus Research
Tumour Virus Research Medicine-Infectious Diseases
CiteScore
6.50
自引率
2.30%
发文量
16
审稿时长
56 days
期刊最新文献
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