Reduction in HPV 16/18 prevalence in sexually active young women following the introduction of HPV immunisation in England

Autor: Simon Beddows, P. Manyenga, O.N. Gill, Kavita Panwar, Mark Jit, K Soldan, Rebecca Howell-Jones, David Mesher
Rok vydání: 2013
Předmět:
Cervarix
PHE
Public Health England
Risk Factors
Odds Ratio
Prevalence
PCR
Polymerase Chain Reaction
Reproductive health
LR
Low-risk
Cervical cancer
Human papillomavirus 16
Surveillance
Human papillomavirus 18
Vaccination
Age Factors
HPV infection
virus diseases
female genital diseases and pregnancy complications
Infectious Diseases
England
Family planning
HPV
Human Papillomavirus
Molecular Medicine
Female
LA
Linear Array
Adult
medicine.medical_specialty
Adolescent
PCT
Primary Care Trust
Sexual Behavior
Article
Young Adult
HC2
Hybrid Capture 2
Immunology and Microbiology(all)
HPV immunisation
medicine
Humans
Papillomavirus Vaccines
Genotyping
Gynecology
VVS
Vulva-vaginal Swab
General Veterinary
General Immunology and Microbiology
business.industry
HPV prevalence
Papillomavirus Infections
Public Health
Environmental and Occupational Health
GP
General Practice
LSOA
Lower Super Output Area
Odds ratio
medicine.disease
veterinary(all)
CI
Confidence Interval
Confidence interval
NCSP
National Chlamydia Screening Programme
REC
Research Ethics Committee
HR
High-risk
PDH
Pyruvate dehydrogenase
business
OR
Odds ratio
Demography
Zdroj: Vaccine
ISSN: 0264-410X
Popis: Highlights • We monitor HPV infection in sexually active young women in England. • The prevalence of HPV 16/18 has reduced within 3 years of HPV immunisation. • Reductions in HPV 16/18 were greatest at ages with highest immunisation coverage. • The data suggest reductions in HPV 16/18 amongst unvaccinated young women and men.
Background Reduction in the prevalence of vaccine type HPV infection in young women is an early indication of the impact of the HPV immunisation programme and a necessary outcome if the subsequent impact on cervical cancer is to be realised. Methods Residual vulva-vaginal swab (VVS) specimens from young women aged 16–24 years undergoing chlamydia screening in community sexual health services (formerly known as family planning clinics), general practice (GP), and youth clinics in 2010–2012 were submitted from 10 laboratories in seven regions around England. These specimens were linked to demographic and sexual behaviour data reported with the chlamydia test, anonymised, and tested for type-specific HPV DNA using a multiplex PCR and Luminex-based genotyping test. Estimated immunisation coverage was calculated and findings were compared to a baseline survey conducted prior to the introduction of HPV immunisation in 2008. Results A total of 4664 eligible specimens were collected and 4178 had a valid test result. The post-immunisation prevalence of HPV 16/18 infection was lowest in this youngest age group (16–18 years) and increased with age. This increase with age was a reversal of the pattern seen prior to immunisation and was inversely associated with estimates of age-specific immunisation coverage (65% for 16–18 year olds). The prevalence of HPV 16/18 infection in the post-immunisation survey was 6.5% amongst 16–18 year olds, compared to 19.1% in the similar survey conducted prior to the introduction of HPV immunisation. Conclusions These findings are the first indication that the national HPV immunisation programme is successfully preventing HPV 16/18 infection in sexually active young women in England. The reductions seen suggest, for the estimated coverage, high vaccine effectiveness and some herd-protection benefits. Continued surveillance is needed to determine the effects of immunisation on non-vaccine HPV types.
Databáze: OpenAIRE
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