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首页> 外文期刊>Vaccine >Impact of human papillomavirus (HPV) vaccination on HPV 16/18-related prevalence in precancerous cervical lesions.
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Impact of human papillomavirus (HPV) vaccination on HPV 16/18-related prevalence in precancerous cervical lesions.

机译：人乳头瘤病毒（HPV）疫苗接种对宫颈癌前病变中HPV 16/18相关流行的影响。

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Background: Vaccination against human papillomavirus (HPV) types 16 and 18 is recommended for girls aged 11 or 12 years with catch-up vaccination through age 26 in the U.S. Cervical intraepithelial neoplasia (CIN) grade 2 or 3 and adenocarcinoma in situ (CIN2+) are used to monitor HPV vaccine impact on cervical disease. This report describes vaccination status in women diagnosed with CIN2+ and examines HPV vaccine impact on HPV 16/18-related CIN2+. Methods: As part of a vaccine impact monitoring project (HPV-IMPACT), females 18-31 years with CIN2+ were reported from pathology laboratories in CA, CT, NY, OR, TN from 2008 to 2011. One diagnostic block was selected for HPV DNA typing with Roche Linear Array. Demographic, abnormal Papanicolaou (Pap) test dates and vaccine status information were collected. The abnormal Pap test immediately preceding the CIN2+ diagnosis was defined as the 'trigger Pap'. Results: Among 5083 CIN2+ cases reported to date, 3855 had vaccination history investigated; 1900 had vaccine history documented (vaccinated, with trigger Pap dates, or unvaccinated). Among women who initiated vaccination >24 months before their trigger Pap, there was a significantly lower proportion of CIN2+ lesions due to 16/18 compared to women who were not vaccinated (aPR=.67, 95% CI: .48-.94). Among the 1900 with known vaccination status, 20% initiated vaccination on/after their trigger screening. Women aged 21-23 years were more likely to initiate vaccination on/after the trigger Pap compared to 24-26 year olds (29.0% vs. 19.6%, p=.001), as were non-Hispanic blacks compared to non-Hispanic whites (27.3% vs. 19.0%, p=.001) and publicly compared to privately insured women (38.1% vs. 17.4%, p<.0001). Conclusion: We found a significant reduction in HPV 16/18-related lesions in women with CIN2+ who initiated vaccination at least 24 months prior to their trigger Pap. These preliminary results suggest early impact of the HPV vaccine on vaccine-type disease, but further evaluation is warranted.
机译：背景：建议对年龄在11或12岁，在美国2或3级宫颈上皮内瘤变（CIN）到26岁进行补充疫苗接种以及原位腺癌（CIN2 +）的11或12岁女孩接种16和18型人乳头瘤病毒（HPV）疫苗。用于监测HPV疫苗对宫颈疾病的影响。该报告描述了诊断为CIN2 +的女性的疫苗接种状况，并检查了HPV疫苗对与HPV 16/18相关的CIN2 +的影响。方法：作为疫苗影响监测项目（HPV-IMPACT）的一部分，从2008年至2011年，在CA，CT，NY，OR，TN的病理实验室报告了18-31岁CIN2 +的女性。为HPV选择了一个诊断区使用罗氏线性阵列进行DNA分型。收集了人口统计信息，异常的Papanicolaou（Pap）测试日期和疫苗状态信息。即将在CIN2 +诊断之前的异常子宫颈抹片检查定义为“触发子宫颈抹片”。结果：迄今已报告的5083例CIN2 +病例中，有3855例曾接种疫苗。 1900年有疫苗接种史记录（已接种疫苗，带子宫颈抹片日期或未接种疫苗）。与未接种疫苗的女性相比，在开始使用子宫颈抹片检查前24个月以上开始接种疫苗的女性中，由于16/18而导致的CIN2 +病变比例要低得多（aPR = .67，95％CI：.48-.94） 。在1900年已知疫苗接种状况的人群中，有20％的人在进行触发筛查时/之后开始接种疫苗。与24-26岁的女性相比，年龄在21-23岁之间的女性更有可能在Pap触发后/之后开始接种疫苗（29.0％比19.6％，p = .001），非西班牙裔黑人与非西班牙裔黑人相比白人（27.3％vs. 19.0％，p = .001），以及与私人参保妇女相比（38.1％vs. 17.4％，p <.0001）。结论：我们发现在CIN2 +的女性中，HPV 16/18相关的病变显着减少，这些女性至少在触发Pap前24个月开始接种疫苗。这些初步结果表明，HPV疫苗对疫苗类型疾病具有早期影响，但有必要进行进一步评估。

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