Monitoring vaccine and non-vaccine HPV type prevalence in the post-vaccination era in women living in the Basilicata region, Italy View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-01-15

AUTHORS

Francesca Carozzi, Donella Puliti, Cristina Ocello, Pasquale Silvio Anastasio, Espedito Antonio Moliterni, Emilia Perinetti, Laurence Serradell, Elena Burroni, Massimo Confortini, Paola Mantellini, Marco Zappa, Géraldine Dominiak-Felden

ABSTRACT

BACKGROUND: A large free-of-charge quadrivalent HPV (qHPV) vaccination program, covering four cohorts annually (women 11, 14, 17 and 24 years), has been implemented in Basilicata since 2007. This study evaluated vaccine and non-vaccine HPV prevalence 5-7 years post-vaccination program implementation in vaccinated and unvaccinated women. METHODS: This population-based, cross-sectional study was conducted in the public screening centers of the Local Health Unit in Matera between 2012 and 2014. Cervical samples were obtained for Pap and HPV testing (HC2, LiPA Extra® assay) and participants completed a sociodemographic and behavioral questionnaire. Detailed HPV vaccination status was retrieved from the official HPV vaccine registry. HPV prevalence was described overall, by type and vaccination status. The association between HPV type-detection and risk/protective factors was studied. Direct vaccine protection (qHPV vaccine effectiveness [VE]), cross-protection, and type-replacement were evaluated in cohorts eligible for vaccination, by analyzing HPV prevalence of vaccine and non-vaccine types according to vaccination status. RESULTS: Overall, 2793 women (18-50 years) were included, 1314 of them having been in birth cohorts eligible for the HPV vaccination program (18- to 30-year-old women at enrolment). Among the latter, qHPV vaccine uptake was 59% (at least one dose), with 94% completing the schedule; standardized qHPV type prevalence was 0.6% in vaccinated versus 5.5% in unvaccinated women (P <0.001); adjusted VE against vaccine type infections was 90% (95% CI: 73%-96%) for all fully vaccinated women and 100% (95% CI not calculable) in women vaccinated before sexual debut. No statistically significant difference in overall high-risk HPV, high-risk non-vaccine HPV, or any single non-vaccine type prevalence was observed between vaccinated and unvaccinated women. CONCLUSIONS: These results, conducted in a post-vaccine era, suggest a high qHPV VE and that a well-implemented catch-up vaccination program may be efficient in reducing vaccine-type infections in a real-world setting. No cross-protective effect or evidence of type-replacement was observed a few years after HPV vaccine introduction. More... »

PAGES

38

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12879-018-2945-8

DOI

http://dx.doi.org/10.1186/s12879-018-2945-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1100405038

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29334901


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28 schema:description BACKGROUND: A large free-of-charge quadrivalent HPV (qHPV) vaccination program, covering four cohorts annually (women 11, 14, 17 and 24 years), has been implemented in Basilicata since 2007. This study evaluated vaccine and non-vaccine HPV prevalence 5-7 years post-vaccination program implementation in vaccinated and unvaccinated women. METHODS: This population-based, cross-sectional study was conducted in the public screening centers of the Local Health Unit in Matera between 2012 and 2014. Cervical samples were obtained for Pap and HPV testing (HC2, LiPA Extra® assay) and participants completed a sociodemographic and behavioral questionnaire. Detailed HPV vaccination status was retrieved from the official HPV vaccine registry. HPV prevalence was described overall, by type and vaccination status. The association between HPV type-detection and risk/protective factors was studied. Direct vaccine protection (qHPV vaccine effectiveness [VE]), cross-protection, and type-replacement were evaluated in cohorts eligible for vaccination, by analyzing HPV prevalence of vaccine and non-vaccine types according to vaccination status. RESULTS: Overall, 2793 women (18-50 years) were included, 1314 of them having been in birth cohorts eligible for the HPV vaccination program (18- to 30-year-old women at enrolment). Among the latter, qHPV vaccine uptake was 59% (at least one dose), with 94% completing the schedule; standardized qHPV type prevalence was 0.6% in vaccinated versus 5.5% in unvaccinated women (P <0.001); adjusted VE against vaccine type infections was 90% (95% CI: 73%-96%) for all fully vaccinated women and 100% (95% CI not calculable) in women vaccinated before sexual debut. No statistically significant difference in overall high-risk HPV, high-risk non-vaccine HPV, or any single non-vaccine type prevalence was observed between vaccinated and unvaccinated women. CONCLUSIONS: These results, conducted in a post-vaccine era, suggest a high qHPV VE and that a well-implemented catch-up vaccination program may be efficient in reducing vaccine-type infections in a real-world setting. No cross-protective effect or evidence of type-replacement was observed a few years after HPV vaccine introduction.
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35 schema:keywords Basilicata
36 Basilicata region
37 Detailed HPV vaccination status
38 HPV
39 HPV prevalence
40 HPV prevalence 5
41 HPV testing
42 HPV type prevalence
43 HPV vaccination program
44 HPV vaccination status
45 HPV vaccine introduction
46 HPV vaccine registry
47 Italy
48 Local Health Unit
49 Matera
50 PAP
51 VE
52 association
53 behavioral questionnaires
54 birth cohort
55 catch
56 center
57 cervical samples
58 charge quadrivalent HPV (qHPV) vaccination program
59 cohort
60 cross-protective effect
61 cross-sectional study
62 debut
63 differences
64 direct vaccine protection
65 effect
66 era
67 evidence
68 factors
69 health units
70 high qHPV VE
71 high-risk HPV
72 high-risk non-vaccine HPV
73 implementation
74 infection
75 introduction
76 non-vaccine HPV
77 non-vaccine HPV prevalence 5
78 non-vaccine HPV type prevalence
79 non-vaccine type prevalence
80 non-vaccine types
81 official HPV vaccine registry
82 overall high-risk HPV
83 participants
84 post-vaccination era
85 post-vaccination program implementation
86 post-vaccine era
87 prevalence
88 prevalence 5
89 program
90 program implementation
91 protection
92 protective factors
93 public screening centers
94 qHPV VE
95 qHPV type prevalence
96 qHPV vaccine uptake
97 quadrivalent HPV vaccination program
98 questionnaire
99 real-world setting
100 region
101 registry
102 results
103 risk/protective factors
104 samples
105 schedule
106 screening center
107 setting
108 sexual debut
109 significant differences
110 single non-vaccine type prevalence
111 standardized qHPV type prevalence
112 status
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114 testing
115 type infection
116 type prevalence
117 types
118 units
119 unvaccinated women
120 uptake
121 vaccination
122 vaccination program
123 vaccination status
124 vaccine
125 vaccine introduction
126 vaccine protection
127 vaccine registry
128 vaccine uptake
129 vaccine-type infections
130 women
131 years
132 years post-vaccination program implementation
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