Vaccination against human papillomavirus (HPV) is changing the performance of cytology as a cervical screening test, but its effect on HPV testing is unclear. We review the effect of HPV16/18 vaccination on the epidemiology and the detection of HPV infections and high-grade cervical lesions (CIN2+) to evaluate the likely direction of changes in HPV test accuracy. The reduction in HPV16/18 infections and cross-protection against certain non-16/18 high-risk genotypes, most notably 31, 33, and/or 45, will likely increase the test’s specificity but decrease its positive predictive value (PPV) for CIN2+. Post-vaccination viral unmasking of non-16/18 genotypes due to fewer HPV16 co-infections might reduce the specificity and the PPV for CIN2+. Post-vaccination clinical unmasking exposing a higher frequency of CIN2+ related to non-16/18 high-risk genotypes is likely to increase the specificity and the PPV of HPV tests. The effect of HPV16/18 vaccination on HPV test sensitivity is difficult to predict based on these changes alone. Programmes relying on HPV detection for primary screening should monitor the frequency of false-positive and false-negative tests in vaccinated (younger) vs. unvaccinated (older) cohorts, to assess the outcomes and performance of their service.

人乳头瘤病毒 (HPV) 疫苗正在改变细胞学作为宫颈筛查检测的性能，但其对 HPV 检测的影响尚不清楚。我们回顾了 HPV16/18 疫苗接种对流行病学以及 HPV 感染和高度宫颈病变 (CIN2+) 检测的影响，以评估 HPV 检测准确性的可能变化方向。 HPV16/18 感染的减少以及针对某些非 16/18 高危基因型（尤其是 31、33 和/或 45）的交叉保护可能会提高检测的特异性，但会降低其阳性预测值 (PPV)。 CIN2+。由于 HPV16 合并感染较少，疫苗接种后病毒暴露非 16/18 基因型可能会降低 CIN2+ 的特异性和 PPV。疫苗接种后临床揭露暴露与非 16/18 高危基因型相关的 CIN2+ 频率较高，可能会增加 HPV 检测的特异性和 PPV。仅根据这些变化很难预测 HPV16/18 疫苗接种对 HPV 检测敏感性的影响。依靠 HPV 检测进行初级筛查的计划应监测已接种疫苗（年轻）和未接种疫苗（老年）人群中假阳性和假阴性检测的频率，以评估其服务的结果和表现。