当前位置: X-MOL 学术J. Infect. Dis. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Vaccination With Moderate Coverage Eradicates Oncogenic Human Papillomaviruses If a Gender-Neutral Strategy Is Applied.
The Journal of Infectious Diseases ( IF 5.0 ) Pub Date : 2020-03-11 , DOI: 10.1093/infdis/jiaa099
Simopekka Vänskä 1, 2 , Tapio Luostarinen 3 , Iacopo Baussano 4 , Dan Apter 5 , Tiina Eriksson 6 , Kari Natunen 6 , Pekka Nieminen 7 , Jorma Paavonen 7 , Ville N Pimenoff 2, 6, 8 , Eero Pukkala 6 , Anna Söderlund-Strand 9 , Gary Dubin 10 , Geoff Garnett 11 , Joakim Dillner 2 , Matti Lehtinen 2, 6, 12
Affiliation  

Background
Human papillomavirus (HPV) vaccination of girls with very high (>90%) coverage has the potential to eradicate oncogenic HPVs, but such high coverage is hard to achieve. The herd effect (HE), however, depends both on the HPV type and the vaccination strategy.
Methods
We randomized 33 Finnish communities into gender-neutral HPV16/18 vaccination, girls-only HPV16/18 vaccination, and hepatitis B-virus vaccination arms. In 2007-2010, 11,662/20,513 of 40,852/39,420 resident boys/girls from 1992-1995 birth cohorts consented. In 2010-14, cervicovaginal samples from vaccinated and unvaccinated girls at age 18.5 years were typed for HPV6/11/16/18/31/33/35/39/45/51/52/56/58/59/66/68. Vaccine efficacy (VE) for vaccinated girls, HE for unvaccinated girls, and the protective effectiveness (PE) for all girls, were estimated. We extended the community-randomized trial results about vaccination strategy with mathematical modeling to assess HPV eradication.
Results
The HE and PE estimates in the 1995 birth cohort for HPV18/31/33 were significant in the gender-neutral arm, and 150% and 40% stronger than in the girls-only arm. Concordantly, HPV18/31/33 eradication was predicted in adolescents/young adults in already 20 years with 75% coverage of gender-neutral vaccination. With the 75% coverage, eventual HPV16 eradication was also predicted, but only with the gender-neutral strategy.
Conclusions
Gender-neutral vaccination is superior for eradication of oncogenic HPVs.


中文翻译:


如果采用性别中立策略,中等覆盖率的疫苗接种可以根除致癌人乳头瘤病毒。


 背景

对女孩进行人乳头瘤病毒 (HPV) 疫苗接种的覆盖率非常高 (>90%),有可能根除致癌 HPV,但如此高的覆盖率很难实现。然而,羊群效应 (HE) 取决于 HPV 类型和疫苗接种策略。
 方法

我们将 33 个芬兰社区随机分为性别中立的 HPV16/18 疫苗接种组、仅限女孩的 HPV16/18 疫苗接种组和乙型肝炎病毒疫苗接种组。 2007-2010年,1992-1995年出生队列的40,852/39,420名居民男孩/女孩中,有11,662/20,513人同意。 2010-14年,对18.5岁已接种疫苗和未接种疫苗的女孩的宫颈阴道样本进行了HPV6/11/16/18/31/33/35/39/45/51/52/56/58/59/66/68分型。评估了已接种疫苗的女孩的疫苗效力(VE)、未接种疫苗的女孩的 HE 以及所有女孩的保护效力(PE)。我们利用数学模型扩展了有关疫苗接种策略的社区随机试验结果,以评估 HPV 根除情况。
 结果

1995 年出生队列中 HPV18/31/33 的 HE 和 PE 估计值在中性组中显着,比仅女孩组强 150% 和 40%。一致地,预计 HPV18/31/33 在青少年/年轻人中将在 20 年内根除,性别中性疫苗接种覆盖率达到 75%。随着覆盖率达到 75%,HPV16 也有望最终被根除,但仅限于性别中立策略。
 结论

不分性别的疫苗接种对于根除致癌 HPV 效果更佳。
更新日期:2020-03-12
down
wechat
bug