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Trend of HPV 16/18 Genotypes in Cervical Intraepithelial Neoplasia Grade 3: Data for 2007–2018
Infection and Drug Resistance ( IF 2.9 ) Pub Date : 2021-09-16 , DOI: 10.2147/idr.s326851 Luca Giannella 1 , Giovanni Delli Carpini 1 , Jacopo Di Giuseppe 1 , Giorgio Bogani 2 , Barbara Gardella 3 , Ermelinda Monti 4 , Carlo Antonio Liverani 4 , Alessandro Ghelardi 5 , Salvatore Insinga 1 , Michele Montanari 1 , Francesco Raspagliesi 2 , Arsenio Spinillo 3 , Paolo Vercellini 4 , Elena Roncella 4 , Andrea Ciavattini 1
Infection and Drug Resistance ( IF 2.9 ) Pub Date : 2021-09-16 , DOI: 10.2147/idr.s326851 Luca Giannella 1 , Giovanni Delli Carpini 1 , Jacopo Di Giuseppe 1 , Giorgio Bogani 2 , Barbara Gardella 3 , Ermelinda Monti 4 , Carlo Antonio Liverani 4 , Alessandro Ghelardi 5 , Salvatore Insinga 1 , Michele Montanari 1 , Francesco Raspagliesi 2 , Arsenio Spinillo 3 , Paolo Vercellini 4 , Elena Roncella 4 , Andrea Ciavattini 1
Affiliation
Aim: In the post-vaccination era, the starting age and time intervals of cervical screening could change (older age and longer screening intervals). This scenario may be achieved by significantly reducing human papillomavirus (HPV) 16/18 prevalence (genotypes included in the current vaccines). In this regard, assessing the trend over time of these HPV infections in high-grade cervical lesions can provide information on the objective. The present study aimed to evaluate the trend of HPV 16/18 over the years 2007– 2018 in women with cervical intraepithelial neoplasia (CIN) grade 3.
Methods: This is a retrospective multi-institutional study including HPV genotyped and unvaccinated women under 30 with CIN3. The sample was divided into the following periods: 2007– 2010, 2011– 2014, 2015– 2018. HPV genotypes were grouped in genotypes 16/18, genotypes 31/33/35/52/58/67 (genetically related to HPV16), genotypes 39/45/59/68/70 (genetically related to HPV18), genotypes 31/33/45/52/58 (high-risk types included in the nonavalent vaccine), possibly carcinogenic HPV (genotypes 26/30/53/67/70/73/82/85), low-risk HPV (genotypes 6/11/40/42/43/44/54/55/61). The trend between periods and HPV genotypes was measured using the Cochran–Armitage test for trend.
Results: The final analysis included 474 participants. HPV 16/18 prevalence decreased significantly over the years (77.8% vs 68.9% vs 66.0%, respectively, Ptrend=0.027). Possibly carcinogenic HPV (genotypes 26/30/53/67/70/73/82/85) showed a significant negative prevalence trend over time (4.9% vs 1.1% vs 1.3%, respectively, Ptrend=0.046). Finally, there was a significant positive trend over the years for high-risk HPV genotypes 31/33/45/52/58 in women under 25 (9.9% vs 17.0% vs 24.0%, respectively, Ptrend=0.048).
Conclusion: The prevalence of CIN3 lesions related to HPV 16/18 genotypes decreased over time from 2007 to 2018. These data highlight a herd effect of the HPV vaccine. However, fifteen years after HPV vaccine introduction, we are still a long way from herd immunity. The increase in high-risk types 31/33/45/52/58 will need to be reassessed when the nonavalent vaccine impact will be more reliable.
Keywords: cervical cancer, cervical intraepithelial neoplasia, cervical cancer screening program, HPV vaccine, HPV-16/18
中文翻译：
宫颈上皮内瘤变 3 级 HPV 16/18 基因型趋势：2007-2018 年数据
目的：在疫苗接种后时代，宫颈筛查的起始年龄和时间间隔可能会发生变化（年龄越大，筛查间隔越长）。这种情况可以通过显着降低人乳头瘤病毒 (HPV) 16/18 流行率（当前疫苗中包含的基因型）来实现。在这方面，评估这些 HPV 感染在高级别宫颈病变中随时间变化的趋势可以提供有关目标的信息。本研究旨在评估 2007-2018 年 3 级宫颈上皮内瘤变 (CIN) 女性中 HPV 16/18 的趋势。
方法：这是一项回顾性多机构研究，包括 HPV 基因分型和未接种疫苗的 30 岁以下患有 CIN3 的女性。样本分为以下时期：2007-2010、2011-2014、2015-2018。HPV 基因型分为基因型 16/18、基因型 31/33/35/52/58/67（与 HPV16 基因相关）、基因型 39/45/59/68/70（与 HPV18 基因相关），基因型 31/33/45/52/58（包括在非价疫苗中的高危型），可能致癌的 HPV（基因型 26/30/53/ 67/70/73/82/85），低风险 HPV（基因型 6/11/40/42/43/44/54/55/61）。使用 Cochran-Armitage 趋势检验测量周期和 HPV 基因型之间的趋势。
结果：最终分析包括 474 名参与者。HPV 16/18 患病率多年来显着下降（分别为 77.8% vs 68.9% vs 66.0%，Ptrend=0.027）。可能致癌的 HPV（基因型 26/30/53/67/70/73/82/85）随着时间的推移呈现出显着的负流行趋势（分别为 4.9% vs 1.1% vs 1.3%，Ptrend=0.046）。最后，多年来，25 岁以下女性的高危 HPV 基因型 31/33/45/52/58 有显着的积极趋势（分别为 9.9% vs 17.0% vs 24.0%，Ptrend=0.048）。
结论：从 2007 年到 2018 年，与 HPV 16/18 基因型相关的 CIN3 病变的患病率随着时间的推移而下降。这些数据突出了 HPV 疫苗的群体效应。然而，在 HPV 疫苗推出十五年后，我们距离群体免疫还有很长的路要走。当非价疫苗的影响更加可靠时，需要重新评估高风险类型 31/33/45/52/58 的增加。
关键词：宫颈癌，宫颈上皮内瘤变，宫颈癌筛查项目，HPV疫苗，HPV-16/18
更新日期：2021-09-15
Methods: This is a retrospective multi-institutional study including HPV genotyped and unvaccinated women under 30 with CIN3. The sample was divided into the following periods: 2007– 2010, 2011– 2014, 2015– 2018. HPV genotypes were grouped in genotypes 16/18, genotypes 31/33/35/52/58/67 (genetically related to HPV16), genotypes 39/45/59/68/70 (genetically related to HPV18), genotypes 31/33/45/52/58 (high-risk types included in the nonavalent vaccine), possibly carcinogenic HPV (genotypes 26/30/53/67/70/73/82/85), low-risk HPV (genotypes 6/11/40/42/43/44/54/55/61). The trend between periods and HPV genotypes was measured using the Cochran–Armitage test for trend.
Results: The final analysis included 474 participants. HPV 16/18 prevalence decreased significantly over the years (77.8% vs 68.9% vs 66.0%, respectively, Ptrend=0.027). Possibly carcinogenic HPV (genotypes 26/30/53/67/70/73/82/85) showed a significant negative prevalence trend over time (4.9% vs 1.1% vs 1.3%, respectively, Ptrend=0.046). Finally, there was a significant positive trend over the years for high-risk HPV genotypes 31/33/45/52/58 in women under 25 (9.9% vs 17.0% vs 24.0%, respectively, Ptrend=0.048).
Conclusion: The prevalence of CIN3 lesions related to HPV 16/18 genotypes decreased over time from 2007 to 2018. These data highlight a herd effect of the HPV vaccine. However, fifteen years after HPV vaccine introduction, we are still a long way from herd immunity. The increase in high-risk types 31/33/45/52/58 will need to be reassessed when the nonavalent vaccine impact will be more reliable.
Keywords: cervical cancer, cervical intraepithelial neoplasia, cervical cancer screening program, HPV vaccine, HPV-16/18
中文翻译：
宫颈上皮内瘤变 3 级 HPV 16/18 基因型趋势：2007-2018 年数据
目的：在疫苗接种后时代，宫颈筛查的起始年龄和时间间隔可能会发生变化（年龄越大，筛查间隔越长）。这种情况可以通过显着降低人乳头瘤病毒 (HPV) 16/18 流行率（当前疫苗中包含的基因型）来实现。在这方面，评估这些 HPV 感染在高级别宫颈病变中随时间变化的趋势可以提供有关目标的信息。本研究旨在评估 2007-2018 年 3 级宫颈上皮内瘤变 (CIN) 女性中 HPV 16/18 的趋势。
方法：这是一项回顾性多机构研究，包括 HPV 基因分型和未接种疫苗的 30 岁以下患有 CIN3 的女性。样本分为以下时期：2007-2010、2011-2014、2015-2018。HPV 基因型分为基因型 16/18、基因型 31/33/35/52/58/67（与 HPV16 基因相关）、基因型 39/45/59/68/70（与 HPV18 基因相关），基因型 31/33/45/52/58（包括在非价疫苗中的高危型），可能致癌的 HPV（基因型 26/30/53/ 67/70/73/82/85），低风险 HPV（基因型 6/11/40/42/43/44/54/55/61）。使用 Cochran-Armitage 趋势检验测量周期和 HPV 基因型之间的趋势。
结果：最终分析包括 474 名参与者。HPV 16/18 患病率多年来显着下降（分别为 77.8% vs 68.9% vs 66.0%，Ptrend=0.027）。可能致癌的 HPV（基因型 26/30/53/67/70/73/82/85）随着时间的推移呈现出显着的负流行趋势（分别为 4.9% vs 1.1% vs 1.3%，Ptrend=0.046）。最后，多年来，25 岁以下女性的高危 HPV 基因型 31/33/45/52/58 有显着的积极趋势（分别为 9.9% vs 17.0% vs 24.0%，Ptrend=0.048）。
结论：从 2007 年到 2018 年，与 HPV 16/18 基因型相关的 CIN3 病变的患病率随着时间的推移而下降。这些数据突出了 HPV 疫苗的群体效应。然而，在 HPV 疫苗推出十五年后，我们距离群体免疫还有很长的路要走。当非价疫苗的影响更加可靠时，需要重新评估高风险类型 31/33/45/52/58 的增加。
关键词：宫颈癌，宫颈上皮内瘤变，宫颈癌筛查项目，HPV疫苗，HPV-16/18
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