Prevalence of high-risk HPV genotypes, categorised by their quadrivalent and nine-valent HPV vaccination coverage, and the genotype association with high-grade lesions
Open accessAbstract
BACKGROUND: The new nine-valent vaccine against human papillomavirus (HPV) includes the four HPV genotypes (6, 11, 16, and 18) that are targeted by the older quadrivalent HPV vaccine, plus five additional oncogenic types (31, 33, 45, 52, and 58) remain significantly associated with high grade lesions. We aimed to determine the prevalence of high-risk HPV genotypes in unvaccinated subjects and the association of these genotypes with the incidence of high-grade lesions. We also assessed which, if either, of these two HPV vaccines could have prevented these cases. METHODS: This cross-sectional study, conducted from 4 January 2010 to 30 December 2011, was composed of 595 women attending the Hospital General Universitario de Elche (Spain) gynaecology department who were positively screened for opportunistic cervical cancer by pap smears and HPV detection during a routine gynaecological health check. The pap smear results were classified using the Bethesda system. HPV genotyping was performed with the Linear Array HPV genotyping test, and viruses were classified by the International Agency for Research on Cancer assessment of HPV carcinogenicity. Odds ratios (ORs) with their 95% confidence intervals (95% CI) were estimated by logistic regression, adjusting for age and immigrant status. The prevented fraction among those exposed (PFe-adjusted) was determined as a measure of impact. RESULTS: At least one of the additional five high-risk HPV genotypes present in the nine-valent HPV vaccine was detected in 20.5% of subjects. After excluding women with genotype 16 and/or 18 co-infection, high-risk genotypes (31, 33, 45, 52, and 58) were associated with a higher risk of intraepithelial lesion or malignancy: adjusted OR = 3.51 (95% CI, 1.29-9.56), PFe-adjusted = 0.72 (95% CI, 0.22-0.90). Genotypes that are still non-vaccine-targeted were detected in 17.98% of the women, but these were not significantly associated with high-grade lesions. CONCLUSION: The greater protection of the nine-valent HPV vaccine is likely to have a positive impact because, in the absence of genotype 16 or 18 infection, these five genotypes on their own remained significantly associated with high-grade lesions.
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HPV genotyping is needed to establish the impact of HPV vaccination programs.
“establish the impact of HPV vaccination programs [27, 28]”
From Comparison of Seegene Anyplex II HPV28 assay with BD Onclarity HPV assay for human papillomavirus genotyping (2022) · cites this paper as [27]
The Discussion (page unavailable) says that HPV genotype prevalence in unvaccinated women can be used to estimate the potential impact of quadrivalent and nine-valent vaccines. It does not say genotyping is necessary to establish the observed impact of vaccination programs; it also cautions against generalizing its estimates to the general population. (LLM, conf=0.86)
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- Authors
- Paz-Zulueta, M., Álvarez-Paredes, L., Rodríguez Díaz, J. C., Parás-Bravo, P., Andrada Becerra, M. E., Rodríguez Ingelmo, J. M., Ruiz García, M. M., Portilla, J., & Santibañez, M.
- Affiliations
- Hospital Universitario de Burgos (ES)
- Venue
- BMC Cancer
- Published
- 2018-01-30
- Volume
- 18
- Issue
- 1
- Pages
- 112-112
- ISSN
- 1471-2407 (ISSN-L)
- PMC
- PMC5791190
- OpenAlex
- W2796708781
- Cited by
- 58
- References
- 51
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 8 · 2023: 5 · 2022: 7 · 2021: 9 · 2020: 9 · 2019: 8 · 2018: 1
- FWCI
- 5.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Cancer (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCrea (University of Cantabria) (publishedVersion, cc-by)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Fundación para la Investigación del Hospital Universitario de Elche (FIBELX) and Fundación Navarro Tripodi
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- high-risk HPV genotypes, 9-valent HPV vaccine, quadrivalent HPV vaccine, HPV genotyping, cervical intraepithelial neoplasia, high-grade cervical lesions, vaccination coverage, HPV 16/18, vaccine impact
- MeSH terms
- Vaccination Coverage, Adult, Uterine Cervical Neoplasms, Female, Genotype, Humans, Middle Aged, Spain, Vaginal Smears, Papillomavirus Infections, Human papillomavirus 18, Human papillomavirus 16, Papillomavirus Vaccines
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