宫颈癌及癌前病变HPV型别分布与疫苗保护性研究

目的:分析来源于甘肃省的宫颈癌及高危型癌前病变组中人乳头瘤病毒(HPV)感染及HPV型别分布情况,预测HPV疫苗的潜在影响。方法:采用TCT、HC-Ⅱ检测进行宫颈病变筛查,异常者进行宫颈组织病理学检查;确诊为宫颈癌(ICC)或高危型癌前病变(≥CINⅡ)术前未进行放疗及化疗的为研究对象,标本运用SPF10-PCR技术进行分型检测。结果:ICC、≥CINⅡ中,HPV感染率分别为95.83%、96.37%。分布最广的为HPV16,累计感染分别为75.00%、57.81%;排第2位的是HPV18,分别为16.67%、26.56%;排第3位的是HPV58,分别为12.5%、20.31%。HPV16与HPV18混合感染为4.35%、11.29%。结论:HPV16、18型二价或HPV16、18、6、11型四价疫苗在本省宫颈癌的潜在保护能力较强,达69.56%。     

西安非医学专业女大学生对HPV和HPV疫苗的认知

目的 了解西安市高校非医学专业女大学生对人乳头瘤病毒(HPV)的认知情况及其对接种HPV疫苗的态度,为制定针对非医学专业大学生健康教育模式,推广HPV疫苗的接种提供依据.方法 采用整群随机抽样的方法,在西安市6所非医学类本科高校中抽取16个专业的大学二、三年级女大学生共2 131名,用自行设计的问卷进行调查,获有效问卷2 096份,有效回收率为98.4％.结果 仅11.3％被调查者知晓HPV,有性生活组大学生对HPV知晓率显著高于无性生活组(x2=20.182,P＜0.05),来自单亲或重组家庭的女大学生对HPV知晓率显著高于来自原生家庭组(x2=4.329,P＜0.05).不同年级间(x2=0.921),来自城市或农村(x2=0.891),是否独生子女(x2 =0.330)组间对HPV知晓率差异无统计学意义(P＞0.05).仅9.7％被调查者知晓HPV疫苗.79.9％的被调查者表示愿意接种HPV疫苗;担心会感染HPV (44.1％)或患宫颈癌(19.3％)的被调查者有较强的接种意愿;公众健康教育(42.2％)及医务人员推荐(34.7％)是女大学生们更愿意接受的疫苗推荐方式.超过半数被调查者(50.1％)能够接受的疫苗价格在50～ 100元.结论 西安非医学专业大学生对HPV及HPV疫苗的知晓率低,但接种意愿强.应加强科普健康教育,普及宫颈癌一级预防、HPV及HPV疫苗相关知识.     

西安市妇科门诊患者HPV和HPV疫苗的认知调查

目的 了解西安市妇科门诊患者对人乳头瘤病毒(HPV)的认知情况及其接种HPV疫苗的态度,为推广HPV疫苗的接种提供依据. 方法 在西安市第四医院妇科门诊单纯随机抽取前来就诊的患者1 000人,采用自行设计的问卷,进行调查.问卷内容主要包括患者的基本资料(年龄、婚姻、学历、职业)、对HPV的认知、对HPV疫苗的认知及态度. 结果 32.5％患者知晓HPV,不同年龄、教育程度、职业的女性在HPV知晓率上差异均有统计学意义.30＜年龄≤40岁年龄段的女性对HPV的知晓率(49％)明显高于21≤年龄≤30岁(34.4％)和60＜年龄≤71岁(17.6％)年龄段的女性,大学及以上学历的女性对HPV的知晓率(44.3％)明显高于初高中组,未受过教育的女性对HPV的知晓率(29.7％)最低;干部/职员/技术人员对HPV的知晓率(41.7％)最高,而工人、农民、个体户/服务人员对HPV的知晓率普遍偏低.76.0％患者愿意接种HPV疫苗,担心会感染HPV(32.1％)或患宫颈癌(26.1％)的女性有较强的接种意愿.56.6％的患者能接受的疫苗价格在50 ～ 100元,有49.9％的患者更愿意接受政府提供的疫苗,40.8％的患者更愿意接受医疗机构提供的疫苗. 结论 西安市门诊患者对HPV及其疫苗的知晓率较低,应加强公众健康教育宣传力度,普及HPV疫苗相关知识.     

HPV疫苗上市后中国女学生HPV疫苗知识和接受性的变化

目的 了解HPV疫苗在中国内地上市后,中国女学生HPV疫苗知识和接受性的变化,为制订免疫策略提供理论依据.方法 2014年和2019年,使用同一调查问卷对相同学校、年龄组女学生进行HPV及疫苗的知识知晓情况、接受性调查分析.结果 2014年和2019年分别调查1384人和1027人,HPV知晓率分别为8.89％和29....     

中山大学本科生对HPV及疫苗认知的调查

摘要:目的　了解中山大学本科学生对HPV及其预防性疫苗认知情况,分析其影响因素,为HPV疫苗在国内推广提供建议。方法　采用分层整群抽样方法,获得中山大学本科学生共2 004名。调查方式为问卷自填式。内容包括基本情况及人口统计学特征、对HPV疫苗和相关疾病的认知情况以及HPV疫苗接种的意愿。结果　2 004名本科生中,有261人（13.1%）听说过HPV疫苗,听说过HPV相关疾病的有1 649人（82.9%）,有80.2%和79.7%的人愿意自己接种疫苗和鼓励男/女朋友接种疫苗。年级和专业是影响是否听说HPV疫苗的因素,是否听说HPV相关疾病、是否担心患HPV相关疾病是影响接种疫苗意愿因素。结论　大学本科学生对HPV疫苗以及相关疾病的认识欠缺全面,接种疫苗的意愿积极。学校推进HPV疫苗以及相关专业知识在本科阶段的教育,国家增加对HPV疫苗的补贴,有利于HPV疫苗的推广。     

青海高海拔地区女性对HPV和HPV疫苗的认知情况

目的 了解高海拔欠发达地区部分女性对人乳头瘤病毒(HPV)和HPV疫苗的认知情况,以及主要影响接种HPV疫苗的因素,为更好地开展HPV疫苗接种、预防子宫颈癌的发生提供参考依据.方法 于2019年1-11月选取青海西宁和玉树州的206例女性进行问卷调查,收集资料,了解其对HPV以及HPV疫苗的认知情况,并对影响调查对象认...     

新疆维吾尔族、汉族妇女对宫颈癌、HPV及HPV疫苗认知情况的调查分析

目的:调查新疆维吾尔族、汉族妇女对宫颈癌、人乳头瘤病毒(HPV)及HPV疫苗的相关认知情况,为宫颈癌的防治提供健康教育干预基础,降低宫颈癌的发病率和死亡率,提高广大妇女的保健意识。方法:对新疆地区自愿参与调查的妇女发放维吾尔语和汉语两种语言的调查问卷,统计问卷结果。结果:维吾尔族妇女对宫颈癌、HPV及HPV疫苗的知晓率分别为25.0%、8.0%和4.0%,汉族妇女的知晓率分别为35.0%、19.0%和7.0%。维吾尔族、汉族妇女宫颈癌发病高危因素知晓率分别为15.6%和26.5%,做过宫颈涂片检查的比例分别为18.0%和31.0%,做过HPV检查的比例分别为4.5%和11.0%。认知程度与调查对象的文化水平有关,差异有统计学意义(P<0.05)。维吾尔族、汉族妇女对宫颈癌、HPV及HPV疫苗的认知程度随着文化水平的提高而增高。结论:新疆维吾尔族妇女对宫颈癌、HPV及HPV疫苗的知晓率低。新疆是我国宫颈癌高发地区,维吾尔族妇女是新疆地区宫颈癌的高发人群,维吾尔族妇女对宫颈癌、HPV及HPV疫苗相关知识缺乏了解。因此提高新疆地区妇女尤其是维吾尔族妇女对宫颈癌的预防保健意识,提高对宫颈癌、HPV及HPV疫苗相关知识的认知程度是早期发现子宫颈癌前病变、降低宫颈癌发病率及死亡率的关键。     

国内引入HPV疫苗的必要性研究

HPV(人乳头瘤病毒)是一种小DNA病毒,对人的皮肤和黏膜有特异性感染能力,是宫颈癌发生癌前病变及其进展为宫颈癌的主要因素。2006年HPV疫苗在全球上市,宫颈癌预防取得突破性进展,成为历史上第一个病因明确、可以通过接种疫苗、早期筛查和及时治疗来预防和治疗的癌症,大大降低了由宫颈癌导致的医疗费用和劳动生产力损失。加之,国内宫颈癌疫苗需求高,多有组团赴港澳接种的报道,就健康价值来说,引入宫颈癌疫苗对缓解国内需求及降低宫颈癌发病率极有必要。     

武汉初中生家长对接种HPV疫苗接受度调查

目的了解武汉市初中生家长对孩子接种HPV疫苗的接受度,为在中国进行HPV疫苗接种提供科学依据。方法采取整群抽样方法抽取某初中一、二年级学生家长进行问卷调查。结果341名调查对象中,36．66％的人愿意孩子接种HPV疫苗。多元Logistic回归结果显示,家长的性别、HPV知晓情况和疫苗价格是影响家长对HPV疫苗接受度的主要因素。结论初中生家长对孩子接种HPV疫苗的接受度不高,积极开展HPV及HPV疫苗的认知教育对今后HPV疫苗的预防接种有潜在意义。     

女性HPV感染情况及对HPV和HPV疫苗的认知情况调查

目的了解女性人群人乳头瘤病毒(HPV)的感染情况,调查女性人群对HPV及HPV疫苗的认知情况。方法选取2017年9月-2018年3月就诊的20~60岁女性患者804例,对其进行HPV及HPV疫苗相关知识调查并进行HPV检测。结果人群HPV阳性检测率为15.67%,人群高危型HPV(HR-HPV)阳性检测率为13.60%,低危型HPV(LR-HPV)阳性检测率为4.73%,同时感染HR-HPV及LR-HPV的阳性检出率为2.66%。低年龄组的HPV感染率高于高年龄组的感染率;在HPV、宫颈癌及HPV疫苗的认知水平调查中发现:70.02%的人知道HPV,67.91%的人知道HPV与宫颈癌有关,40.92%的人知道HPV疫苗,并有23.13%的人表示有意愿接种疫苗;单因素结果显示:年龄、户籍类型、文化程度及家庭月平均收入均对HPV认知产生影响(P<0.05)。对于影响HPV疫苗认知程度的因素赋值,引入Logistic多因素回归模型进行分析,结果显示:年龄、户籍及文化程度会对HPV疫苗认知程度产生影响。结论女性HPV感染情况及对HPV和HPV疫苗的认知情况仍不容乐观,政府和及医疗卫生机构应积极在各个层面有针对性地开展健康教育活动。     

Estimating effectiveness of HPV vaccination against HPV infection from post-vaccination data in the absence of baseline data

BackgroundHPV vaccination programs have been introduced in large parts of the world, but monitoring of effectiveness is not routinely performed. Many countries introduced vaccination programs without establishing the baseline of HPV prevalences. We developed and validated methods to estimate protective effectiveness (PE) of vaccination from the post-vaccination data alone using references, which are invariant under HPV vaccination.MethodsType-specific HPV prevalence data for 15–39 year-old women were collected from the pre- and post-vaccination era in a region in southern Sweden. In a region in middle Sweden, where no baseline data had been collected, only post-vaccination data was collected. The age-specific baseline prevalence of vaccine HPV types (vtHPV, HPV 6, 11, 16, 18) were reconstructed as Beta distributions from post-vaccination data by applying the reference odds ratios between the target HPV type and non-vaccine-type HPV (nvtHPV) prevalences. Older non-vaccinated age cohorts and the southern Sweden region were used as the references. The methods for baseline reconstructions were validated by computing the Bhattacharyya coefficient (BC), a measure for divergence, between reconstructed and actual observed prevalences for vaccine HPV types in Southern Sweden, and in addition, for non-vaccine types in both regions. The PE estimates among 18–21 year-old women were validated by comparing the PE estimates that were based on the reconstructed baseline prevalences against the PE estimates based on the actual baseline prevalences.ResultsIn Southern Sweden the PEs against vtHPV were 52.2% (95% CI: 44.9–58.5) using the reconstructed baseline and 49.6% (43.2–55.5) using the actual baseline, with high BC 82.7% between the reconstructed and actual baseline. In the middle Sweden region where baseline data was missing, the PE was estimated at 40.5% (31.6–48.5).ConclusionsProtective effectiveness of HPV vaccination can be estimated from post-vaccination data alone via reconstructing the baseline using non-vaccine HPV type data.     

Effectiveness of HPV vaccines against genital warts in women from Valencia,Spain

ObjectivesTo assess the effectiveness of the HPV vaccines in preventing genital warts in young women.DesignPopulation-based study using health databases.SettingValencian Community (Spain).ParticipantsAll girls and women aged 14–19 years who were registered in the Valencian Community between January 2009 and December 2014 (n = 279,787).Main outcome measuresIncident cases of genital warts were defined as the first activation of diagnosis code ICD-9-CM 078.11 (Condyloma acuminatum) in primary care and outpatient clinics during the study period.ResultsThere were 612 cases of genital warts. The overall incidence rate was 75.8/100,000 person-years (95% CrI 69.7–81.8). There was a decrease in genital warts when female candidates to be vaccinated with quadrivalent HPV vaccine reached the age of 18 (in 2012), compared to previous years. Incidence of genital warts in unvaccinated women and those who received the bivalent vaccine was higher than in girls and women who received the quadrivalent HPV vaccine. The effectiveness of a three-dose regimen of the quadrivalent HPV vaccine was 77% (95 CrI: 66–85%), whereas that of a single dose was 61% (95 CrI: 20–87%). No effectiveness was seen with a full vaccination course with the bivalent HPV vaccine.ConclusionsThree doses of the quadrivalent HPV vaccine were effective against genital warts in our population. Moreover, with low vaccine coverage the incidence of genital warts decreased only in the vaccinated.     

Immunogenicity of next-generation HPV vaccines in non-human primates: Measles-vectored HPV vaccine versus Pichia pastoris recombinant protein vaccine

Human papillomavirus (HPV) infection is the most common sexually transmitted disease worldwide. HPVs are oncogenic small double-stranded DNA viruses that are the primary causal agent of cervical cancer and other types of cancers, including in the anus, oropharynx, vagina, vulva, and penis. Prophylactic vaccination against HPV is an attractive strategy for preventing cervical cancer and some other types of cancers. However, there are few safe and effective vaccines against HPV infections. Current first-generation commercial HPV vaccines are expensive to produce and deliver.The goal of this study was to develop an alternate potent HPV recombinant L1-based vaccines by producing HPV virus-like particles into a vaccine that is currently used worldwide. Live attenuated measles virus (MV) vaccines have a well-established safety and efficacy record, and recombinant MV (rMV) produced by reverse genetics may be useful for generating candidate HPV vaccines to meet the needs of the developing world.We studied in non-human primate rMV-vectored HPV vaccine in parallel with a classical alum adjuvant recombinant HPV16L1 and 18L1 protein vaccine produced in Pichia pastoris. A combined prime-boost approach using both vaccines was evaluated, as well as immune interference due to pre-existing immunity against the MV.The humoral immune response induced by the MV, Pichia-expressed vaccine, and their combination as priming and boosting approaches was found to elicit HPV16L1 and 18L1 specific total IgG and neutralizing antibody titres. Pre-existing antibodies against measles did not prevent the immune response against HPV16L1 and 18L1.     

Neutralizing and cross-neutralizing antibody titres induced by bivalent and quadrivalent human papillomavirus vaccines in the target population of organized vaccination programmes

Aim of this investigator-initiated study was to evaluate and compare the titres of neutralizing and cross-neutralizing antibodies (NAbs) induced by the bivalent (Cervarix^®) and quadrivalent (Gardasil^®) HPV vaccines in a cohort of girls aged 11–13 years from organized vaccination programmes. To this aim, HPV16 and HPV18 NAbs were measured by pseudovirion-based neutralization assays in serum collected at 1–6 months after the third vaccine dose in 107 girls vaccinated with Cervarix^® and 126 vaccinated with Gardasil^®, while HPV31 and HPV45 cross-NAbs were tested in the first 50 consecutive girls of both vaccine groups. The results of this study demonstrated that all vaccinated girls developed HPV16 and HPV18 NAbs, with the exception of two Gardasil^® vaccinees with undetectable HPV18 NAbs. Geometric mean titres (GMTs) of both HPV16 and HPV18 NAbs were significantly higher in Cervarix^® than in Gardasil^® vaccinees [HPV16 NAb GMT 22,136 (95% CI, 18,811–26,073) vs 5092 (4230–6151), respectively; P < 0.0001; HPV18 NAb GMT 11,962 (9536–14,363) vs 1804 (1574-2110), respectively; P < 0.0001]. Cross-NAbs to HPV31 and HPV45 were detected more frequently Cervarix^® (HPV31 NAb positivity rates 92.7% and 36%, respectively; P < 0.05) than in Gardasil^® vaccinees (HPV45 NAb positivity rates 56% and 6%, respectively; P < 0.0001). The titres of cross-NAbs against HPV31 and HPV45 were also significantly higher in Cervarix^® than in Gardasil^® vaccinees [HPV31 NAb GMT 157.2 (95% CI, 92–269) vs 13.0 (6.5–25.8), respectively; P < 0.0001; HPV45 NAb GMT 4.7 (2.1–10.2) vs 1.3 (0.3–3.1), respectively; P < 0.01].     

人乳头瘤病毒感染现状的分析

目的:分析宫颈疾病患者的人乳头瘤病毒(HPV)感染及相关情况,为宫颈疾病的防治提供线索和依据。方法:收集2009年7月~2010年5月210例宫颈疾病患者的宫颈外口和宫颈脱落细胞及分泌物进行HPV-PCR的检测。结果:HPV感染的阳性率为30.00%,HPV阳性患者的平均年龄为(24.16±8.18)岁,HPV阴性患者平均年龄为(36.94±9.95)岁;HPV的感染与患者的受教育水平,饮酒吸烟及性伴侣多有统计学相关性,HPV阳性患者中饮酒患者占55.56%,吸烟的患者占38.10%;并且运用单危险因素分析发现,月收入、婚姻状况、吸烟状况及性伴侣个数几个因素与HPV感染之间具有相关性。结论:HPV的感染可能与性伴侣个数,吸烟饮酒等多种因素相关;HPV-DNA检测在宫颈病变的检查中具有重要意义。     

A phase III clinical study to compare the immunogenicity and safety of the 9-valent and quadrivalent HPV vaccines in men

BackgroundA nine-valent human papilloma virus (9vHPV) vaccine has been developed to prevent infections and diseases related to HPV 6/11/16/18 (as per the licensed quadrivalent HPV (qHPV) vaccine) as well as to five additional oncogenic HPV types (HPV 31/33/45/52/58). The 9vHPV vaccine has the potential to prevent 90% of cervical cancers, HPV-related anal, vaginal and vulval cancers and anogenital warts. We compared the immunogenicity and safety of the 9vHPV vaccine versus the qHPV vaccine in 16–26-year-old men.MethodsParticipants (N = 500) were randomised to receive 9vHPV or qHPV vaccines on day 1, month 2 and month 6. Serology testing was performed on day 1 and month 7. HPV type-specific antibody titres (anti-HPV 6/11/16/18/31/33/45/52/58) were determined by competitive Luminex immunoassay and expressed as geometric mean titres and seroconversion rates. Vaccine safety was also assessed.ResultsThe HPV 6/11/16/18 immune responses elicited by the 9vHPV vaccine were comparable with those elicited by the qHPV vaccine. All participants receiving the 9vHPV vaccine seroconverted for HPV 31/33/45/52/58. The 9vHPV and qHPV vaccines showed comparable safety profiles.ConclusionsIn addition to immune responses to HPV 31/33/45/52/58, a three-dose regimen of the 9vHPV vaccine elicited a similar immune response to HPV 6/11/16/18 when compared with the qHPV vaccine in men aged 16–26 years. The safety profile was also similar for the two vaccines. The results from this study support extending the efficacy findings with qHPV vaccine to 9vHPV vaccine in men aged 16–26 years.NCT02114385     

Effects of three commercial vaccines against porcine parvovirus 1 in pregnant gilts

Porcine parvovirosis is a common and important cause of reproductive failure in naïve dams. Even though vaccination is generally effective at preventing disease occurrence, the homology between the vaccine and challenge strains has been recently suggested to play a role in protection. Therefore, the purpose of this study was to evaluate and compare the efficacy of three currently available commercial vaccines against porcine parvovirus genotype 1 (PPV1) in an experimental model using pregnant gilts. Seventy-seven PPV1-negative gilts were included in the trial and randomly allocated to four groups. In group 1, gilts received two doses, three weeks apart, of a PPV1 subunit vaccine (ReproCyc® ParvoFLEX). Following the same scheme, gilts from group 2 received two doses of a PPV1 bivalent vaccine (ERYSENG® PARVO). In group 3, gilts received two doses, four weeks apart, of a PPV1 octavalent vaccine (Porcilis® Ery + Parvo + Lepto). Lastly, gilts from group 4 were left untreated and were used as challenge controls. All gilts were artificially inseminated three weeks after completion of vaccination. Pregnant animals were subsequently challenged around 40 days of gestation with a heterologous PPV1 strain. Foetuses were harvested at around day 90 of gestation and evaluated for their macroscopic appearance (i.e., normal, mummified, or autolytic). Along the study, safety parameters after vaccination, antibody responses against PPV1 and viremia in gilts were also measured. All the foetuses in the challenge control group were mummified, which validated the challenge model, whereas the three evaluated vaccines protected the progeny against PPV1 by preventing the appearance of clinical manifestations associated to parvovirosis. Remarkably, the PPV1 subunit vaccine induced an earlier seroconversion of gilts and was the only vaccine that could prevent viremia after challenge. This vaccine also achieved the largest average litter size accompanied with a high average proportion of clinically healthy foetuses.     

Knowledge and attitudes about human papillomavirus (HPV) and HPV vaccines among women living in metropolitan and rural regions of China

Infection with the human papillomavirus (HPV) is one of the most common sexually transmitted infections and causes virtually all cervical cancer globally. The recent development of two safe and clinically effective vaccines against HPV is a promising step towards lowering cervical cancer rates in the future. What Chinese women think about HPV and the vaccines remains unknown. We undertook a population-based survey, which was embedded in a cervical cancer screening project and was designed to assess women's knowledge about HPV and their acceptability to the vaccines. We found that only 15.0% of women in our study reported to have ever heard of HPV, and this knowledge differs by rural (9.3%) and metropolitan areas (21.6%) and also by education. Most (84.6%) participants were willing to be vaccinated if HPV vaccine became available to them. The present study documents ways in which women learn about HPV and indicates the potential barriers and success of introducing HPV vaccine to China.     

女性生育史与生殖道HPV感染关系探讨

目的：探讨女性生育史与生殖道HPV感染的关系。方法：对2005年1月-2007年8间在绍兴市人民医院妇科门诊接受宫颈阴道分泌物标本HPV基因型分型检测的1155位女性,同时调查其生育史,比较不同妊娠次数、流产次数、足月分娩次数下的HPV阳性率。结果：本组资料HPV总阳性率为53.77%,除4次及4次以上分娩组阳性率极高外,但不同妊娠次数（0次、1次、2次、3次、≥4次）,流产次数（同前）及足月分娩次数（同前）下各组HPV阳性率差异无显著性,P值均〉0.05。结论：女性生育史与生殖道HPV感染关系并不明显。