Estimation of HPV prevalence in young women in Scotland; monitoring of future vaccine impact

BMC Infectious Diseases

Chris Robertson³  Martin Donaghy⁵  Heather Cubie¹  Kevin GJ Pollock⁵  Alison Potts⁵  John Love⁵  Kate Cuschieri⁴  Katy Sinka⁵  Kimberley Kavanagh² 

[1] Human Papillomavirus Group and Scottish HPV Investigators Network (SHINe), MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh EH16 4TJ, UK;Department of Mathematics and Statistics, University of Strathclyde, Glasgow G1 1XH, UK;International Prevention Research Institute (iPRI), 69006, Lyon, France;Department of Laboratory Medicine, Scottish HPV Reference Lab, Royal Infirmary of Edinburgh, NHS Lothian EH16 4SA, UK;Health Protection Scotland, Glasgow G2 6QE, UK

关键词: Multiple infections;    Prevalence;    Vaccination;    Human papilloma virus;   

Others  :  1145550
DOI  :  10.1186/1471-2334-13-519

 received in 2013-05-07, accepted in 2013-10-29,  发布年份 2013

【 摘 要 】

Background

Estimation of pre-immunisation prevalence of HPV and distribution of HPV types is fundamental to understanding the subsequent impact of HPV vaccination. We describe the type specific prevalence of HPV in females aged 20–21 in Scotland who attended or defaulted from cervical screening using three specimen types; from attenders liquid based cytology and from defaulters urine or self-taken swabs.

Methods

Residual liquid based cytology samples (n = 2148), collected from women aged 20–21 attending for their first smear were genotyped for HPV. A sample (n = 709) from women who had defaulted from screening was also made available for HPV testing through the use of postal testing kits (either urine samples (n = 378) or self-taken swabs (n = 331)). Estimates of prevalence weighted by deprivation, and for the postal testing kit, also by reminder status and specimen type were calculated for each HPV type. The distribution of HPV types were compared between specimen types and the occurrence of multiple high-risk infections examined. The influence of demographic factors on high-risk HPV positivity and multiple infections was examined via logistic regression.

Results

The prevalence of any HPV in young women aged 20–21 was 32.2% for urine, 39.5% for self-taken swab, and 49.4% for LBC specimens. Infection with vaccine specific types (HPV 16, 18) or those associated with cross-protection (HPV 31, 33, 45, 51) was common. Individuals were more likely to test positive for high-risk HPV if they resided in an area of high deprivation or in a rural area. The overall distribution of HPV types did not vary between defaulters and attenders. Multiple infections occurred in 48.1% of high-risk HPV positive individuals. Excluding vaccine types the most common pairing was HPV 56 and 66.

Conclusions

Understanding of the pre-immunisation prevalence of HPV in young women puts Scotland in a prime position to assess the early effect of vaccination as the first highly vaccinated cohorts of individuals enter the screening programme. Differences in results with different specimen types must be taken into account when monitoring the impact of vaccination programmes.

【 授权许可】

   
2013 Kavanagh et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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