BACKGROUND Various studies have reported on the impact of human papillomavirus (HPV) vaccines. Here we present the largest population-based investigation of genotype-specific distributions over the decade following implementation of the 4-valent HPV vaccine (HPV6/11/16/18) in the United States. METHODS Liquid-based cervical cytology samples from individuals aged 15-30 years undergoing cervical screening throughout New Mexico were tested by broad-spectrum HPV genotyping. Weighted relative differences in HPV type-specific prevalence (RDP) and 95% confidence intervals (95%CI) were calculated comparing individuals screened in 2007-2009 (n = 95,915) to those screened in 2013-2016 (n = 103,371). Weighted logistic regression was used to estimate relative risk of type-specific HPV infections. Tests of significance were 2-sided. RESULTS Genotype-specific prevalence reduced significantly for HPV16 (RDP=-52.6%, 95%CI -56.9 to -48.3), HPV18 (RDP=-62.1%, 95%CI -68.5 to -55.8), HPV31 (RDP=-34.2%, 95%CI -42.1 to -26.3) and HPV33 (RDP=-31.8%, 95%CI -48.4 to -15.1). The RDP increased for other carcinogenic HPV types by 19.5% (95%CI +14.3 to + 24.6) when excluding HPV16/18. Large reductions in HPV6/11 RDP were observed but overall, non-carcinogenic, non-vaccine types increased. Comparing females born in 1996 to those born in 1989, risk of infection with HPV6/11/16/18 decreased by 80.0% among individuals aged 21-25 years. High-grade squamous intraepithelial lesions or worse (HSIL+) decreased by 49.4% when extending the evaluation from 2007 to 2018. CONCLUSION(S) HSIL+ incidence is decreasing with large reductions in the prevalence of 4-valent HPV vaccine types and non-vaccine types HPV31 and 33, reflecting vaccine cross-protection. Increases in non-vaccine HPVs may attenuate anticipated reductions in HPV-related abnormalities including cancers however the benefits of HPV vaccination remain substantial.

中文翻译：

---

HPV 基因型特异性患病率和感染风险：一项来自美国的 10 年基于人群的研究。


背景 各种研究报告了人瘤病毒 （HPV） 疫苗的影响。在这里，我们提出了在美国实施 4 价 HPV 疫苗 （HPV6/11/16/18） 后十年中最大的基于人群的基因型特异性分布调查。方法 通过广谱 HPV 基因分型测试来自整个新墨西哥州接受宫颈筛查的 15-30 岁个体的液体宫颈细胞学样本。计算 HPV 类型特异性患病率 （RDP） 和 95% 置信区间 （95% CI） 的加权相对差异，将 2007-2009 年筛查的个体 （n = 95,915） 与 2013-2016 年筛查的个体 （n = 103,371） 进行比较。加权 logistic 回归用于估计类型特异性 HPV 感染的相对风险。显著性检验是 2 侧的。结果 HPV16 （RDP=-52.6%， 95%CI -56.9 至 -48.3）、HPV18 （RDP=-62.1%， 95% CI -68.5 至 -55.8）、HPV31 （RDP=-34.2%， 95% CI -42.1 至 -26.3） 和 HPV33 （RDP=-31.8%，95% CI -48.4 至 -15.1） 的基因型特异性患病率显著降低。排除 HPV16/18 后，其他致癌 HPV 类型的 RDP 增加了 19.5% （95% CI +14.3 至 + 24.6）。观察到 HPV6/11 RDP 大幅降低，但总体而言，非致癌、非疫苗类型增加。将 1996 年出生的女性与 1989 年出生的女性进行比较，21-25 岁个体感染 HPV6/11/16/18 的风险降低了 80.0%。将评估范围从 2007 年延长至 2018 年，高级别鳞状上皮内病变或更严重 （HSIL+） 下降了 49.4%。结论 HSIL+ 发病率正在下降，4 价 HPV 疫苗类型和非疫苗类型 HPV31 和 33 的流行率大幅降低，反映了疫苗的交叉保护。 非疫苗 HPV 的增加可能会减弱 HPV 相关异常（包括癌症）的预期减少，但 HPV 疫苗接种的好处仍然很大。