High prevalence of human papillomavirus (HPV) in unvaccinated adolescent girls in South Africa, particularly those living with HIV

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-10-18 DOI:10.1016/j.vaccine.2024.126442

Danielle I. Travill , Dorothy A. Machalek , Helen Rees , Zizipho Mbulawa , Admire Chikandiwa , Richard Munthali , Kathy Petoumenos , John M. Kaldor , Sinead Delany-Moretlwe

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引用次数: 0

Abstract

Introduction

In 2014, South Africa implemented a national two-dose HPV vaccination programme using the bivalent vaccine for girls aged 9 years and older attending Grade 4 at public schools. We assessed HPV prevalence and risk factors among South African adolescent girls and young women (AGYW) aged 17–18 years who were ineligible for vaccination.

Methods

From June to December 2019, we surveyed AGYW aged 17–18 years attending primary care clinics in four South African provinces. Consenting participants completed a questionnaire, underwent HIV counselling and testing, and self-collected a vaginal swab for HPV testing. Samples were tested by Seegene AnyPlex™ II HPV28. We used summary statistics to describe the population characteristics and logistic regression to examine the association between risk factors and high-risk HPV detection.

Results

910 participants were screened, 900 enrolled, 896 had valid HPV results, and 819 were unvaccinated and included in this study. Of these, 248 (30.3 %) were living with HIV and 597 (72.9 %) reported ever having vaginal sex. Overall, 463 (56.5 %) had at least one high-risk HPV detected, and 177 (21.6 %) had HPV16/18 detected. AGYW living with HIV had a higher prevalence of any high-risk HPV (65.3 % vs 52.7 %, p < 0.001) and HPV 16/18 (29.4 % vs 18.2 %, p < 0.001) compared to those without HIV. Multiple infections were also more common in participants living with HIV, with three or more high-risk HPV types detected in 32.3 % compared with 15.4 % of those without HIV (p < 0.001). In multivariate analyses, HIV status (p < 0.001) and higher number of lifetime sexual partners (p-trend<0.001) were associated with high-risk HPV detection.

Conclusions

High-risk HPV was very common in unvaccinated South Africa AGYW, especially among those living with HIV, highlighting the importance of HPV vaccination in settings with high HIV prevalence.

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南非未接种疫苗的少女，尤其是感染艾滋病毒的少女中人类乳头瘤病毒 (HPV) 感染率很高

导言2014 年，南非实施了一项全国性的两剂 HPV 疫苗接种计划，为公立学校四年级 9 岁及以上的女生接种二价疫苗。我们评估了不符合接种条件的 17-18 岁南非少女和年轻女性（AGYW）的 HPV 感染率和风险因素。方法从 2019 年 6 月到 12 月，我们对在南非四个省的初级保健诊所就诊的 17-18 岁 AGYW 进行了调查。征得同意的参与者填写了调查问卷，接受了 HIV 咨询和检测，并自行采集了阴道拭子进行 HPV 检测。样本由 Seegene AnyPlex™ II HPV28 进行检测。我们使用摘要统计来描述人群特征，并使用逻辑回归来研究风险因素与高危 HPV 检测之间的关联。结果910 名参与者接受了筛查，900 人注册，896 人获得了有效的 HPV 检测结果，819 人未接种疫苗并纳入本研究。其中，248 人（30.3%）为 HIV 感染者，597 人（72.9%）称曾有过阴道性交。总体而言，463 人（56.5%）至少检测到一种高危 HPV，177 人（21.6%）检测到 HPV16/18。与未感染艾滋病病毒的人相比，感染艾滋病病毒的 AGYW 的高危 HPV 感染率更高（65.3 % vs 52.7 %，p < 0.001），HPV16/18 感染率更高（29.4 % vs 18.2 %，p < 0.001）。多重感染在艾滋病毒感染者中也更为常见，32.3%的感染者检测到三种或三种以上的高危 HPV 类型，而未感染艾滋病毒的感染者只有 15.4%（p <0.001）。在多变量分析中，HIV 感染状况（p <0.001）和终生性伴侣数量较多（p-trend<0.001）与高危 HPV 检测相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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