Impact of HPV vaccination with Gardasil® in Switzerland.

Details

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State: Public
Version: Final published version
Serval ID
serval:BIB_B488477F8671
Type
Article: article from journal or magazin.
Collection
Publications
Title
Impact of HPV vaccination with Gardasil® in Switzerland.
Journal
BMC infectious diseases
Author(s)
Jacot-Guillarmod M., Pasquier J., Greub G., Bongiovanni M., Achtari C., Sahli R.
ISSN
1471-2334 (Electronic)
ISSN-L
1471-2334
Publication state
Published
Issued date
22/12/2017
Peer-reviewed
Oui
Volume
17
Number
1
Pages
790
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Gardasil®, a quadrivalent vaccine targeting low-risk (6, 11) and high-risk (16, 18) human papillomaviruses (HPV), has been offered to 11-14 year-old schoolgirls in Switzerland since 2008. To evaluate its success and its potential impact on cervical cancer screening, HPV genotypes were examined in 18-year-old girls five years later (sub-study 1) and in outpatients participating to cervical cancer screening before and after vaccine implementation (sub-study 2).
For sub-study 1, 3726 females aged 18 in 2013 were invited to fill a questionnaire on personal demographics and HPV risk factors and to provide a self-collected cervicovaginal sample for HPV genotyping and Chlamydia trachomatis PCR. Personal data were evaluated by univariable and multivariable statistics. In sub-study 2, the proportion of the vaccine-type HPV among anogenital HPV was examined with archived genotyping data of 8039 outpatients participating to cervical cancer screening from 1999 till 2015. The yearly evolution of this proportion was evaluated by segmented logistic regression.
690 (18.5%) women participated to sub-study 1 and 327 (8.8%) provided a self-collected sample. Prevalence of Chlamydia trachomatis (4.6%) and demographics confirmed that the subjects were representative of sexually-active Swiss young women. Vaccine (five-year coverage: 77.5%) was preferentially accepted by contraceptive-pill users (P = 0.001) and samples were mainly provided by sexually-active subjects (P < 0.001). The proportion (4%) of the vaccine-type HPV in this population was lower than in sub-study 2 outpatients (n = 849, <26 years old) in the pre-vaccine era (25.7%). The proportion of the high-risk vaccine-type HPV decreased significantly (59%, P = 0.0048) in the outpatients during the post-vaccine era, yet this decrease was restricted to those aged less than 26 years (n = 673, P < 0.0001).
The low proportion of vaccine-type HPV in 18-year-old females and its rapid decrease in young women participating to cervical cancer screening extend the success of HPV vaccination to Switzerland. Our data suggest that cervical cancer screening is now entering a stage of reduced proportion of HPV16 and/or 18 in samples reported positive by cytology. In view of the high likelihood of reduced clinical specificity of cytology, primary screening modalities involving HPV testing and cytology should now be re-evaluated in Switzerland.

Keywords
Adolescent, Child, Chlamydia Infections/diagnosis, Chlamydia Infections/epidemiology, Chlamydia trachomatis/genetics, Chlamydia trachomatis/isolation & purification, DNA, Viral/genetics, DNA, Viral/metabolism, Female, Follow-Up Studies, Genotype, Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/immunology, Humans, Papillomaviridae/genetics, Papillomaviridae/isolation & purification, Papillomavirus Infections/diagnosis, Papillomavirus Infections/epidemiology, Papillomavirus Infections/prevention & control, Papillomavirus Vaccines/immunology, Surveys and Questionnaires, Switzerland/epidemiology, Uterine Cervical Neoplasms/diagnosis, Uterine Cervical Neoplasms/prevention & control, Vaccination, Anyplex II™ HPV28, Cervical cancer screening, Chlamydia trachomatis, Gardasil®, HPV genotyping, HPV vaccine, Human papillomavirus, PGMY-CHUV, Real-time PCR, Segmented logistic regression
Pubmed
Web of science
Open Access
Yes
Create date
28/12/2017 10:14
Last modification date
20/08/2019 16:22
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