International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2020
Candidate HPV genotypes not included in the 9-valent vaccine for prevention of CIN 2-3.
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Gonzalez-Bosquet Eduardo, Gibert Monica, Serra Mariona, Hernandez-Saborit Alicia, Gonzalez-Fernandez Alba
Аннотация
OBJECTIVES: To identify the prevalence of human papillomavirus genotypes - as a single infection or co-infection - not included in the 9-valent (9v) HPV vaccine among women with cervical intraepithelial neoplasia (CIN 2-3).
METHODS: Retrospective study of 1700 women referred due to abnormal cytology to Sant Joan de Deu Hospital. We selected 849 patients with CIN 2 or CIN 3 diagnosis confirmed by biopsy. An HPV test, a second cytology, and colposcopy were performed on all patients.Those with abnormal colposcopy underwent cervical biopsy. Patients with abnormal cytology and normal colposcopy or transformation zone type 3 underwent endocervical curetage. Conization was performed if punch biopsy or endocervical curetage confirmed CIN 2-3 or if a CIN 1 lesion persisted (diagnosed by biopsy) over 2 years in patients over 25 years of age. Comparisons for qualitative variables were analyzed with the chi-squared test. Analysis of variance was used for comparisons involving more than two samples.
RESULTS: HPV was detected in 746 of 849 patients (87.9%) and in 306 (41%) of those where more than one HPV genotype was present. The more frequent genotypes detected as single infection were: HPV-16 (267/849%-31.4%), HPV 31 (34/849-4%), HPV-33 (20/849%-2.4%), HPV-58 (17/849%-2%), HPV-51 (15/849%-1.8%), and HPV-53 (12/849%-1.4%). The more frequent genotypes isolated including multiple HPV infection were HPV-16 (427/849%-50.2%), HPV-31 (108/849%-12.7%), HPV-51 (79/849%-9.3%), HPV-33 (67/849%-7.8%), HPV-58 (67/849%-7.8%), and HPV-52 (59/849%-6.9%). In total, 78% of women diagnosed with CIN 2 or CIN 3 had an infection by a HPV genotype included in the 9v vaccine. Of the 849 women diagnosed with CIN 2 or CIN 3, 103 (12.1%) tested negative for HPV and 106 (12.4%) tested positive for low-risk HPV types.
CONCLUSIONS: Inclusion of HPV-51, 53, 66, and 35 in a new vaccine may not be advisable as most are detected as coinfection with other high-risk genotypes that are already included in the current vaccines.
METHODS: Retrospective study of 1700 women referred due to abnormal cytology to Sant Joan de Deu Hospital. We selected 849 patients with CIN 2 or CIN 3 diagnosis confirmed by biopsy. An HPV test, a second cytology, and colposcopy were performed on all patients.Those with abnormal colposcopy underwent cervical biopsy. Patients with abnormal cytology and normal colposcopy or transformation zone type 3 underwent endocervical curetage. Conization was performed if punch biopsy or endocervical curetage confirmed CIN 2-3 or if a CIN 1 lesion persisted (diagnosed by biopsy) over 2 years in patients over 25 years of age. Comparisons for qualitative variables were analyzed with the chi-squared test. Analysis of variance was used for comparisons involving more than two samples.
RESULTS: HPV was detected in 746 of 849 patients (87.9%) and in 306 (41%) of those where more than one HPV genotype was present. The more frequent genotypes detected as single infection were: HPV-16 (267/849%-31.4%), HPV 31 (34/849-4%), HPV-33 (20/849%-2.4%), HPV-58 (17/849%-2%), HPV-51 (15/849%-1.8%), and HPV-53 (12/849%-1.4%). The more frequent genotypes isolated including multiple HPV infection were HPV-16 (427/849%-50.2%), HPV-31 (108/849%-12.7%), HPV-51 (79/849%-9.3%), HPV-33 (67/849%-7.8%), HPV-58 (67/849%-7.8%), and HPV-52 (59/849%-6.9%). In total, 78% of women diagnosed with CIN 2 or CIN 3 had an infection by a HPV genotype included in the 9v vaccine. Of the 849 women diagnosed with CIN 2 or CIN 3, 103 (12.1%) tested negative for HPV and 106 (12.4%) tested positive for low-risk HPV types.
CONCLUSIONS: Inclusion of HPV-51, 53, 66, and 35 in a new vaccine may not be advisable as most are detected as coinfection with other high-risk genotypes that are already included in the current vaccines.