Cervical HPV natural history among young Western Cape, South African women: The randomized control EVRI Trial

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• 作者：Staci L. Sudenga^a ; B. Nelson Torres^a ; Matthys H. Botha^b ; Michele Zeier^c ; Martha E. Abrahamsen^a ; Richard H. Glashoff^d ; Susan Engelbrecht^d ; Maarten F. Schim Van der Loeff^e ; ^f ; Louvina E. Van der Laan^b ; Siegfried Kipping^b ; Douglas Taylor^g ; Anna R. Giuliano^a ; ^{Anna.Giuliano@moffitt.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：HPV vaccine ; Clinical trial ; EVRI ; STIs
• 刊名：Journal of Infection
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：72
• 期：1
• 页码：60-69
• 全文大小：309 K

文摘

The objective of this analysis was to assess human papillomavirus (HPV) infection persistence and incidence 7-months post-enrollment by HPV vaccine study arm (vaccine or placebo).

Methods

HIV-negative, sexually active women aged 16–24 years in the Western Cape, South Africa, were enrolled in the EVRI Trial and were randomized to receive 4-valent HPV vaccine or placebo. Cervical specimens were collected at enrollment and at the 7-month visit and were genotyped for HPV. HPV prevalence, persistence, and incidence were calculated. Prevalence ratios and odds ratios were calculated to assess factors associated with a prevalent and incident HPV infection.

Results

HPV incidence rates were marginally higher for the placebo group (n = 163) compared to the vaccine group (n = 169). A large proportion of the prevalent high-risk (HR-HPV) HPV types (49%) persisted over the 7-month period in both arms. Prevalent HR-HPV infection was significantly associated with a prevalent gonorrhea infection and detection of Herpes simplex type 2 antibodies. Incident HR-HPV infection was significantly associated with abnormal cervical cytology at enrollment and younger age.

Conclusions

Women living in geographic areas, such as southern Africa, at high-risk for HPV need to receive HPV vaccination at a very young age to maximally prevent infection and subsequent disease.