High throughput monitoring of Human Papillomavirus type distribution
Menée en Suède à partir de l'analyse de 44 146 prélèvements effectués sur de jeunes participants au dépistage d'une infection à Chlamydia trachomatis, cette étude évalue la faisabilité d'une méthode pour mesurer la prévalence d'une infection, par sous-type histologique, du papillomavirus humain et l'efficacité d'une stratégie de vaccination
Background: There is a need for a rapid and cost-effective evaluation of the effects of different human papillomavirus (HPV) vaccination strategies. Sexually active adolescents are a preferred target group for monitoring, as effects on HPV prevalence would be measurable shortly after implementation of vaccination programs. Methods: The Swedish Chlamydia trachomatis testing program offers free Chlamydia trachomatis testing and reaches a majority of all adolescents in the population. We anonymised the 44146 samples submitted for Chlamydia trachomatis testing in Southern Sweden during March 2008-November 2008 and performed HPV genotyping using PCR followed by mass spectrometry. Results: The HPV positivity peaked at 54.4% (95% confidence interval [CI] 52.2-56.6) among 21-year-old women and at 15.0% (95% CI 12.4-17.6) among 23-year-old men. The HPV positivity was 37.8% (95% CI 37.3-38.3) for women and 11.2% (95% CI 10.6-11.8) for men. The most prevalent types among women were HPV 16 (10.0%, 95% CI 9.7-10.3) and HPV 51 (6.0%, 95% CI 5.7-6.3), and among men HPV 16 (2.1%, 95% CI 1.8-2.4) HPV 6 and HPV 51 (1.7%, 95% CI 1.5-1.9). Conclusions: The high HPV prevalences seen in the Chlamydia trachomatis screening population enables monitoring of the HPV type distribution among sexually active adolescents at high precision. Impact: Effectiveness of HPV vaccination programs in terms of reducing HPV infections has been difficult to measure because of logistic constraints. We describe a system for high throughput monitoring of HPV type-specific prevalences using samples from the Chlamydia trachomatis screening program.