Human Papillomavirus types in cervical dysplasia among young HPV-vaccinated women: Population-based nested case-control study
Menée en Suède à l'aide de données portant sur 242 témoins et sur 125 femmes nées entre 1980 et 2000, vaccinées contre le papillomavirus humain, ayant réalisé un dépistage du cancer du col de l'utérus et présentant des lésions intra-épithéliales, cette étude identifie les types de HPV associés à ces lésions
Human papillomavirus (HPV) vaccines protect against infections with the most oncogenic HPV types, cervical intraepithelial neoplasia (CIN) and cervical cancer. We investigated whether development of cervical intraepithelial neoplasia (CIN) lesions in HPV-vaccinated women is associated with vaccine-targeted HPV types or not. Linkage of the Swedish vaccination and cervical screening registries identified all females born 1980-2000 who had been HPV vaccinated before 2014-12-31 (n=305,320) and had attended cervical screening in 2006-2018 (N=79,491). We further selected women HPV vaccinated below 17 years of age and screened in the capital region (N=5,874). Among those, 125 developed CIN and had a cervical cryopreserved sample available (42.5 % of all eligible CIN cases). After 1:2 matching to disease-free HPV vaccinated controls (N=242), samples were analyzed for HPV DNA and associations between HPV type and CIN diagnosis were estimated with conditional logistic regression. Vaccine-targeted HPV types were rare among both CIN cases (2.4 % HPV16, 0.8 % HPV18) and their matched controls (0.4 % HPV16 and 18). No woman had HPV6 or 11. The CIN lesions were associated with the non-vaccine HPV types 31, 33, 42, 45, 51, 52, 56, 59 and 66. CIN lesions among young HPV vaccinated women are mostly attributable to infection with non-vaccine HPV types. The phenomenon may be important for surveillance and design of cervical cancer control strategies. This article is protected by copyright. All rights reserved.