女性接种人乳头瘤病毒疫苗后感染状况的meta分析
华北理工大学, 基础医学院 (河北省慢性疾病基础医学重点实验室), 河北唐山 063210
| 摘 要： | 目的：通过meta分析，探讨女性接种人乳头瘤状病毒（human papillomavirus，HPV）疫苗后的感染状况。方法：检索Pubmed、Wiley、Science Direct、Web of Science数据库，以HPV和疫苗接种为关键词，收集建库以来公开发表的英文具有全文的文献，筛选出符合纳入标准的文献并使用RevMan5.3进行分析。结果：最终纳入9篇文献，研究人数60570人。结果表明接种疫苗后的女性HPV16/18型和HPV31/33/45/52/58型相关6个月持续感染保护效力高于未接种女性，保护率为95%（RR：0.05，95% CI：0.04~0.06）。实验组女性HPV任何型别相关12个月的持续感染保护效力高于对照组，保护率为96%（RR：0.04，95% CI：0.03~0.06）。在符合协议人群（PPE）中接种疫苗后女性与HPV16/18型和（或）HPV6/11/16/18型相关的CIN1+发病率降低（RR：0.12，95% CI：0.06~0.22）；CIN2+发病率低于未接种人群（RR：0.06，95% CI：0.02~0.18）。在改良后的意向性分析人群（mITT）中接种疫苗后女性与HPV16/18型和（或）HPV6/11/16/18型相关的CIN1+发病率低于未接种人群（RR：0.15，95% CI：0.07~0.31）。CIN2+发病率低于未接种人群（RR：0.11，95% CI：0.04~0.34）。HPV6/11/16/18/31/33/45/52/58型相关任何等级和高等级宫颈病变发生率低于对照组，最终合并效应值为RR=0.02（95% CI：0.01~0.04）。HPV6/11/16/18/31/33/45/52/58型相关的任何等级和高等级阴道及外阴疾病发病率低于对照组，最终合并效应值为RR=0.06（95% CI：0.03~0.10）。结论：接种HPV疫苗的女性HPV持续感染保护效力更高，相关宫颈、阴道及外阴疾病发病率更低，二价、四价和九价疫苗都表现出长期保护性。 |
| 关 键 词： | 疫苗接种; HPV感染; Meta分析 |
| DOI： | 10.57237/j.life.2023.04.004 |
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收稿日期: 2023-05-31
接受日期: 2023-08-03
在线出版日期: 2023-12-27
Meta Analysis of Infection Status of Women After Vaccination with Human Papillomavirus Vaccine
School of Basic Medical Science, North China University of Science and Technology, Tangshan 063210, China
| Abstract: | Objective: To analyze the infection status of human papillomavirus (HPV) in women after vaccination by meta-analysis. Methods: The PubMed, Wiley, science direct and web of science databases were searched by computer. The full-text English literatures published since the establishment of the database were collected with HPV and vaccination as key words. The literatures that met the inclusion criteria were selected and used RevMan5.3 analysis. Results: Nine literatures were included, and the number of researchers was 60570. The results showed that the protective effect of HPV16/18 and HPV31/33/45/52/58 related 6-month persistent infection in vaccinated women was higher than that in non vaccinated women, and the protective rate was 95% (RR: 0.05, 95% CI: 0.04 ~ 0.06). The protective effect of 12-month persistent infection related to any type of HPV in the experimental group was higher than that in the control group, and the protective rate was 96% (RR: 0.04, 95% CI: 0.03 ~ 0.06). The incidence of CIN1+ associated with HPV16/18 and (or) HPV6/11/16/18 decreased in women after vaccination in a protocol compliant population (PPE) (RR: 0.12, 95% CI: 0.06 ~ 0.22); The incidence rate of CIN2+ was lower than that of non vaccinated population (RR: 0.06, 95% CI: 0.02 ~ 0.18). The incidence of CIN1+ associated with HPV16/18 and (or) HPV6/11/16/18 in vaccinated women was lower than that in non vaccinated people in the modified intention to analyze population (mITT) (RR: 0.15, 95% CI: 0.07 ~ 0.31). The incidence rate of CIN2+ was lower than that of non vaccinated population (RR: 0.11, 95% CI: 0.04 ~ 0.34). The incidence of HPV6/11/16/18/31/33/45/52/58 related cervical lesions was lower than that of the control group, and the final combined effect value was RR = 0.02 (95% CI: 0.01 ~ 0.04). The incidence rate of hpv6/11/16/18/31/33/45/52/58 related vaginal and vulvar diseases of any grade and high grade was lower than that of the control group, and the final combined effect value was RR=0.06 (95% CI: 0.03 ~ 0.10). Conclusion: The protective effect of HPV vaccine against persistent HPV infection in women is higher, and the incidence rate of related cervical, vaginal and vulvar diseases is lower. Bivalent, tetravalent and ninvalent vaccines all show long-term protection. |
| Keywords: | Meta Analysis; HPV Infection; Vaccination |
基金
| 1. | 河北省自然基金中医药联合基金培育项目 (编号: H202209048) |
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