Declines in anogenital warts diagnoses since the change in 2012 to use the quadrivalent HPV vaccine in England: data to end 2017

Checchi, Marta; Mesher, David; Mohammed, Hamish; Soldan, Kate

doi:10.1136/sextrans-2018-053751

Cited by 29 publications

(18 citation statements)

References 15 publications

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“…Participants were vaccinated either with the quadrivalent HPV (types 6, 11, 16 and 18) vaccine (vaccinated group) or with placebo (aluminium hydroxyphosphate sulphate adjuvant) by three doses of intramuscular injection. The vaccine was composed of [17,[27][28][29][30][31][32][33] were included in the present meta-analysis. Five studies [27][28][29][30][31] were performed in Australia, one [17] in Belgium, one [32] in England, and one [33] in the USA ( Table 2).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…The vaccine was composed of [17,[27][28][29][30][31][32][33] were included in the present meta-analysis. Five studies [27][28][29][30][31] were performed in Australia, one [17] in Belgium, one [32] in England, and one [33] in the USA ( Table 2). The Belgian studies assessed the population-level effect of the quadrivalent HPV vaccination on GW in women [17] and the other 7 articles [27][28][29][30][31][32][33] measured the number of GW cases also in men to investigate the herd effect of the vaccine.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Five studies [27][28][29][30][31] were performed in Australia, one [17] in Belgium, one [32] in England, and one [33] in the USA ( Table 2). The Belgian studies assessed the population-level effect of the quadrivalent HPV vaccination on GW in women [17] and the other 7 articles [27][28][29][30][31][32][33] measured the number of GW cases also in men to investigate the herd effect of the vaccine. The quadrivalent vaccine was introduced as a school-based programme in Australia, in 2007.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis

et al. 2020

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Background: The quadrivalent human papillomavirus (HPV) vaccine has been assumed to give protection against genital warts (GW) as well as cervical cancer. Our main question was whether HPV vaccine has any effects on the prevention of GW reported in randomised controlled clinical trials (RCTs) and time-trend analyses. Methods: This meta-analysis was performed according to the PRISMA guidelines using the PICO format. We searched in three electronic databases (PubMed, Embase, Cochrane Trials), and assessed heterogeneity using the Q-test and Isquared statistics, meta-regression was also performed. Odds ratios (OR) and their confidence intervals (CI) were calculated. The sensitivity was tested by leave-one-out method. We evaluated the presence of publication bias using the funnel plot graph and the Copas selection model. The strength of evidence was assessed using the GRADE approach. Results: Eight RCTs (per-protocol populations) and eight time-trend ecological studies were included in this meta-analysis. A significant reduction (pooled OR = 0.03, 95% CI: 0.01-0.09; I-squared = 53.6%) of GW in young women was recorded in RCTs, and in time-trend analyses both in young women (pooled OR = 0.36, CI 95% = 0.26-0.51; I-squared = 98.2%), and in young men (pooled OR = 0.69, 95% CI = 0.61-0.78; I-squared = 92.7%). In subgroup analysis, a significant reduction of the number of GW events was observed especially in women under 21 years (pooled OR = 0.33, 95% CI = 0.17-0.63). Leave-one-out analysis showed that similar results could be obtained after excluding one study, meta-regression did not show significant difference. Conclusions: Prophylactic, quadrivalent HPV vaccination can prevent GW in healthy women and men, therefore, it should be included in routine immunization programme.

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis

et al. 2020

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“…These vaccines have led to a significant decline in AGW incidence in countries that have managed to achieve high vaccination coverage rates. 16–26 HPV vaccination has also been used off-label for the treatment of recalcitrant common warts. 27 , 28 However, HPV vaccination has created considerable controversy and the vaccination rates are low in many countries.…”

Section: Introductionmentioning

confidence: 99%

Incidence of anogenital warts: epidemiological risk factors and real-life impact of human papillomavirus vaccination

et al. 2020

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Anogenital warts (AGWs) rank among the most frequent sexually transmitted infections in young adults. They are benign lesions, but they pose a significant economic cost to health care systems and a substantial psychological burden on patients, who need evidence-based counselling. Human papillomavirus (HPV) vaccination has shown very high protection rates against AGWs in clinical trials and real-world settings but vaccination coverage remains low in many countries. The aim of this review is to summarize the current evidence on the risk factors for AGW development and to present the available real-life data on the impact of HPV vaccination on AGW incidence. An increased number of lifetime sexual partners, a new sexual partner in the last 12 months, smoking, and immunosuppression have been associated with increased risk for AGWs. HPV vaccination has led to a dramatic decline in AGW incidence in populations that have achieved high vaccination rates. These conclusions can contribute to primary prevention of AGWs and evidence-based counselling of AGW patients.

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“…6 Furthermore, data from England, Australia and elsewhere suggest a herd protection effect, with a decline in the incidence of genital warts among young women and heterosexual men. [7][8][9][10] However, men who have sex with men (MSM) are likely to have little or no herd protection from vaccinating only women and will continue to have a high risk of HPV infection and related diseases. 11 12 We have previously published data on the prevalence of current HPV infection, determined by HPV DNA detection, among MSM attending a London sexual health clinic.…”

Section: Introductionmentioning

confidence: 99%

HPV16 and HPV18 seropositivity and DNA detection among men who have sex with men: a cross-sectional study conducted in a sexual health clinic in London

et al. 2020

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ObjectivesMen who have sex with men (MSM) have an increased risk of human papillomavirus (HPV) infection and related diseases compared with men who have sex exclusively with women. From April 2018, there has been a phased roll-out of HPV vaccination offered to MSM aged up to 45 years old who are attending sexual health clinics and HIV clinics in England. The vaccine is most effective if delivered prior to HPV infection. We estimated the proportion of MSM with no current vaccine-type infection and no serological evidence of prior infection, in a study undertaken prior to vaccine introduction.MethodsWe conducted a cross-sectional study among 484 MSM aged 18–40 years old who attended a sexual health clinic in London between 2010 and 2012. We estimated the prevalence of current and past infection by testing for HPV DNA in anogenital samples and for serum antibodies to HPV16 and HPV18.ResultsThe median age was 30 years (IQR 25–35). The prevalence of HPV16 and HPV18 DNA was 13.2% and 6.2%, respectively. Seropositivity for HPV16 and HPV18 was 28.5% and 17.1%, respectively, with 11.4% seropositive for both types. Seropositivity for the same HPV type was strongly associated with anogenital DNA detection. 279 MSM (57.6%) tested negative for both HPV16 and HPV18 serology and were DNA negative for these two types; only 5 MSM (1.0%) were seropositive and DNA positive for both HPV types.ConclusionsThis is the first study to determine both the prevalence of HPV DNA in anogenital samples and HPV seroprevalence among MSM attending a sexual health clinic in the UK. Over half of MSM in this study had no evidence of a previous or current infection with either of the high-risk HPV types included in the quadrivalent vaccine, which supports the rationale for opportunistic HPV vaccination of MSM attending sexual health clinics.

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Declines in anogenital warts diagnoses since the change in 2012 to use the quadrivalent HPV vaccine in England: data to end 2017

Cited by 29 publications

References 15 publications

The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis

The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis

Incidence of anogenital warts: epidemiological risk factors and real-life impact of human papillomavirus vaccination

HPV16 and HPV18 seropositivity and DNA detection among men who have sex with men: a cross-sectional study conducted in a sexual health clinic in London

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