Vaccination of young women decreases human papillomavirus transmission in heterosexual couples: findings from the HITCH cohort study
Menée au Canada sur la période 2005-2013 auprès de 497 couples hétérosexuels (âge des femmes : 18-24 ans), cette étude analyse l'effet de la vaccination des jeunes femmes sexuellement actives contre le papillomavirus humain sur la transmission du HPV au sein du couple
Background : Vaccination against human papillomaviruses (HPV) prevents HPV infections and consequently, cervical lesions. However, the effect of vaccination on HPV transmission within couples is unknown.
Methods : We used data from HITCH, a prospective cohort study of heterosexual couples (women aged 18-24y) in Montreal, 2005-2013. Vaccination history was self-reported. Genital samples were tested for HPV DNA by PCR (Linear Array). Type-specific viral loads were quantified using real-time PCR. Odds and hazard ratios (OR/HR) were estimated using multi-level mixed-effects logistic regression and a parametric model for interval-censored survival-time data, respectively. Differences in viral loads were evaluated using the Friedman's ANOVA test.
Results : Among 497 couples, 12, 16, and 35 women received 1, 2, or 3 vaccination doses at baseline, respectively. Median age at vaccination was 18y. Most women (92.1%) had their first coitus before vaccination. At baseline, partner concordance of persistent HPV6/11/16/18 infections was lower in vaccinated than unvaccinated women (adjusted OR=0.10, 95%CI: 0.01-0.65) but not for non α7/α9/α10-HPV types (adjusted OR=1.00, 95%CI: 0.44-2.29). Incidence of persistent α7/α9/α10 HPV types in women was inversely associated with vaccination status at baseline (adjusted HR=0.12, 95%CI: 0.03-0.47). Likewise, male partners of vaccinated women had a lower incidence of α7/α9/α10 HPV infections (adjusted OR=0.22, 95%CI: 0.05-0.95). Vaccinated women with HPV 6/11/16/18 infections had lower viral loads (p=0.001) relative to unvaccinated women.
Conclusion : Vaccination of sexually active women significantly reduced transmission of α7/α9/α10 HPV types in heterosexual couples.
Impact : These results underscore and quantify the positive effect of HPV vaccination on HPV transmission within heterosexual couples.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2018