文章：

人乳头瘤病毒疫苗在扩展年龄组中的有效性：基于韩国HPV队列研究的真实世界分析

Effectiveness of the Human Papillomavirus Vaccine in Extended Age Groups: A Real-World Analysis Based on the Korean HPV Cohort Study

原文发布日期：3 August 2025

DOI: 10.3390/cancers17152561

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: This study evaluated the real-world effectiveness of prophylactic Human Papillomavirus (HPV) vaccination in Korean women aged over 26 years, focusing on its impact on persistent HPV infection and disease progression. Methods: This multicenter prospective study analyzed data from the Korea HPV Cohort (2010–2021). After applying exclusion criteria, the final analytical cohort included 1,231 women aged ≥ 27 years with cytologic findings of atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions and HPV infection. Propensity score matching was used to compare vaccinated (n= 340) and unvaccinated (n= 891) participants. After matching, 273 vaccinated and 273 unvaccinated individuals were included in the final analysis. The primary outcomes were persistent HPV infection and progression to biopsy-confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Logistic and Cox regression models were employed, with additional age-stratified analyses. Results: Among women aged 27–39 years, vaccination was significantly associated with a 54% reduction in the odds of persistent HPV infection (odds ratio = 0.46; 95% CI: 0.22–0.96;p= 0.040). In the full cohort, vaccinated participants had a 62% lower risk of progression to CIN2+ compared with unvaccinated participants (hazard ratio = 0.38; 95% CI: 0.18–0.81;p= 0.011). Body mass index had a notable impact on HPV persistence in HPV 16/18 genotype groups. Conclusions: HPV vaccination effectively reduced persistent infection and progression to CIN2+ in Korean women, particularly those vaccinated before age 40. These findings support the age-extended HPV vaccination policies in South Korea.

摘要翻译： 

背景/目的：本研究评估了人乳头瘤病毒（HPV）预防性疫苗在26岁以上韩国女性中的真实世界有效性，重点关注其对持续性HPV感染及疾病进展的影响。方法：这项多中心前瞻性研究分析了韩国HPV队列（2010–2021年）的数据。经排除标准筛选后，最终分析队列纳入了1,231名年龄≥27岁、细胞学检查结果为未明确意义的非典型鳞状细胞/低度鳞状上皮内病变且存在HPV感染的女性。采用倾向评分匹配法比较接种疫苗者（n=340）与未接种者（n=891）。匹配后，最终分析纳入273名接种者与273名未接种者。主要结局指标为持续性HPV感染及进展为经活检确诊的宫颈上皮内瘤变2级或更严重病变（CIN2+）。研究采用逻辑回归和Cox回归模型，并进行了年龄分层分析。结果：在27–39岁女性中，疫苗接种与持续性HPV感染发生几率降低54%显著相关（比值比=0.46；95%置信区间：0.22–0.96；p=0.040）。在整个队列中，接种者进展为CIN2+的风险较未接种者降低62%（风险比=0.38；95%置信区间：0.18–0.81；p=0.011）。在HPV 16/18基因型组中，体重指数对HPV持续性感染具有显著影响。结论：HPV疫苗接种能有效降低韩国女性的持续性感染及CIN2+进展风险，特别是在40岁前接种的女性中效果显著。这些发现为韩国扩展HPV疫苗接种年龄范围的政策提供了依据。

原文链接：

Effectiveness of the Human Papillomavirus Vaccine in Extended Age Groups: A Real-World Analysis Based on the Korean HPV Cohort Study