Genotype Distribution Change After Human Papillomavirus Vaccination in Two Autonomous Communities in Spain

Overview

Journal Front Cell Infect Microbiol

Specialties Cell Biology
Infectious Diseases
Microbiology

Date 2021 Oct 11

PMID 34631594

Citations 7

Authors

Javier Freire-Salinas

Rafael Benito

Ainara Azueta

Joaquina Gil

Claudia Mendoza

Montserrat Nicolas

Pilar Garcia-Berbel

Sonia Algarate

Javier Gomez-Roman

Affiliations

Soon will be listed here.

Abstract

Context: It has been more than 10 years since the human papillomavirus (HPV) vaccination program was initiated in most advanced countries. Thus, it seems necessary to change the uterine cervical cancer screening strategy. Molecular-based tests are considered essential in this scenario.

Objective: We aimed to review the distribution of the HPV genotypes after the introduction of the vaccination program with Cervarix® and Gardasil 4® in two autonomous communities in Spain, looking for possible changes in distribution and the occurrence of a herd effect.

Design: A cross-sectional study was performed in 45,362 samples that were processed in the Cantabria and Aragon communities during the period from 2002 to 2016. We compared the genotype distribution before and after the vaccination program was initiated.

Results: Genotypes HPV6 and HPV11 have decreased significantly after the introduction of the vaccine. HPV16 has had a decrease, but not a significant one in the statistical analysis. However, HPV31, HPV52, and HPV45 have increased in percentage. A replacement phenomenon with other genotypes not included in the vaccine has been observed in our population.

Conclusions: Continued surveillance is needed to provide further indication of any changes over time in the genotypes in circulation. This will be facilitated by monitoring the genotyping results from the new model of cervical screening using primary HPV DNA testing.

Citing Articles

Prophylactic vaccines against HPV-caused cervical cancer: novel vaccines are still demanded.

Amiri S, Rasekh S, Moezzi S, Seifi N, Fatemi S, Fathi S Infect Agent Cancer. 2025; 20(1):16.

PMID: 40059217 PMC: 11892266. DOI: 10.1186/s13027-025-00643-5.

Update on Effects of the Prophylactic HPV Vaccines on HPV Type Prevalence and Cervical Pathology.

Hampson I, Oliver A Viruses. 2024; 16(8).

PMID: 39205218 PMC: 11359832. DOI: 10.3390/v16081245.

Genital Warts in Women Vaccinated against HPV in Childhood: A Systematic Review.

Malheiro R, Magalhaes C, Dias C, Rodrigues A, Lisboa C Vaccines (Basel). 2024; 12(5).

PMID: 38793799 PMC: 11126080. DOI: 10.3390/vaccines12050548.

Monitoring HPV Prevalence and Risk Cofactors for Abnormal Cytology in the Post-Vaccination Period among Croatian Women.

Pesut E, Simic I, Fures R, Milutin Gasperov N, Lez C, Feratovic F Viruses. 2024; 16(4).

PMID: 38675981 PMC: 11054414. DOI: 10.3390/v16040642.

Recent Developments in Human Papillomavirus (HPV) Vaccinology.

Williamson A Viruses. 2023; 15(7).

PMID: 37515128 PMC: 10384715. DOI: 10.3390/v15071440.

References

Dillner J, Nygard M, Munk C, Hortlund M, Hansen B, Lagheden C . Decline of HPV infections in Scandinavian cervical screening populations after introduction of HPV vaccination programs. Vaccine. 2018; 36(26):3820-3829. DOI: 10.1016/j.vaccine.2018.05.019. View

Harper D, DeMars L . HPV vaccines - A review of the first decade. Gynecol Oncol. 2017; 146(1):196-204. DOI: 10.1016/j.ygyno.2017.04.004. View

Cornall A, Phillips S, Cummins E, Garland S, Tabrizi S . In vitro assessment of the effect of vaccine-targeted human papillomavirus (HPV) depletion on detection of non-vaccine HPV types: implications for post-vaccine surveillance studies. J Virol Methods. 2014; 214:10-4. DOI: 10.1016/j.jviromet.2014.12.007. View

zur Hausen H . Papillomavirus infections--a major cause of human cancers. Biochim Biophys Acta. 1996; 1288(2):F55-78. DOI: 10.1016/0304-419x(96)00020-0. View

Martcheva M, Bolker B, Holt R . Vaccine-induced pathogen strain replacement: what are the mechanisms?. J R Soc Interface. 2007; 5(18):3-13. PMC: 2405901. DOI: 10.1098/rsif.2007.0236. View

Schiffman M, Burk R, Boyle S, Raine-Bennett T, Katki H, Gage J . A study of genotyping for management of human papillomavirus-positive, cytology-negative cervical screening results. J Clin Microbiol. 2014; 53(1):52-9. PMC: 4290932. DOI: 10.1128/JCM.02116-14. View

Zhao C, Crothers B, Ghofrani M, Li Z, Souers R, Hussain M . Human Papillomavirus Genotyping Testing Practice in 2014: Results of a College of American Pathologists National Survey. Arch Pathol Lab Med. 2016; 140(12):1364-1370. DOI: 10.5858/arpa.2016-0061-CP. View

Yusupov A, Popovsky D, Mahmood L, Kim A, Akman A, Yuan H . The nonavalent vaccine: a review of high-risk HPVs and a plea to the CDC. Am J Stem Cells. 2020; 8(3):52-64. PMC: 6971474. View

Singleton R, Hennessy T, Bulkow L, Hammitt L, Zulz T, Hurlburt D . Invasive pneumococcal disease caused by nonvaccine serotypes among alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage. JAMA. 2007; 297(16):1784-92. DOI: 10.1001/jama.297.16.1784. View

10.

Tabrizi S, Brotherton J, Kaldor J, Skinner S, Liu B, Bateson D . Assessment of herd immunity and cross-protection after a human papillomavirus vaccination programme in Australia: a repeat cross-sectional study. Lancet Infect Dis. 2014; 14(10):958-66. DOI: 10.1016/S1473-3099(14)70841-2. View

11.

Berman T, Schiller J . Human papillomavirus in cervical cancer and oropharyngeal cancer: One cause, two diseases. Cancer. 2017; 123(12):2219-2229. DOI: 10.1002/cncr.30588. View

12.

Bouvard V, Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F . A review of human carcinogens--Part B: biological agents. Lancet Oncol. 2009; 10(4):321-2. DOI: 10.1016/s1470-2045(09)70096-8. View

13.

Gomez-Roman J, Echevarria C, Salas S, Gonzalez-Moran M, Perez-Mies B, Garcia-Higuera I . A type-specific study of human papillomavirus prevalence in cervicovaginal samples in three different Spanish regions. APMIS. 2009; 117(1):22-7. DOI: 10.1111/j.1600-0463.2008.00009.x. View

14.

Gardella B, Dominoni M, Sosso C, Arrigo A, Gritti A, Cesari S . Human Papillomavirus Distribution in Women with Abnormal Pap Smear and/or Cervical Intraepithelial Neoplasia in Vaccination Era. A Single-Center Study in the North Italian Population. Microorganisms. 2021; 9(4). PMC: 8066698. DOI: 10.3390/microorganisms9040729. View