Genital warts and chlamydia in Australian women: comparison of national population-based surveys in 2001 and 2011

Liu, Bette; Donovan, Basil; Brotherton, Julia; Saville, Marion; Kaldor, John

doi:10.1136/sextrans-2013-051307

Cited by 10 publications

(8 citation statements)

References 12 publications

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“…The observed increased GWs IRs in older age groups is consistent with data from other countries, for example Sweden and Germany [ 22 , 26 ]. This increase could reflect changes in sexual behaviour, a phenomenon that is supported by the reported increased incidence of other sexually-transmitted infections (STIs), such as chlamydia, in Belgium and Australia [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 98%

Evaluating the Early Benefit of Quadrivalent HPV Vaccine on Genital Warts in Belgium: A Cohort Study

2015

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Genital warts (GWs) are common, with about 5% to 10% of people having at least one episode in their lifetime. They develop about 2–3 months after infection with human papillomavirus (HPV) genotypes 6 and 11. The prophylactic quadrivalent HPV vaccine (qHPV), protects against HPV6/11 infections and diseases. In Belgium, HPV vaccines started to be reimbursed in 2007 and have been fully reimbursed since December 2008 for women 12 to 18 years old. This study aimed at evaluating the real-life benefit of qHPV vaccine introduction in Belgium on GWs by measuring both vaccine impact (VI) at a population level and the direct effect of the qHPV vaccine at an individual level (vaccine effectiveness (VE)), using data from a large sick-fund (MLOZ) reimbursement database. A first reimbursement for imiquimod (most common first-line GWs treatment in Belgium) was used as a surrogate for a first GWs episode; reimbursement of qHPV vaccine was used as surrogate for vaccination. VI was estimated by comparing the incidence of GWs before and after qHPV vaccine introduction in Belgium (ecologic evaluation). VE was assessed by comparing GWs incidences in vaccinated vs. unvaccinated women, among women eligible for HPV vaccination. VI was evaluated in 9,223,384 person-years. Overall, GWs incidence rates decreased significantly between the pre- and post-vaccination periods (-8.1% (95% CI: -15.3; -0.3) for men and women aged 18–59 years. This decrease was highest in women targeted by the HPV vaccination programme (-72.1% (95% CI: -77.9; -64.7) in women aged 16–22 years, with a 43% vaccine uptake in 2013). A significant decrease was also observed in men aged 16-22 years (-51.1%, 95%CI: -67.6; -26.2), suggesting herd-protection. VE was evaluated in 369,881 person-years. Age-adjusted VE for fully vaccinated women was 88.0% (95% CI: 79.4; 93.0). VE was higher when the first dose was given younger and remained high for over 4 years post-vaccination in all ages. High VI and VE of the qHPV vaccine were observed in a real-life setting in Belgium.

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Section: Discussionmentioning

confidence: 98%

Evaluating the Early Benefit of Quadrivalent HPV Vaccine on Genital Warts in Belgium: A Cohort Study

2015

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“…The decline in GWs contrasted with the increase in chlamydia infections and no change in genital herpes infections, over the same period. The comparison of national population-based surveys in 2001 and 2011 confirmed the decline in GWs and the increase in chlamydia infections [ 23 ]. The analysis of Australian national hospital data between 1999 and 2011 confirmed the reduction of GWs in young females and also in young men (herd protection), with a similar impact in indigenous and non-indigenous populations [ 22 ].…”

Section: Resultsmentioning

confidence: 98%

“…1 ). These reported data on the impact or effectiveness of 4HPV in 6 countries [Australia ( n = 6) [ 18 – 23 ], New Zealand ( n = 2) [ 24 , 25 ], US ( n = 3) [ 26 – 28 ], Denmark ( n = 2) [ 29 , 30 ], Germany ( n = 1) [ 31 ] and Sweden ( n = 2) [ 32 , 33 ]] (Table 1 ). Since both impact and effectiveness publications assess the effect of vaccination programs on the incidence of the disease, both types of studies have been included.…”

Section: Resultsmentioning

confidence: 99%

“…We identified two publications that reported data from the Melbourne Sexual Health Centre 1 year (2008) and 4 years (2011) after 4HPV introduction [ 20 , 21 ] and two that reported data from eight Sexual Health Centers throughout Australia 2 years (2009) and 4 years (2011) after 4HPV introduction [ 18 , 19 ] (Table 1 ). In addition, we identified one study comparing national population surveys on GWs in 2001 and 2011 and another that analyzed national hospital data for GWs [ 22 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

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Early Direct and Indirect Impact of Quadrivalent HPV (4HPV) Vaccine on Genital Warts: a Systematic Review

Mariani¹,

Vici²,

Suligoi³

et al. 2015

Adv Ther

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IntroductionSince 2007, many countries have implemented national human papillomavirus (HPV) vaccination programs with the quadrivalent HPV (4HPV) vaccine that has been shown to be efficacious in clinical trials involving 25,000 subjects. Two vaccine serotypes, HPV16 and 18, are responsible for cervical cancer and other HPV-related cancers, but the impact of the 4HPV vaccine on these cancers cannot be seen immediately as there is a considerable lag between infection with HPV and cancer development. The other two serotypes, HPV6 and 11, are responsible for genital warts (GWs), which develop within a few months after infection, making GWs an early clinical endpoint for the assessment of the impact of 4HPV vaccination.MethodsWe performed a systematic literature search in PubMed to identify all published studies on 4HPV vaccination, including those that assessed the impact of 4HPV vaccination programs on the incidence of GWs at a population level around the world.ResultsA total of 354 records were identified in the PubMed search. After screening and obtaining full papers for 56 publications, 16 publications presenting data on the impact or effectiveness of 4HPV vaccination on GWs were identified. These reported data on the impact or effectiveness of 4HPV in six countries [Australia (n = 6), New Zealand (n = 2), United States (n = 3), Denmark (n = 2), Germany (n = 1), and Sweden (n = 2)]. In Australia, no GWs were diagnosed in women aged <21 years who reported being vaccinated. A 92.6% reduction in GWs incidence was reported for all women in this age group, where the vaccine uptake rate (VUR) was 70% for 3 doses. The highest reductions were reported in countries with high VURs, mostly through school-based vaccination programs, although high VURs were obtained with some non-school-based programs.ConclusionThe results are coherent with the GWs incidence reduction reported in clinical trials and are an early indicator of what can be expected for the long-term clinical impact on vaccine-type HPV-related cancers.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-015-0178-4) contains supplementary material, which is available to authorized users.

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“…These articles together provide a thought provoking update on contemporary inequities in HPV vaccination. The potential of HPV vaccination to achieve population level control is borne out in a clinic based survey which compares self-reported genital warts and chlamydia in Australian population based surveys between 2001 and 20114.…”

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confidence: 99%

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Cassell¹

2014

Sex Transm Infect

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Genital warts and chlamydia in Australian women: comparison of national population-based surveys in 2001 and 2011

Abstract: Our results add to evidence from clinic-based studies showing a significant reduction in genital warts among HPV vaccine-eligible women in the general community and increases in the proportion of Australian women diagnosed with chlamydia.

Cited by 10 publications

References 12 publications

Evaluating the Early Benefit of Quadrivalent HPV Vaccine on Genital Warts in Belgium: A Cohort Study

Evaluating the Early Benefit of Quadrivalent HPV Vaccine on Genital Warts in Belgium: A Cohort Study

Early Direct and Indirect Impact of Quadrivalent HPV (4HPV) Vaccine on Genital Warts: a Systematic Review

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