亚洲人群HPV疫苗免疫原性及安全性的Meta分析  

Immunogenicity and safety of HPV vaccine in Asia population:a meta-analysis

作　　者：胡熙明 孙九峰 赵卫[1] HU Ximing;SUN Jiufeng;ZHAO Wei(School of Public Health,Southern Medical University,Guangdong Guangzhou 510515,China;Guangdong Institute of Public Health,Guangdong Guangzhou 511400,China;Guangdong Provincial Center for Disease Control and Prevention,Guangdong Guangzhou 511400,China)

机构地区：[1]南方医科大学公共卫生学院,广东广州510515 [2]广东省公共卫生研究院,广东广州511400 [3]广东省疾病预防控制中心,广东广州511400

出　　处：《中国妇幼健康研究》2024年第1期58-66,共9页Chinese Journal of Woman and Child Health Research

摘　　要：目的评估人乳头状瘤病毒(HPV)疫苗在亚洲人群中接种后的免疫原性和安全性。方法本研究分别检索英文数据库(PubMed、Embase、Web of Science、Clinical Trails、Cochrane library)和中文数据库(中国知网、万方、维普),自建库至2022年4月,关于亚洲人群进行的HPV疫苗安全性和免疫原性临床试验文献。采用主题词与自由词灵活搭配检索并结合纳排标准筛选文献,对最终纳入文献进行质量评价并提取资料,应用Meta分析合并评估。结果最终纳入16篇随机对照试验(RCT)研究,累计研究对象25485人。Meta分析表明对于HPV疫苗免疫原性,HPV16型特异性血清转化率合并效应值RR为43.74(16.51~115.85),HPV18型特异性血清转化率合并效应值RR为45.72(8.78~238.13)。对于HPV疫苗安全性,二价与四价HPV疫苗接种局部不良事件风险试验组高于对照组,RR为1.52(1.34~1.73)和1.38(1.20~1.59)。二价HPV疫苗与四价HPV疫苗试验组发生全身性不良事件的风险也高于对照组,RR分别为1.21(1.11~1.32)和1.13(0.99~1.30)。结论接种亚洲人群HPV疫苗后血清抗体阳转率高于未接种者,提示接种HPV疫苗可以提高个体特异性抗体水平,接种HPV疫苗发生局部和全身性安全事件的风险均高于对照组,提示仍要高度重视HPV疫苗的安全性问题。Objective To evaluate immunogenicity and safety of human papillomavirus(HPV)vaccine in Asia population.Methods English databases such as PubMed,Embase,Web of Science,Clinical trails and Cochrane Library,and Chinese databases such as CNKI and Wan Fang Data were searched from their inception to April 2022 for randomized controlled trials(RCTs)about immunogenicity and safety of HPV vaccine.Using flexible collocation of subject words and free words,the literature were searched and screened according to inclusion and exclusion criteria.Then quality of the literature finally included was assessed and the data were extracted.A meta-analysis was conducted to merge the assessments through Review Manager 5.4 and Stata14.0 software.Results 16 RCTs were included,and 25485 subjects were involved in these studies.Meta-analysis showed that HPV vaccine had good immunogenicity:the RR(relative risk)of HPV16 specific serum conversion rate merged effect value was 43.74(16.51-115.85)and that of HPV18 specific serum conversion rate merged effect value was 45.72(8.78-238.13).In safety of HPV vaccine,the risks of local adverse events caused by bivalent HPV vaccine(RR=1.52,95%CI:1.34-1.73)and quadrivalent HPV vaccine(RR=1.38,95%CI:1.20-1.59)in the experimental group were higher than those in the control group.Also,the risks of systemic adverse events caused by bivalent HPV vaccine(RR=1.21,95%CI:1.11-1.32)and quadrivalent HPV vaccine(RR=1.13,95%CI:0.99-1.30)in the experimental group were higher than those in the control group.Conclusion In these women population who had been inoculated HPV vaccine,the positive serum antibody conversion rate after inoculation of HPV vaccine for Asian population is higher than that in those women who hadn't been inoculated the HPV vaccine,suggesting that inoculation of HPV vaccine can improve individual's specific antibody level.However,the risks of local and systemic safety events caused by HPV vaccines in the experimental group are higher than those in the control group,suggesting that the safety problem

关 键 词：人乳头瘤病毒 HPV疫苗 META分析 免疫原性 安全性 

分 类 号：R173[医药卫生—妇幼卫生保健]