Abstract
BackgroundPersistent high-risk human papillomavirus (HPV) infection is endorsed by the World Health Organization as an intermediate endpoint for evaluating HPV vaccine effectiveness/efficacy. There are different approaches to estimate the vaccine effectiveness/efficacy against persistent HPV infections.MethodsWe performed a systematic literature search in Pubmed to identify statistical approaches that have been used to estimate the vaccine effectiveness/efficacy against persistent HPV infections. We applied these methods to data of a longitudinal observational study to assess their performance and compare the obtained vaccine effectiveness (VE) estimates.ResultsOur literature search identified four approaches: the conditional exact test for comparing two independent Poisson rates using a binomial distribution, Generalized Estimating Equations for Poisson regression, Prentice Williams and Peterson total time (PWP-TT) and Cox proportional hazards regression. These approaches differ regarding underlying assumptions and provide different effect measures. However, they provided similar effectiveness estimates against HPV16/18 and HPV31/33/45 persistent infections in a cohort of young women eligible for routine HPV vaccination (range VE 93.7-95.1% and 60.4-67.7%, respectively) and seemed robust to violations of underlying assumptions.ConclusionsAs the rate of subsequent infections increased in our observational cohort, we recommend PWP-TT as the optimal approach to estimate the vaccine effectiveness against persistent HPV infections in young women. Confirmation of our findings should be undertaken by applying these methods after longer follow-up in our study, as well as in different populations.
Original language | English |
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Article number | 482 |
Number of pages | 11 |
Journal | BMC Infectious Diseases |
Volume | 20 |
Issue number | 1 |
DOIs | |
Publication status | Published - 8 Jul 2020 |
Keywords
- Human papillomavirus
- HPV
- Persistent infection
- HPV vaccination
- Follow-up
- HPV-16/18 AS04-ADJUVANTED VACCINE
- HUMAN-PAPILLOMAVIRUS TYPE-16
- CROSS-PROTECTIVE EFFICACY
- PATRICIA RANDOMIZED-TRIAL
- SUSTAINED EFFICACY
- DOUBLE-BLIND
- PARTICLE VACCINE
- YOUNG-WOMEN
- FOLLOW-UP
- CERVICAL COINFECTION