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Prev Med. 2019 Jun;123:288-298. doi: 10.1016/j.ypmed.2019.03.040. Epub 2019 Apr 5.

Multisite HPV infections in the United States (NHANES 2003-2014): An overview and synthesis.

Author information

1
Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address: brouweaf@umich.edu.
2
Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
3
Department of Otolaryngology/Head & Neck Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor 48109, United States.

Abstract

HPV is the most common sexually transmitted infection in the U.S., infecting both anogenital and oral sites. Nationally representative data are collected through the National Health and Nutrition Examination Survey (NHANES). However, changing designations of HPV genotypes as high or low risk and varying underlying populations as new results are reported have made direct comparison of results difficult. We reanalyzed HPV data from NHANES derived from self-collected cervicovaginal swabs (women ages 18-59, 2003-14), penile swabs (men ages 18-59, 2013-14), and oral rinses (men and women ages 18-69, 2009-14), using consistent populations and definitions across NHANES cycles. These data strengthen our understanding of age trends in HPV prevalence: cervicovaginal prevalence decreases with age, penile prevalence increases with age, and oral prevalence is bimodal but with an earlier first peak in women. There is strong evidence for reduced prevalence of vaccine genotypes (6, 11, 16, 18) in vaccinated men and women (ages 18-24) at both genital (RR 0.2 (0.1-0.3) in women and 0.7 (0.1-5.4) in men) and oral sites (RR 0.1 (0.0-1.3) in women; no infections detected in vaccinated men). A more complete picture of the burden of HPV in the U.S. is emerging, including evidence for reduced HPV genital and oral prevalence in vaccinated individuals.

KEYWORDS:

Concordant infection; Human papillomavirus; Multisite; NHANES; Prevalence; Vaccine efficacy

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