Racial/ethnic variation in the prevalence of vaccine-related human papillomavirus genotypes

Ethn Health. 2019 Oct;24(7):804-815. doi: 10.1080/13557858.2017.1373073. Epub 2017 Sep 4.

Abstract

Objective: There are currently three licensed human papillomavirus (HPV) vaccines that protect against cervical cancer. Here we compare the prevalence of bi-, quadri-, and nonavalent vaccine-related HPV genotypes in a multi-ethnic sample of non-Hispanic white, non-Hispanic black, Hispanic, and Asian women. Design: Patients in this analysis (n = 419) represent a subset of women with a previous abnormal Pap test participating in a clinical trial. HPV genotyping was conducted using the Roche Linear Array. Prevalent HPV genotypes were grouped according to their inclusion in each of the vaccines: bivalent (16, 18), quadrivalent (16, 18, 6, 11), and nonavalent (16, 18, 31, 33, 45, 52, 58, 6, 11). Results: The prevalence of HPV genotypes covered by the bi-/quadrivalent vaccines was lowest among non-Hispanic black (15%) and Hispanic women (20%), compared to non-Hispanic white (38%) and Asian women (38%). Across all racial/ethnic groups, a large proportion of infections (38%-49%) were with genotypes included in the nonavalent vaccine. However, the prevalence of HPV genotypes not covered by any vaccine was significantly higher among non-Hispanic black (36%) and Hispanic women (42%), compared to non-Hispanic white (24%) and Asian women (16%) (p < 0.001). Racial/ethnic differences in HPV genotype prevalence were observed when controlling for demographic and sexual behavior characteristics, as well as when restricting the analysis to women with CIN 2+. Conclusion: Our data suggest racial/ethnic differences in the prevalence of vaccine-related HPV genotypes. In particular, non-Hispanic black and Hispanic women had the lowest prevalence of HPV genotypes covered by the bi-/quadrivalent vaccines. While a large proportion of their infections were covered by the nonavalent vaccine, non-Hispanic black and Hispanic women also had the highest prevalence of HPV genotypes not covered by any vaccine.

Keywords: Human papillomavirus; cervical neoplasia; race/ethnicity; vaccine.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • African Americans / statistics & numerical data*
  • Asian Americans / statistics & numerical data*
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Genotype
  • Hispanic Americans / statistics & numerical data*
  • Humans
  • Papillomaviridae / genetics
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / ethnology
  • Papillomavirus Infections / virology
  • Papillomavirus Vaccines / genetics*
  • Papillomavirus Vaccines / therapeutic use
  • Prevalence
  • United States / epidemiology
  • Uterine Cervical Neoplasms / ethnology
  • Uterine Cervical Neoplasms / prevention & control
  • Uterine Cervical Neoplasms / virology
  • Vaccination Coverage / statistics & numerical data

Substances

  • Papillomavirus Vaccines