Targeted human papillomavirus vaccination for young men who have sex with men in Australia yields significant population benefits and is cost-effective

被引：38

作者：

Zhang, Lei ^{[1
,2
,3
,4
]}

Regan, David G. ^{[5
]}

Ong, Jason J. ^{[1
,2
]}

Gambhir, Manoj ^{[3
]}

Chow, Eric P. F. ^{[1
,2
]}

Zou, Huachun ^{[5
]}

Law, Matthew ^{[5
]}

Hocking, Jane ^{[6
]}

Fairley, Christopher K. ^{[1
,2
]}

机构：

[1] Alfred Hlth, Melbourne Sexual Hlth Ctr, Melbourne, Vic, Australia

[2] Monash Univ, Cent Clin Sch, Fac Med Nursing & Hlth Sci, Melbourne, Vic, Australia

[3] Monash Univ, Fac Med Nursing & Hlth Sci, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia

[4] Tsinghua Univ, Res Ctr Publ Hlth, Beijing 100084, Peoples R China

[5] UNSW Australia, Kirby Inst, Sydney, NSW, Australia

[6] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia

来源：

VACCINE | 2017年 / 35卷 / 37期

关键词：

Human papillomavirus; Vaccination; Men who have sex with men; Mathematical modelling; Cost-effectiveness analysis; HPV VACCINATION; GENITAL WARTS; UNITED-STATES; LEVEL IMPACT; ANAL CANCER; INFECTION; COVERAGE; AGE;

D O I：

10.1016/j.vaccine.2017.07.078

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: We investigated the effectiveness and cost-effectiveness of a targeted human papillomavirus (HPV) vaccination program for young (15-26) men who have sex with men (MSM). Methods: We developed a compartmental model to project HPV epidemic trajectories in MSM for three vaccination scenarios: a boys program, a targeted program for young MSM only and the combination of the two over 2017-2036. We assessed the gain in quality-adjusted-life-years (QALY) in 190,000 Australian MSM. Results: A targeted program for young MSM only that achieved 20% coverage per year, without a boys program, will prevent 49,283 (31,253-71,500) cases of anogenital warts, 191 (88-319) person-years living with anal cancer through 2017-2036 but will only stablise anal cancer incidence. In contrast, a boys program will prevent 82,056 (52,100-117,164) cases of anogenital warts, 447 (204-725) person-years living with anal cancers through 2017-2036 and see major declines in anal cancer. This can reduce 90% low- and high-risk HPV in young MSM by 2024 and 2032, respectively, but will require vaccinating >84% of boys. Adding a targeted program for young MSM to an existing boys program would prevent an additional 14,912 (8479-21,803) anogenital wart and 91 (42-152) person-years living with anal cancer. In combination with a boys' program, a catch-up program for young MSM will cost an additional $AUD 6788 ($4628-11,989) per QALY gained, but delaying its implementation reduced its cost-effectiveness. Conclusions: A boys program that achieved coverage of about 84% will result in a 90% reduction in HPV. A targeted program for young MSM is cost-effective if timely implemented. (C) 2017 Elsevier Ltd. All rights reserved.

引用

页码：4923 / 4929

页数：7

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