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. 2021 Jul 2;21(1):634.
doi: 10.1186/s12879-021-06139-y.

Significant decline of HPV 6 infection and genital warts despite low HPV vaccination coverage in young women in Germany: a long-term prospective, cohort data analysis

Agnieszka Denecke  1   2 , Thomas Iftner  3 , Angelika Iftner  3 , Sebastian Riedle  4 , Marion Ocak  4 , Alexander Luyten  5 , Isak Üye  6 , Kübra Tunc  6 , Karl Ulrich Petry  6
Affiliations

Significant decline of HPV 6 infection and genital warts despite low HPV vaccination coverage in young women in Germany: a long-term prospective, cohort data analysis

Agnieszka Denecke et al. BMC Infect Dis. .

Abstract

Background: The introduction of human papillomavirus (HPV) vaccination has resulted in a remarkable decline of genital warts in women and men, but in Germany historical rates of vaccination are relatively low. We report long-term surveillance data on changes in HPV 6 and HPV 11 infection and the prevalence of genital warts in young women in the Wolfsburg HPV epidemiological study (WOLVES).

Methods: Women born in 1983/84, 1988/89, and 1993/94 participated in four cohorts between 2009/10 and 2014/15. Quadrivalent vaccination coverage and prevalence of HPV 6/11 infection and genital warts are reported for participants aged 19-22 years and 24-27 years at the time of sample collection. Statistical analyses were done to compare similarly aged participants using 2 × 2 contingency tables (Röhmel-Mansmann unconditional exact test; two-side alpha of 0.05).

Results: A total of 2456 women were recruited. Between 2010 and 2015, there was a statistically significant decrease in the prevalence of HPV 6 infection among women aged 24-27 years (2.1% versus 0.0%; P < 0.0001) and women aged 19-22 years (2.0% versus 0.0%; P = 0.0056). There was no significant decline in HPV 11 infection. In total, 52 of 2341 participants were diagnosed with genital warts. There was a statistically significant drop in the risk of developing genital warts in women aged 24-27 years between 2010 and 2015 (4.7% versus 1.7%, respectively; P = 0.0018). The overall risk of developing genital warts in women aged 19-27 years decreased from 3.1% in 2010 to 1.2% in 2015 (P = 0.0022).

Conclusions: An increase in vaccination coverage was associated with a decreased prevalence of genital warts in young women. A protective effect greater than herd immunity alone was seen despite low vaccination rates. Quadrivalent vaccine had a protective effect on genital HPV 6 infection and an almost fully protective effect on the development of genital warts in the youngest population.

Keywords: Condylomata acuminata; Genital warts; HPV-vaccination; Human papillomavirus.

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Conflict of interest statement

KUP received an honorarium from Merck-MSD for participation in an advisory board. TI has patents for “Primer and probes for detection of papillomaviruses” DE 103 57 677 A1 (Co-Inventor, T. Iftner; ownership, Greiner Bio-One GmbH) and “Detection of human papillomaviruses” European patent and EP Swiss EPÜ 1272675 (Inventor, T. Iftner; ownership, Eberhard-Karls-Universitaet Tuebingen, Germany), has received speaker honoraria from Hologic, BD Diagnostics, and MSD, and has received unconditional research grants to the University Hospital of Tuebingen from Hologic, USA (IIT) and Becton-Dickinson, Germany (IIT). The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Timeline for recuitment and analysis of particpants in the study. Cohort 1 = born 1983/84 analyzed in 2009/10; cohort 2 = born in 1988/89 analyzed in 2009/10; cohort 3 = born 1988/89 analyzed in 2014/15; cohort 4 = born 1993/94 analyzed in 2014/15
See this image and copyright information in PMC

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