Changing dynamics of HR-HPV infection and associated cervical precancer in the population-based WOLVES cohort study 15 years after vaccination

We evaluated the distribution of HPV-genotypes in HSIL and LSIL a prospective cohort of young unscreened women. The relationship between hr-HPV status, HPV-genotyping cervical histology, and vaccination status were examined. Between 2009/10 and 2019/2020, three cohorts of young women between 21- and 26 years of age participated in a large epidemiological study with cytology-and HPV testing. Annual colposcopic examination of HPV positive participants and SPF10 LIPA for HPV genotyping was performed in this group. Our study showed changes of HPV-genotype distribution in the immunized- and non-immunized cohort of young women in Germany within 10 years after the introduction of vaccination against HPV. We confirm that immunization against HPV effectively protects against the development of dysplastic changes in our study population. We note that in our vaccinated populations, the HPV subtypes that were not part of the vaccine were more likely to be found in CIN cases. Additionally, only few LSIL (CIN 1) and hardly any HSIL (CIN2-3) cases were seen in the vaccinated population, indicating an increased protection against advanced cervical disease conferred by vaccination.