Projects

Introduction

The Centre is conducting studies at a laboratory level eg on human papillomavirus (HPV), development of molecular testing technologies for clinical related research, protecting premature babies against infection with probiotics and understanding how they might work and study young women’s health through the Young Female Health Initiative (YFHI) using innovative IT methods.

Some examples of current projects:

IMPACT STUDY – National Human Papillomavirus (HPV) Monitoring Program

Australia was the first country to implement a fully funded, comprehensive, population-based human papillomavirus (HPV) vaccination program. Between 2007 and 2009, all females aged 12–26 years were offered vaccination against HPV using a three‐dose course of the quadrivalent HPV vaccine (Gardasil). From 2013, the program was extended to include 12–13 year old males, with a 2‐year catch up vaccination program for males aged 14–15 years. It has been well documented that the vaccine program has led to a substantial reduction in the prevalence of vaccine targeted HPV genotypes and in specific disease outcomes linked to HPV, including genital warts and cervical precancerous lesions. However there is a need for ongoing and sustainable surveillance of HPV infection among the Australian male and female populations to continue to monitor the impact of the National HPV Vaccination Program.

In 2014 a pilot HPV sentinel surveillance program was initiated. The aim of this pilot was to evaluate and initiate repeatable and sustainable strategies for monitoring prevalence of circulating HPV genotypes in the Australian population. In general terms, the sentinel surveillance strategy involves prospective collection of specimens for HPV genotyping at geographically diverse sites on an ongoing basis. Using repeatable recruitment, sampling and detection methodologies, monitoring HPV prevalence using this strategy will allow for the detection of changes in circulating HPV types over time. Over the 2014-15 pilot period over 1,300 men and women were recruited for HPV testing across Australia. Building on the framework of the pilot, an ongoing surveillance program (called the Impact study) is being rolled out in 2016.  The program aims to monitor the impact of the National HPV Vaccination Program by measuring the prevalence of 37 circulating anogenital HPV genotypes in the Australian population over time. Over 4,000 men and women will be recruited for HPV testing from participating sentinel clinics over a three year period.

The program is led by the Regional HPV LabNet Reference Laboratory for HPV detection and genotyping (established through World Health Organization), located at the Royal Women’s Hospital in collaboration with a consortium of member organisations. The member organisations include the Kirby Institute at the University of New South Wales, The University of Melbourne, Alfred Health (Melbourne Sexual Health Centre), Sexual Health Victoria (previously Family Planning Victoria) and Family Planning NSW and The University of Sydney, Department of Child Health. Funding for the program is provided by the Commonwealth Government Department of Health. The IMPACT study website.

Leading research on human papillomavirus (HPV) and its role in cervical cancer in a number of clinically based research projects, including

• Assessment of prophylactic cervical vaccine effectiveness in the Victorian population.  This has been funded by the Victorian Cancer Agency.  It is evaluating geno prevalence of HPV in a vaccine eligible age general population cohort and found it has dropped from 27% to 1.8% [1].  Osborne SL, Tabrizi SN, Brotherton JM, Cornall AM, Wark JD, Wrede CD, et al. Assessing genital human papillomavirus genoprevalence in young Australian women following the introduction of a national vaccination program. Vaccine. 2015;33(1):201-8. Using sophisticated technology (laser micro-dissection of cells from high grade cervical dysplasia [CIN3], WCID is measuring the impact of vaccine on similar populations [2]. Callegari ET, Tabrizi SN, Pyman J, Saville M, Cornall AM, Brotherton JM, et al. How best to interpret mixed human papillomavirus genotypes in high-grade cervical intraepithelial neoplasia lesions. Vaccine. 2014;32(32):4082-8.
• Evaluation of molecular markers that can predict disease recurrence after treatment of cervical abnormalities
• Evaluation of genetic and environmental factor responsible for development of cervical cancer. 
• Being a Regional WHO HPV Reference Laboratories with the aim of improving the quality of laboratory services for effective surveillance and monitoring of HPV vaccination impact, through enhanced, state-of-the-art laboratory support as well as to harmonize and standardize laboratory testing procedures (HPV DNA and antibody detection) worldwide to support consistent laboratory evaluation of regional disease burden and monitor HPV vaccine performance.
• Establishment of the Asian-Oceania Research Organization on Genital Infection and Neoplasia (AOGIN) - brings together clinicians and scientists within the Asian and Oceania regions and whose work is related to genital infections and neoplasia.

Development and application of molecular testing for detection of sexually transmitted infection (STI) of marginalised, remote populations by combining sensitive molecular techniques with self-sampling and point of care methodology. 

Young Female Health Initiative (YFHI) is an exciting and ambitious new project that is studying 600 Victorian women aged 16-25 years, tracking their lifestyle, behaviour and physical and mental health. This study will give us important new insight into the health patterns of young women today, and will enable the development of education and intervention tools and health policies to improve health and wellbeing throughout their lives.

YFHI is a comprehensive prospective study of health, lifestyle and wellbeing focusing on young females 16-25 years of age recruited through Facebook advertising. YFHI comprises of 5 health themes and is investigating how the various health themes inter-relate:

1. Health behaviours;
2. Body weight, metabolic and cardiovascular health;
3. Bone and joint health;
4. Sexual and reproductive health;
5. Mental health.

---