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Vaccine. 2016 Sep 14;34(40):4799-806. doi: 10.1016/j.vaccine.2016.08.016. Epub 2016 Aug 17.

HIV viral suppression results in higher antibody responses in HIV-positive women vaccinated with the quadrivalent human papillomavirus vaccine.

Author information

1
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada; Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network (CTN), Vancouver, BC, Canada. Electronic address: dmoney@cw.bc.ca.
2
Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada.
3
Toronto General Research Institute, University Health Network, Toronto, ON, Canada.
4
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada.
5
Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network (CTN), Vancouver, BC, Canada; Toronto General Research Institute, University Health Network, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.
6
Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network (CTN), Vancouver, BC, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
7
Département Microbiologie-infectiologie et immunologie, Université Laval, QC, Canada.
8
Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
9
Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada.
10
Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network (CTN), Vancouver, BC, Canada; Canada Chronic Viral Illness Service, Montreal Chest Institute, McGill University Health Centre, Montreal, QC, Canada.
11
AIDS Research Program, St. Paul's Hospital, Vancouver, BC, Canada; Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
12
HIV Care Program, Windsor Regional Hospital, Windsor, ON, Canada.
13
Department of Medicine at Queen's University, Kingston, ON, Canada.
14
Department of Pediatrics, University of Toronto, Toronto, ON, Canada; The Hospital for Sick Children, Toronto, ON, Canada.
15
Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; Centre maternel et infantile sur le SIDA, CHU Sainte-Justine, Montreal, QC, Canada.
16
Department Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
17
Department of Paediatrics, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montreal, QC, Canada; Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.
18
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada; Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; BC Centre for Disease Control, Vancouver, BC, Canada.
19
Departement de Microbiologie et Infectiologie, Hôpital Notre-Dame Du Centre De Recherche Du Centre Hospitalier De L'Uuniversité De Montréal, Montreal, QC, Canada.
20
Toronto General Research Institute, University Health Network, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
21
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
22
Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network (CTN), Vancouver, BC, Canada.
23
Department of Medicine, University of Toronto, Toronto, ON, Canada.
24
School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
25
BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada; Division of Infectious and Immunological Diseases, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
26
Positive Women's Network, Vancouver, BC, Canada; Amsterdam Institute for Global Health and Development, Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands.
27
Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
28
Pathology & Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
29
Division of Infectious Diseases, St. Michael's Hospital, Toronto, ON, Canada; Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
30
BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.
31
School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.

Abstract

OBJECTIVE:

To evaluate the immunogenicity and safety of the quadrivalent HPV (qHPV) vaccine in HIV-positive women over 24months.

DESIGN:

Between November 2008 and December 2012, 372 women aged 15 and older were enrolled from 14 Canadian HIV outpatient clinics in an open label cohort study. The qHPV vaccine (0.5mL) was administered intramuscularly at months 0, 2 and 6. The primary study endpoint was seroconversion to any of the HPV types targeted by the qHPV vaccine. Antibody levels were measured at 0, 2, 7, 12, 18, and 24months. Adverse events were recorded throughout.

RESULTS:

Of 372 participants enrolled, 310 (83%) received at least one dose of the qHPV vaccine and 277 (74%) received all three doses. Ninety-five percent (293/308) were seronegative for at least one vaccine type at baseline. The median age was 38years (IQR 32-45, range 15-66), 36% were white, 44% black and 13% were of Indigenous origin. Seventy-two percent of participants had a suppressed HIV viral load (VL<40c/ml) at baseline, with a median CD4 count of 510cells/mm(3) (376-695). Month 7 HPV type-specific seroconversion rates were 99.0%, 98.7%, 98.1% and 93.6% for HPV types 6, 11, 16 and 18 respectively in the per-protocol population. Participants with suppressed HIV VL at first vaccine had a 1.74-3.05fold higher peak antibody response compared to those without (p from 0.006 to <0.0001).

CONCLUSIONS:

This study is the first to examine the qHPV vaccine in HIV-positive women out to 24months and the first to include HIV-positive women through to age 66. The qHPV vaccine was well tolerated, and highly immunogenic. As women with suppressed viral load had higher antibody responses, planning HPV vaccination to occur when persons are virologically suppressed would be optimal for maximizing immune response. Findings provide strong evidence that older HIV-positive women can still benefit from HPV vaccination.

CLINICAL TRIAL REGISTRATION:

http://www.isrctn.com/ISRCTN33674451.

KEYWORDS:

HIV-positive; HPV antibody response; Human papillomavirus vaccines; Immunogenicity; Safety

PMID:
27544584
DOI:
10.1016/j.vaccine.2016.08.016
[Indexed for MEDLINE]

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