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J Acquir Immune Defic Syndr. 2020 Jan 8. doi: 10.1097/QAI.0000000000002258. [Epub ahead of print]

Persistence of Non-Vaccine Oncogenic HPV Genotypes in Quadrivalent HPV-Vaccinated Women Living with HIV.

Author information

1
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
2
Département de Microbiologie Médicale et Infectiologie, l'Université de Montréal, Montréal, QC, Canada.
3
Women's Health Research Institute, Vancouver, BC, Canada.
4
Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
5
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
6
Women's College Research Institute, University of Toronto, Toronto, ON, Canada.
7
Infectious Diseases Research Centre - Université Laval, Québec City, QC, Canada.
8
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
9
McGill University Health Centre, Montreal, QC, Canada.
10
Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
11
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
12
Departments of Publc Health and Molecular & Biomedical Sciences, Queen's University, Kingston, ON, Canada.
13
Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
14
Department of Paediatrics, University of Ottawa, Ottawa, ON, Canada.

Abstract

BACKGROUND:

HPV vaccines have promising safety and immunogenicity data in women living with HIV (WLWH). However, it is critical to understand the residual burden of oncogenic HPV within WLWH in order to inform post-vaccination cervical screening needs. We assessed rates of persistent infection with non-quadrivalent HPV (qHPV) oncogenic types in a cohort of qHPV-vaccinated WLWH.

SETTING:

Multi-centre, longitudinal cohort across Canada.

METHODS:

WLWH were scheduled to receive three doses of qHPV vaccine. Participants provided health data and HPV DNA samples. Persistent cases of HPV were defined as new HPV in samples from ≥2 consecutive visits or as HPV present in the last sample. HPV31/33/35/39/45/51/52/56/58/59/68/82 were considered to have oncogenic potential. Median follow-up time was 4 years post initial vaccine dose.

RESULTS:

284 participants were eligible for this analysis with 1205 person-years (PY) of follow-up (≥1 dose of vaccine, ≥1 HPV DNA result post-vaccination). The highest incidence of persistent infection was with HPV51 (1.38/100PY), followed by HPV52 (1.18/100PY), and HPV39 (1.06/100PY). The incidence of persistent infection with pooled HPV types added in the nonavalent vaccine (HPV31/33/45/52/58) was lower than the incidence of persistent oncogenic HPV types not contained within available vaccines (HPV35/39/51/56/59/68) (2.4/100PY versus 3.6/100PY, respectively).

CONCLUSIONS:

qHPV-vaccinated WLWH continue to face a burden of persistent oncogenic HPV infection. While the nonavalent vaccine could alleviate some of this burden, two of the top three persistent oncogenic HPVs in this cohort are not contained within any available vaccine. This highlights the need for ongoing cervical screening in HPV-vaccinated WLWH.

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