Four-year persistence of type-specific immunity after quadrivalent human papillomavirus vaccination in HIV-infected children: Effect of a fourth dose of vaccine

Abstract

Objective Although HIV-infected children are recommended to receive quadrivalent human papillo-mavirus vaccine (QHPV) there is limited information on their response to QHPV. This study in HIV-infected children, evaluated the magnitude and duration of immune responses to QHPV. This report describes type-specific serum antibody responses over a 4-to-5 year period after either 3 or 4 doses of QHPV. Design/methods HIV-infected children, ages 7-to-11 years, received 3 doses of QHPV (n = 96) or placebo (n = 30). At 72 weeks QHPV recipients received a fourth dose (n = 84), while placebo recipients began the 3-dose QHPV schedule (n = 27). HPV serotype-specific antibody was determined, by competitive Luminex immunoassay (cLIA) and IgG Luminex immunoassay, at 2, 3.5, and 4-to-5 years after the last dose of QHPV in each treatment arm. Results At 4-to-5 years after the last dose of QHPV, antibody titers were significantly higher in 4-dose than in 3-dose group. However, the proportion of vaccinees with a seroresponse in the cLIA assay was not different between the two groups (86–93% for HPV types 6, 11, and 16, and 64% for HPV type 18). These results were very similar to the seroresponse rate in these HIV-infected children at 1 month after completing vaccination. Conclusions Children with well-controlled HIV infection who receive 3 doses of the QHPV vaccine maintain seropositivity and antibody levels that are generally similar to children of the same age who are not HIV-infected. Antibody titer correlated strongly with low log HIV RNA, low CD8%, and high CD4%. Additionally, a fourth dose of vaccine in HIV-infected children produces a marked rise in antibody characteristic of an anamnestic response and persistence of high antibody levels. Conclusions Study identification: IMPAACT P1085 (V501-021). CLINICALTRIALS.GOV identifier: NCT01206556.

A delayed dose of quadrivalent human papillomavirus vaccine demonstrates immune memory in HIV-1-infected men

“…The titers plateau at lower levels than seen in HIV-uninfected populations or HIV-infected children [12], [14]. We have demonstrated a rapid increase in titers four weeks after a delayed fourth dose of qHPV vaccine consistent with an anamnestic response as has been described in other populations [13], [14].…”

Seropositivity to non-vaccine incorporated genotypes induced by the bivalent and quadrivalent HPV vaccines: A systematic review and meta-analysis

“…A stronger serological response elicited in adolescents compared to adult women has been demonstrated for both vaccines [27][28][29][30], but only against vaccine-incorporated genotypes using binding assays. The removal of data from one study [18,23] comprising HIV-infected subjects made little difference to the pooled estimates for seropositivity against HPV31 and HPV45 suggesting, based on these limited study data, that the HIV serostatus of vaccine recipients may have little impact on HPV vaccine immunogenicity [31].…”

Suppressive antiretroviral therapy associates with effective treatment of high-grade cervical intraepithelial neoplasia

“…Both 2-valent and 4-valent HPV-vaccines have been found to be safe and well tolerated in the population living with HIV and do not alter the CD4 counts or HIV viral loads of those vaccinated [138][139][140][141] . The rate of seroconversion is similar in PLWH on suppressive ART and HIV negative individuals 138,142,143 . Low CD4 counts seem to be associated with a lower antibody titer response but data is limited and the clinical implication of this is unknown, as the protective titers of HPV antibodies are not defined 142,144 .…”