Human Papillomavirus Antibody Levels and Quadrivalent Vaccine Clinical Effectiveness in Perinatally Human Immunodeficiency Virus–infected and Exposed, Uninfected Youth. (21st February 2019)

• Record Type: Journal Article
• Authors: Moscicki, Anna-Barbara; Karalius, Brad; Tassiopoulos, Katherine; Yao, Tzy-Jyun; Jacobson, Denise L; Patel, Kunjal; Purswani, Murli; Seage, George R
• Is Part Of: Clinical infectious diseases. Volume 69:Number 7(2019)
• Page Start: 1183
• Page End: 1191
• Publication Date: 2019-02-21
• Subjects: HPV vaccine -- perinatally HIV infected youth -- antibody titers -- abnormal cytology; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciy1040
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Persons who are infected with human immunodeficiency virus (HIV) are at high risk of human papillomavirus (HPV)-associated cancers. The objectives are to compare antibody titers to HPV 6, 11, 16, and 18 and rate of abnormal cytology between perinatally HIV-infected (PHIV) and perinatally HIV-exposed, uninfected (PHEU) youth. Methods: This is a prospective observational cohort study of HPV4 vaccinated youth performed as part of the multicenter Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol. Seroconversion and geometric mean titer (GMT) against HPV types 6, 11, 16, and 18 were calculated. Vaccine effectiveness included rates of abnormal cervical cytology and genital warts. Results: Seroconversion to HPV 6, 11, 16, and 18 occurred in 83%, 84%, 90%, and 62% of 310 vaccinated PHIV youth compared to 94%, 96%, 99%, and 87% of 148 vaccinated PHEU youth, respectively ( P < .05 for all comparisons). GMTs were lower in the PHIV vs PHEU within each category of HPV4 doses received. Higher GMTs were associated with younger age, lower HIV type 1 RNA viral load, and higher CD4% at first HPV4 vaccination, as well as shorter duration between last vaccine dose and antibody specimen. Abnormal cytology occurred in 33 of 56 PHIV and 1 of 7 PHEU sexually active vaccinated females, yielding incidence rates per 100 person-years of 15.0 (10.9 to 20.6) and 2.9 (0.4 to 22.3), respectively. Conclusion: Antibody titers to HPV4 were lower for all serotypes in PHIV compared to PHEU youth. Protection against abnormal cytology was also diminished in sexually active PHIV females. Abstract : Antibody titers for human papillomavirus (HPV) 6, 11, 16 and 18 were lower in HPV vaccinated perinatally human immunodeficiency virus-infected (PHIV) youth compared to those HIV-exposed, uninfected youth. HPV vaccine effectiveness was reduced in PHIV girls, as 33 of 56 development abnormal cytology during observation.