Abstract
HIV-infected patients are at increased risk of human papillomavirus (HPV) acquisition and HPV-associated diseases. This study set out to determine whether a two-dose (2D) HPV vaccination schedule was sufficient in HIV-infected adolescents with immune reconstitution (IR) following antiretroviral treatment. Participants aged 9–15 years who had CD4 cell counts > 500 cells/mm3 and HIV-1 RNA < 40 copies/mL for at least one year were assigned to the 2D schedule, while older participants or those without IR received a three-dose (3D) schedule. Antibodies to HPV-16 and -18 were measured using a pseudovirion-based neutralization assay. A total of 96 subjects were enrolled; 31.3% and 68.7% received the 2D and 3D schedule, respectively. Of these, 66.7% and 57.6% of the 2D and 3D participants, respectively, were male. The seroconversion rates for HPV-16 and HPV-18 were 100% in all cases, except for HPV-18 in males who received the 3D schedule (97.4%). In males, the anti-HPV-16 geometric mean titers (GMTs) were 6859.3 (95% confidence interval, 4394.3–10,707.1) and 7011.1 (4648.8–10,573.9) in the 2D and 3D groups (p = 0.946), respectively, and the anti-HPV-18 GMTs were 2039.3 (1432.2–2903.8) and 2859.8 (1810.0–4518.4) in the 2D and 3D (p = 0.313) groups, respectively. In females, the anti-HPV-16 GMTs were 15,758.7 (8868.0–28,003.4) and 26,241.6 (16,972.7–40,572.3) in the 2D and 3D groups (p = 0.197), respectively, and the anti-HPV-18 GMTs were 5971.4 (3026.8–11,780.6) and 9993.1 (5950.8–16,781.1) in the 2D and 3D groups (p = 0.271), respectively. In summary, a 2D schedule is as immunogenic in young adolescents with IR as a 3D schedule in older subjects and those without IR.
Highlights
Similar to adults, adolescents living with human immunodeficiency virus (ALHIV)have a higher incidence of human papillomavirus (HPV) infection, abnormal pap smears, and persistent HPV infection, leading to an increased risk of anogenital cancers than nonALHIV [1,2,3]
The proportion of participants who received the non-nucleoside reverse transcriptase inhibitor (NNRTI) regimen was found to be higher among those who received the 2D schedule compared to those who received the 3D schedule, this was only significant in the female cohort (Table 1)
All the female participants who were initially seronegative for an HPV serotype at baseline demonstrated 100% seroconversion for both HPV-16 and -18 in both the 2D and 3D groups (Table 2 and Figure 1)
Summary
Adolescents living with human immunodeficiency virus (ALHIV)have a higher incidence of human papillomavirus (HPV) infection, abnormal pap smears, and persistent HPV infection, leading to an increased risk of anogenital cancers than nonALHIV [1,2,3]. Adolescents living with human immunodeficiency virus (ALHIV). The current evidence has demonstrated that the HPV vaccine is safe and efficacious for people living with HIV, and they should be vaccinated with the HPV vaccine [4]. All three vaccines exhibited excellent safety profiles and were highly efficacious in preventing HPV infections and premalignant anogenital lesions caused by the HPV types included in the vaccines [5,6,7,8]. The 2D HPV vaccine schedule was introduced based on non-inferior antibody responses observed between healthy young adolescents aged 9–14 years and young adults aged 15–25 years [11,12]. For immunocompromised individuals, including those who are infected with HIV, the 3D schedule is recommended regardless of their age [9,10]
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