Human Papillomavirus Antibody Levels and Quadrivalent Vaccine Clinical Effectiveness in Perinatally Human Immunodeficiency Virus-infected and Exposed, Uninfected Youth
Human Papillomavirus Antibody Levels and Quadrivalent Vaccine Clinical Effectiveness in Perinatally Human Immunodeficiency Virus-infected and Exposed, Uninfected Youth
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DOI：
10.1093/cid/ciy1040
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发表时间：
2019-10-01
影响因子：
11.8
通讯作者：
Cuadra, Anai
中科院分区：
文献类型：
--
作者：
Moscicki, Anna-Barbara;Karalius, Brad;Cuadra, Anai
背景感染人类免疫缺陷病毒（HIV）的人患人类乳头瘤病毒（HPV）相关癌症的风险很高。目的是比较围产期HIV感染者（PHIV）和围产期HIV暴露未感染者（PHEU）的HPV 6、11、16和18型抗体滴度和细胞学异常率。这是一项对接种HPV 4疫苗的青少年进行的前瞻性观察性队列研究，作为多中心儿科HIV/AIDS队列研究青少年主方案的一部分。计算针对HPV 6、11、16和18型的血清转化和几何平均滴度（GMT）。疫苗有效性包括宫颈细胞学异常率和生殖器疣率。310名接种PHIV的青年中，HPV 6、11、16和18的血清转化率分别为83%、84%、90%和62%，而148名接种PHEU的青年分别为94%、96%、99%和87%（所有比较P <0.05）。在接受的每种HPV 4剂量范围内，PHIV的GMT均低于PHEU。较高的GMT与较年轻的年龄、较低的HIV 1型RNA病毒载量、首次接种HPV 4疫苗时较高的CD4%以及末次接种疫苗与抗体标本之间较短的持续时间相关。在56例PHIV和7例PHEU性活跃的接种女性中，有33例发生细胞学异常，每100人年的发病率分别为15.0（10.9至20.6）和2.9（0.4至22.3）。与PHEU青年相比，PHHIV中所有血清型的HPV 4抗体滴度均较低。对异常细胞学的保护也减少了性活跃的PHIV女性。
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.