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 papillomavirus 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-5year period after either 3 or 4 doses of QHPV.

Design/methods: HIV-infected children, ages 7-to-11years, received 3 doses of QHPV (n=96) or placebo (n=30). At 72weeks 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-5years after the last dose of QHPV in each treatment arm.

Results: At 4-to-5years 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 1month 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. Study identification: IMPAACT P1085 (V501-021). CLINICALTRIALS.GOV identifier: NCT01206556.

Keywords: Antibody response; Human papillomavirus vaccine; Pediatric HIV infection.

Conflict of interest statement

Conflicts of interest

M.J. Levin (chair) and A. Weinberg (immunologist) were members of the core protocol team supported by research grants from the sponsor and M.J. Levin is a consultant to the sponsor.

A Saah is an employee of the sponsor and may hold stock and/or stock options from the sponsor.

Copyright © 2017 Elsevier Ltd. All rights reserved.

Figures

Fig. 1

Consort diagram. 1Brackets [n] = number in indicated category. 2The interval was calculated after the first dose in each arm. Thus, the fourth dose in Arm A was administered 96 weeks after entering the study. 3Three subjects could not be contacted for P1085; 11 subjects refused to continue into P1085.

Fig. 2

Fig. 2a. Log10 cLIA anti-HPV 6,11 Antibody Titers (mMU/mL) Over Time. Fig. 2b. Log10 cLIA anti-HPV 16, 18 Antibody Titers (mMU/mL) Over Time.

Fig. 2

Fig. 2a. Log10 cLIA anti-HPV 6,11 Antibody Titers (mMU/mL) Over Time. Fig. 2b. Log10 cLIA anti-HPV 16, 18 Antibody Titers (mMU/mL) Over Time.