Patients' high acceptability of a future therapeutic HIV vaccine in France: a French paradox?

Svetlane Dimi, David Zucman, Olivier Chassany, Christophe Lalanne, Thierry Prazuck, Emmanuel Mortier, Catherine Majerholc, Isabelle Aubin-Auger, Pierre Verger, Martin Duracinsky, Svetlane Dimi, David Zucman, Olivier Chassany, Christophe Lalanne, Thierry Prazuck, Emmanuel Mortier, Catherine Majerholc, Isabelle Aubin-Auger, Pierre Verger, Martin Duracinsky

Abstract

Background: France is the European country with the lowest level of confidence in vaccines. Measurement of patients' acceptability towards a future therapeutic HIV vaccine is critically important. Thus, the aim of this study was to evaluate patients' acceptability of a future therapeutic HIV vaccine in a representative cohort of French patients living with HIV-AIDS (PLWHs).

Methods: This multicentre study used quantitative and qualitative methods to assess PLWHs' opinions and their potential acceptance of a future therapeutic HIV vaccine. Cross-sectional study on 220 HIV-1 infected outpatients, aged 18-75 years.

Results: The participants' characteristics were similar to those of the overall French PLWH population. Responses from the questionnaires showed high indices of acceptance: the mean score for acceptability on the Visual Analog Scale VAS was 8.4 of 10, and 92% of patients agreed to be vaccinated if a therapeutic vaccine became available. Acceptability depended on the expected characteristics of the vaccine, notably the duration of its effectiveness: 44% of participants expected it to be effective for life. This acceptance was not associated with socio-demographic, clinical (mode of contamination, duration of disease), quality of life, or illness-perception parameters. Acceptability was also strongly correlated with confidence in the treating physician.

Conclusion: The PLWHs within our cohort had high indices of acceptance to a future therapeutic HIV vaccine.

Trial registration: This study was retroactively registered on ClinicalTrials.gov with ID: NCT02077101 in February 21, 2014.

Keywords: Acceptability; Acceptance; Confidence; HIV; Therapeutic vaccine.

Conflict of interest statement

Ethics approval and consent to participate

All subjects provided their written consent prior to the study. Questionnaires and interviews were fully anonymous. A favorable ethical opinion was obtained from the relevant French Ethics Committee (IDRCB 2013-A01344–41).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Acceptability and quality of life
Fig. 2
Fig. 2
Multivariate analysis of the HIV vaccine acceptability. The angle formed by two vectors is proportional to the correlation between the two variables. Thus, the smaller the angle, the more the variables are correlated with one another; two vectors whose angle is approximately 180 ° indicates a strong negative correlation; finally, two vectors whose angle is 90 ° reflects and absence of correlation between the two variables associated with these vectors

References

    1. Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382(9903):1525–1533. doi: 10.1016/S0140-6736(13)61809-7.
    1. Chang M-L, Vitek C, Esparza J, WHO-UNAIDS-CDC Public health considerations for the use of a first-generation HIV vaccine. Report from a WHO-UNAIDS-CDC consultation, Geneva, 20-21 November 2002. AIDS. 2003;17(15):W1–10. doi: 10.1097/00002030-200310170-00025.
    1. Launay O, Hoch D, Saint-Sardos C, Guillemot D, Participants of round table n° 6 of Giens XXV. Vaccines: specific features, simulation of impact and medico-economic modelling. Thérapie. 2010 [cited 2015 Jun 14];65(4):357–365.
    1. Carcelain G, Autran B. Immune interventions in HIV infection. Immunol Rev. 2013;254(1):355–371. doi: 10.1111/imr.12083.
    1. Puls RL, Emery S. Therapeutic vaccination against HIV: current progress and future possibilities. Clin Sci. 2006;110(1):59–71. doi: 10.1042/CS20050157.
    1. García F, León A, Gatell JM, Plana M, Gallart T. Therapeutic vaccines against HIV infection. Hum Vaccin Immunother. 2012;8(5):569–581. doi: 10.4161/hv.19555.
    1. West AP, Scharf L, Scheid JF, Klein F, Bjorkman PJ, Nussenzweig MC. Structural insights on the role of antibodies in HIV-1 vaccine and therapy. Cell. 2014;156(4):633–648. doi: 10.1016/j.cell.2014.01.052.
    1. Day TA, Kublin JG. Lessons learned from HIV Vaccine clinical efficacy trials. Curr HIV Res. 2013;11(6):441–449. doi: 10.2174/1570162X113116660051.
    1. Rerks-Ngarm S, Pitisuttithum P, Nitayaphan S, Kaewkungwal J, Chiu J, Paris R, et al. Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand. N Engl J Med. 2009;361(23):2209–2220. doi: 10.1056/NEJMoa0908492.
    1. The SAGE Vaccine Hesitancy Working Group. SAGE working group dealing with vaccine hesitancy (march 2012 to November 2014).
    1. Peretti-Watel P, Larson HJ, Ward JK, Schulz WS, Verger P. Vaccine Hesitancy: Clarifying a Theoretical Framework for an Ambiguous Notion. PLOS Curr Outbreaks. 2015. Edition 1.
    1. Larson H. Negotiating vaccine acceptance in an era of reluctance. Hum Vaccin Immunother. 2013;9(8):1779–1781. doi: 10.4161/hv.25932.
    1. Ward JK. Rethinking the antivaccine movement concept : a case study of public criticism pf the swine flu vaccine’s safety in France. Soc Sci Med. 2016;159:48–57. doi: 10.1016/j.socscimed.2016.05.003.
    1. Ward JK, Peretti-Watel P, Larson HJ, Raude J, Verger P. Vaccine-criticism on the internet : new insights based on French speaking websites. Vaccine. 2015;33:1063–1070. doi: 10.1016/j.vaccine.2014.12.064.
    1. Verger P, Fressard L, Collange F, et al. Vaccine hesitancy among general Practitionners and its determinants during controversies : a national cross-sectional survey in France. Ebiomedecine. 2015;2(8):891–897. doi: 10.1016/j.ebiom.2015.06.018.
    1. Raude J, Fressard L, Gautier A, Pulcini C, et al. Opening the “Vaccine Hesitancy” black box : how trust in institutions affects French GP’s vaccination practices. Expert Rev Vaccines. 2016;15(7):937–948. doi: 10.1080/14760584.2016.1184092.
    1. Peretti-Watel P, Verger P, Raude J, Constant A, Gautier A, Jestin C, Beck F. Dramatic change in public attitudes towards vaccination during the 2009 influenza a(H1N1) pandemic in France. Euro Surveill 2013;18(44). Available online: .
    1. Larson HJ, Smith DMD, Paterson P, Cumming M, Eckersberger E, Freifeld CC, Ghinai I, Jarrett C, Paushter L, Brownstein JS, Madoff LC. Measuring vaccine confidence: analysis of data obtained by a media surveillance system used to analyse public concerns about vaccines. Lancet Infect Dis. 2013;13:606–613. doi: 10.1016/S1473-3099(13)70108-7.
    1. Larson HJ, de Figueiredo A, Xiahong Z, Schulz WS, Verger P, et al. The state of Vaccine confidence 2016: global insights through a 67-country survey. EBioMedicine. 2016;12:295–301. doi: 10.1016/j.ebiom.2016.08.042.
    1. Schwarzinger M, Verger P, Guerville M-A, Aubry C, Rolland S, Obadia Y, Moatti J-P. Positive attitudes of French general practitioners towards a/H1N1 influenza-pandemic vaccination: a missed opportunity to increase vaccination uptakes in the general public? Vaccine. 28(15):2743–8.
    1. Flicoteaux R, Pulcini C, Carrieri P, Schwarzinger M, Leport C, Verger P. Correlates of general practitioner recommendations to patients regarding vaccination for the 2009–2010 pandemic influenza (a/H1N1) in France: implications for future vaccination campaigns. Vaccine. 2014;32:2281–2287. doi: 10.1016/j.vaccine.2014.02.074.
    1. Sardy R, Ecochard R, Lasserre E, Dubois J-P, Floret D, Letrilliart L. Social representations of vaccination among patients and general practitioners: a study based on hierarchized evocation. Sante Publique. 2012;24(6):547–560. doi: 10.3917/spub.126.0547.
    1. Dubé E, Gagnon D, Ouakki M, Bettinger JA, et al. Understanding Vaccine Hesitancy in Canada: results of a consultation study by the Canadian immunization research network. PLoS One. 2016;11(6):e0156118. doi: 10.1371/journal.pone.0156118.
    1. Verger P, et al. Vaccine Hesitancy among general practitioners and its determinants during controversies: a National Cross-sectional Survey in France. EBioMedicine. 2015. 10.1016/j.ebiom.2015.06.018.
    1. Newman PA, Logie C. HIV vaccine acceptability: a systematic review and meta-analysis. AIDS. 2010;24(11):1749–1756. doi: 10.1097/QAD.0b013e32833adbe8.
    1. Lau C-Y, Stansbury JP, Gust DA, Kafaar Z. Social and behavioral science in HIV vaccine trials: a gap assessment of the literature. Expert Rev Vaccines. 2009;8(2):179–190. doi: 10.1586/14760584.8.2.179.
    1. Dong Y, Shen X, Guo R, Liu B, Zhu L, Wang J, et al. Willingness to participate in HIV therapeutic vaccine trials among HIV-infected patients on ART in China. PLoS One. 2014;9(11):e111321. doi: 10.1371/journal.pone.0111321.
    1. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60:631–637. doi: 10.1016/j.jpsychores.2005.10.020.
    1. Duracinsky M, Lalanne C, Le Coeur S, Herrmann S, Berzins B, Armstrong AR, Lau JT, Fournier I, Chassany O. Psychometric validation of the PROQOL-HIV questionnaire, a new health-related quality of life instrument-specific to HIV disease. J Acquir Immune Defic Syndr. 2012;59(5):506–515. doi: 10.1097/QAI.0b013e31824be3f2.
    1. Petrie KJ, Broadbent E, Meechan G. Self-regulatory interventions for improving the management of chronic illness. In: Cameron LD, Leventhal H, editors. The self-regulation of health and illness behaviour. New York: Routledge; 2003. pp. 257–277.
    1. Duracinsky M, Herrmann S, Berzins B, Armstrong AR, Kohli R, Le Coeur S, Diouf A, Fournier I, Schechter M, Chassany O. The development of PROQOL-HIV: an international instrument to assess the health-related quality of life of persons living with HIV/AIDS. J Acquir Immune Defic Syndr. 2012;59(5):498–505. doi: 10.1097/QAI.0b013e318245cafe.
    1. Lalanne C, Chassany O, Carrieri P, Marcellin F, Armstrong AR, Lert F, Spire B, Dray-Spira R, Duracinsky M. A reduced factor structure for the PROQOL-HIV questionnaire provided reliable indicators of health-related quality of life. J Clin Epidemiol. 2016;72:116–125. doi: 10.1016/j.jclinepi.2015.10.009.
    1. Nixon A, Wild D. Methologies for assessing and demonstrating data saturation in qualitative inquiry supporting patient-reported outcomes research. Athens: ISPOR 11th annual European congress; 2008.
    1. Kosinska AD, Bauer T, Protzer U. Therapeutic vaccination for chronic hepatitis B. Curr Opin Virol. 2017;23:75–81. doi: 10.1016/j.coviro.2017.03.011.
    1. Yang A, Jeang J, Cheng K, et al. Current state in the development of candidate therapeutic HPV vaccines. Expert Rev Vaccines. 2016;15(8):989–1007. doi: 10.1586/14760584.2016.1157477.
    1. Lobaina Y, Hardtke S, Wedemeyer H, Aguilar JC, Schlaphoff V. In vitro stimulation with HBV therapeutic vaccine candidate Nasvac activates B and T cells from chronic hepatitis B patients and healthy donors. Mol Immunol. 2015;63(2):320–327. doi: 10.1016/j.molimm.2014.08.003.
    1. Litwin MS, Tan HJ. The diagnosis and treatment of prostate Cancer: a review. JAMA. 2017;317(24):2532–2542. doi: 10.1001/jama.2017.7248.
    1. Mohseni-Zadeh M, Rey D, Batard ML, Beck Wirth G, Partisani ML, Lang JM, Hansmann Y, Christmann D, Martinot M. Inadequate vaccination coverage in a French cohort of HIV positive patients. Med Mal Infect. 2010;40(12):683–690. doi: 10.1016/j.medmal.2010.06.005.
    1. Douab T, Marcellin F, Vilotitch A, Protopopescu C, Préau M, Suzan-Monti M, Sagaon-Teyssier L, Lert F, Carrieri MP, Dray-Spira R, Spire B. ANRS-VESPA2 study group - health-related quality of life of people living with HIV followed up in hospitals in France: comparing trends and correlates between 2003 and 2011 (ANRS-VESPA and VESPA2 national surveys) AIDS Care. 2014;26(Suppl 1):S29–S40. doi: 10.1080/09540121.2014.906553.

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