Human Papillomavirus Vaccine Proves Effective in Women With HIV

Key Points

  • The quadrivalent HPV vaccine was found to be safe and immunogenic against HPV types 6, 11, 16, and 18 in HIV-infected women.
  • Seroconversion proportions at week 28 among women in the CD4 stratum A were 96%, 98%, 99%, and 91% for HPV types 6, 11, 16, and 18, respectively, and in 100%, 98%, 98%, and 85% of stratum B participants, respectively.
  • The proportion of stratum C responders came to 84% for type 6, 92% for type 11, 93% for type 16, and 75% for type 18.

Women infected with HIV are disproportionally affected by human papillomavirus (HPV)-related anogenital disease, particularly with increased immunosuppression. In a clinical study of 319 HIV-infected women in the United States, Brazil, and South Africa, researchers assessed the immunogenicity and safety of the quadrivalent HPV vaccine against HPV types 6, 11, 16, and 18. The vaccine was found to be safe and immunogenic even in women who had had HIV for years. The study is published in Clinical Infectious Diseases.

HPV types 6 and 11 cause 90% of all genital warts, and HPV types 16 and 18 are responsible for the majority of HPV-caused cancers, including cervical and anal cancer.

The researchers stratified the study participants based on screening CD4: > 350 cells/mm3 (A), > 200 to 350 cells/mm3 (B), and ≤ 200 cells/mm3 (C). The women had a median age of 36 years and a median CD4 cell count of 310 cells/mm3, and 40% had undetectable HIV-1 viral load. Participants received the vaccine, 0.5 mL intramuscularly, on entry into the study and at weeks 8 and 24.

At baseline, seropositivity for each of the four HPV vaccine types ranged from 13% to 45%, and 4% of the women were seropositive for all four HPV types.

Study Findings

The researchers found that at 28 weeks, among women in CD4 stratum A, antibody production took place in 96%, 98%, 99%, and 91% for HPV types 6, 11, 16, and 18, respectively. Among stratum B participants, antibody production took place in 100%, 98%, 98%, and 85%, respectively. The proportion of stratum C responders came to 84% for type 6, 92% for type 11, 93% for type 16, and 75% for type 18. The researchers identified no significant safety issues.

The researchers concluded, “Quadrivalent HPV vaccine targeted at types 6, 11, 16, and 18 was safe and immunogenic in HIV-infected women 13–45 years old. Women with HIV viral load > 10,000 copies/mL and/or CD4 counts < 200 cell/mm3 had lower seroconversion.”

Erna Milunka Kojic, MD, of Brown University, and Michelle S. Cespedes, MD, MS, of Icahn School of Medicine, are the corresponding authors for the Clinical Infectious Diseases article.

The study was supported by the National Institute of Allergy and Infectious Diseases and the National Institute of Dental and Craniofacial Research. Study author Alfred Saah, MD, and others disclosed ties to Merck.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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