[Evaluation of antibody response to HPV vaccination in HIV infected girls]

Abstract

Background: HIV-infected women have an increased prevalence of HPV infections and high risk of cervical cancer. HPV vaccines seem to be a successive method of prevention in immunocompetent women.

Aim: To evaluate HPV vaccination effectiveness based on the presence of HPV antibodies in HIV infected girls and to establish factors, which influence vaccination effectiveness.

Patients and methods: Post vaccination antibodies were evaluated in 17 HIV -infected girls who received 3 doses of quadrivalent (types 6/11/16/18) HPV vaccine at the mean age of 11,5 years (range 9-17 yr). HPV antibodies were checked 1 month to 2 years (mean 18 months) after the third vaccine dose by ELISA HPV IgG assay (Dia.Pro Diagnostic Bioprobes). All patients have been receiving combined antiretroviral treatment (cART). Analyzed factors included: age at HIV diagnosis, age at the first vaccine dose, Centers for Disease Control and Prevention (CDC) classification at diagnosis, at vaccination and at evaluation.

Results: HPV antibodies were present in all 17 (100%) patients. HIV-infection was diagnosed at the mean age of 3,5 years (range 1 month--10.5 years). Nadir clinical CDC category: 7/17 patients (41%)--A, 5/17 (29,5%)--B, 5/29 (29.5%)--C. Nadir CDC count pointed moderate immunosuppression in 8/17 (47%) children and severe in 9/17 (53%). At vaccination 15/17 girls had CDC classification N1/A1, 2/17 (11.7%) were classified N2. At evaluation all girls had CDC classification N1 or A1. CONCLUSIONS. HPV vaccination in HIV infected girls resulted in successful antibody response. Immune recovery due to cART resulted in a good vaccine response, even in children with prior severe immunodeficiency.