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.

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.