HPV Vaccination May Reduce Risk of HPV in Children With HIV

Antibody titers to the HPV4 vaccine were lower for all HPV serotypes in perinatally HIV-infected youth than in perinatally HIV-exposed, uninfected youth, according to new research.

To conduct their prospective observational cohort study, as part of the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol, the researchers evaluated the effectiveness of the HPV4 vaccine among youth with and without exposure to HIV.

The researchers evaluated seroconversion and geometric mean titers against HPV types 6, 11, 16, and 18, as well as rates of abnormal cervical cytology and genital warts.

Overall, 310 vaccinated perinatally HIV-infected youth and 148 vaccinated perinatally HIV-exposed, uninfected youth were included in the analysis.

Among vaccinated perinatally HIV-infected youth, seroconversion to HPV 6 was 83%, to HPV 11 was 84%, to HPV 16 was 90%, and to HPV 18 was 62%. Whereas, among vaccinated perinatally HIV-exposed, uninfected youth, seroconversion to HPV 6 was 94%, to HPV 11 was 96%, to HPV 16 was 99%, and to HPV 18 was 87%.

Geometric mean titers were lower among perinatally HIV-infected youth vs perinatally HIV-exposed, uninfected youth in each category of HPV4 doses.

“Higher [geometric mean titers] were associated with younger age, lower HIV type 1 RNA viral load, and higher CD4 percentage at first HPV4 vaccination, as well as shorter duration between last vaccine dose and antibody specimen,” the researchers wrote.

In addition, they found that 33 of 56 perinatally HIV-infected and 1 of 7 perinatally HIV-exposed, uninfected sexually active vaccinated girls had abnormal cytology.

“Antibody titers to HPV4 were lower for all serotypes in [perinatally HIV-infected] compared to [perinatally HIV-exposed, uninfected] youth,” the researchers concluded. “Protection against abnormal cytology was also diminished in sexually active [perinatally HIV-infected] females.”

—Amanda Balbi

Reference:

Moscicki AB, Karalius B, Tassiopoulos K, et al; Pediatric HIV/AIDS Cohort Study. Human papillomavirus antibody levels and quadrivalent vaccine clinical effectiveness in perinatally human immunodeficiency virus–infected and exposed, uninfected youth. Clin Infect Dis. 2019;69(7):1183-1191. https://doi.org/10.1093/cid/ciy1040.