Brief Report: Antibody Responses to Quadrivalent HPV Vaccination in HIV-Infected Young Women as Measured by Total IgG and Competitive Luminex Immunoassay

Abstract

We compared antibody responses of HIV-infected young women to the HPV6, 11, 16, 18 vaccine using total IgG LIA and cLIA assays. HPV18 seropositivity after HPV vaccination as measured with IgG LIA remained high (98%) 48 weeks after vaccination, in contrast with seropositivity as measured with cLIA (73%). Seropositivity rates at week 48 as measured by both IgG LIA and cLIA remained high for HPV6, 11 and 16 (93.5–100%). These results suggest that the lower rate of seropositivity to HPV18 when cLIA vs. IgG LIA is used is a function of the assay, and does not imply lower vaccine immunogenicity.

Human Papillomavirus Antibody Levels and Quadrivalent Vaccine Clinical Effectiveness in Perinatally Human Immunodeficiency Virus–infected and Exposed, Uninfected Youth

“…Similar to previous reports in healthy populations [2], HPV 18 seropositivity, relative to the other HPV types, was low for both cohorts with slightly greater than half of PHIV youth testing seropositive. Although this lower seropositivity for HPV 18 has been demonstrated in other studies [20,27], this does not explain the lower GMT in PHIV since the assay should perform similarly in both cohorts.…”

“…The increased risk of HPV-associated cancers among HIVinfected adults has triggered an interest in vaccine efficacy trials in this population. Although these trials have shown good seroconversion in adolescents and adults with HIV [27,29,30], there are no published efficacy trials for the prevention of cervical disease. Because HPV is primarily sexually transmitted, the need to vaccinate PHIV children prior to sexual debut is apparent.…”

Immunogenicity, safety, and efficacy of the HPV vaccines among people living with HIV: A systematic review and meta-analysis

“… 81 , 82 A second trial reported a positive and significant correlation between high CD4% and antibody titers but did not provide stratified estimates 63 whereas a third trial found no difference in antibody titers by CD4% nadir 62 (Supplement Figure S6A-D). Finally, a fourth trial reported higher seropositivity rates and antibody titers in PLHIV on ART than not on ART 52 , 53 while another one reported higher antibody titers for all four HPV vaccine types among PLHIV virally suppressed compared to non-suppressed. 54 …”

“…Only four studies reported seroconversion and/or GMT levels stratified by HIV disease stage (CD4-cell counts, 81 , 82 CD4 cell count percentages/fraction, 62 plasma viral suppression 51 ) or ART status 52 , 53 (Supplement Figure S6A-D, supplement table S11). One trial reported high GMT titers at 28 weeks for PLHIV in any CD4-cell counts subgroups although GMT titers and the proportion that seroconverted following vaccination were lower for PLHIV with CD4 ≤200 (HPV-16, HPV-18, HPV-6, HPV-11: 0.93, 0.75, 0.84, 0.92 if CD4 ≤200 cells/μL and 0.99, 0.91, 0.96, 0.98 if >350 cells/μL, respectively, N s =2, Supplement Table S3).…”

Persistence of memory B-cell and T-cell responses to the quadrivalent HPV vaccine in HIV-infected children

“…There is a decline in antibody titer over time, such that at 9 years after quadrivalent HPV vaccine (QHPV) administrations >90% vaccinees retain antibody concentrations above the level that defines positive serostatus for HPV6 and 16 and >60% for HPV11 and 18 when using a competitive Luminex immunoassay (cLIA) [14, 18-20] . With an noncompetitive ELISA assay >90% vaccinees remain seropositive at 9 years against all 4 vaccine genotypes [20, 21] .…”