Gender‐neutral vaccination provides improved control of human papillomavirus types 18/31/33/35 through herd immunity: Results of a community randomized trial (III)

Lehtinen, Matti; Luostarinen, Tapio; Vänskä, Simopekka; Söderlund-Strand, Anna; Eriksson, Tiina; Natunen, Kari; Apter, Dan; Baussano, Iacopo; Harjula, Katja; Hokkanen, Mari; Kuortti, Marjo; Palmroth, Johanna; Petäjä, Tiina; Pukkala, Eero; Rekonen, Sirpa; Siitari-Mattila, Mari; Surcel, Heljä‐Marja; Tuomivaara, Leena; Paavonen, Jorma; Nieminen, Pekka; Dillner, Joakim; Dubin, Gary; Garnett, Geoff P.

doi:10.1002/ijc.31618

Cited by 47 publications

(80 citation statements)

References 40 publications

(94 reference statements)

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“…This observation may be a reflection of the change in the epidemiology of HPV in women over time related to increased uptake of vaccine and herd immunity, as described in other populations [36], [37], [38], [39]. Equally these women may have had more years of undetectable plasma HIV-1 RNA and have been heavily screened with Pap tests and colposcopy due to their increased burden of HPV disease.…”

Section: Discussionmentioning

confidence: 92%

Anogenital human papillomavirus virus DNA and sustained response to the quadrivalent HPV vaccine in women living with HIV-1

Cespedes

Kang

Kojic

et al. 2018

Papillomavirus Research

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ObjectivesPeople living with HIV have increased Human Papillomavirus (HPV) related lesions and malignancies. We describe HPV DNA recovered from the cervix and anal canal, explore the effect of vaccination on HPV detection, and examine the durability of vaccine titers in women living with HIV-1 who were vaccinated with the quadrivalent HPV vaccine.MethodsAIDS Clinical Trials Group A5240 was a prospective study of the quadrivalent HPV (qHPV) vaccine in 315 HIV-1 infected women in three CD4 strata (A: >350, B; 201–350, C: ≤200 cells/mm3). Vaccine was administered at entry, week 8 and week 24. Cervical and anal HPV DNA specimens were collected at baseline, weeks 28 and 52; serum for antibody testing was obtained at baseline, weeks 28 and 72.ResultsVaccine antibody titers decreased across all four HPV types at week 72 compared to week 28. Lower proportions of sustained seropositivity were observed in women with lower CD4 counts for all four vaccine types, with the lowest titers for HPV 18. Despite the decrease, the geometric mean titer levels were above the seroconversion cut-off levels for all types except HPV 18 in the lowest CD4 stratum. Of the 174 participants who had a negative baseline HPV 16 antibody and developed antibody response at week 28, 95%, 88%, and 86% retained seropositivity at week 72 in strata A, B, and C respectively. Lower antibody retention was observed in women with CD4 < 200 compared to CD4 > 350 (p = 0.016). Anal HPV detection was more prevalent compared to cervical detection at all visits. Among high risk types, type 52, 31, 16, 18 and 51 were the most common in the cervical compartment, while types 16, 35, 18, and 51 were the most prevalent in the anal canal at baseline (listed in the order of prevalence). Later detection of HPV not present at baseline was uncommon in either compartment. Serial recovery of HPV over time was more commonly observed in the anal canal.ConclusionThe qHPV vaccine elicits durable titer response above the seroconversion cut-off levels in HIV-infected women. However, the titer levels were substantially lower by Week 72, most noticeably in type 18. HPV DNA was detected more frequently in the anal canal. Detection of non-vaccine high risk HPV suggests a role for the nonavalent vaccine.

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Section: Discussionmentioning

confidence: 92%

Anogenital human papillomavirus virus DNA and sustained response to the quadrivalent HPV vaccine in women living with HIV-1

Cespedes

Kang

Kojic

et al. 2018

Papillomavirus Research

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“…5,6 However, among the non-HPV vaccinated women the protective impact of herd effect was not observed for HPV16 or HPV31/33/35 among the core-group. 5,6 However, among the non-HPV vaccinated women the protective impact of herd effect was not observed for HPV16 or HPV31/33/35 among the core-group.…”

Section: Discussionmentioning

confidence: 93%

“…Non-HPV vaccinated women consist of women who were either HBV vaccinated or unvaccinated as early adolescents. 6 Laboratory analysis data obtained at the age of 18.5-19 years 7 Prevalence estimates the mean from 21 strata prevalence estimates. 3 Questionnaire data obtained at the age of 18.5-19 years and 22 years.…”

Section: Prevalence Ratios Of Hpv Typesmentioning

confidence: 99%

“…13,14 The former does not take into account the distinctively longer clearance rate for HPV16. 6,15 This is true especially in the subpopulation with increased risk-taking sexual behaviour, and thus with increased R 0. 6,15 This is true especially in the subpopulation with increased risk-taking sexual behaviour, and thus with increased R 0.…”

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

Occurrence of human papillomavirus (HPV) type replacement by sexual risk‐taking behaviour group: Post‐hoc analysis of a community randomized clinical trial up to 9 years after vaccination (IV)

Gray

Luostarinen

Vänskä

et al. 2019

Intl Journal of Cancer

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Oncogenic non‐vaccine human papillomavirus (HPV) types may conceivably fill the vacated ecological niche of the vaccine types. The likelihood of this may differ by the risk of acquiring HPV infections. We examined occurrence of HPV types among vaccinated and unvaccinated subgroups of 1992–1994 birth cohorts with differing acquisition risks up to 9 years post‐implementation of HPV vaccination in 33 Finnish communities randomized to: Arm A (gender‐neutral HPV16/18 vaccination), Arm B (girls‐only HPV16/18 vaccination and hepatitis B‐virus (HBV) vaccination of boys), and Arm C (gender‐neutral HBV vaccination). Out of 1992–1994 born resident boys (31,117) and girls (30,139), 8,618 boys and 15,615 girls were vaccinated, respectively, with 20–30% and 50% coverage in 2007–2009. In 2010–2013, 8,868 HPV16/18 and non‐HPV vaccinated females, and in 2014–2016, 5,574 originally or later (2010–2013) HPV16/18 vaccinated females attended two cervical sampling visits, aged 18.5 and 22‐years. The samples were typed for HPV6/11/16/18/31/33/35/39/45/51/52/56/58/59/66/68 using PCR followed by MALDI‐TOF MS. HPV prevalence ratios (PR) between Arms A/B vs. C were calculated for Chlamydia trachomatis positives (core‐group), and negatives (general population minus core group). At both visits the vaccine‐protected HPV type PRs did not significantly differ between the core‐group and non‐core group. Among the vaccinated 18‐year‐olds, HPV51 occurrence was overall somewhat increased (PRcore = 1.4, PRnon‐core. = 1.4) whereas the HPV52 occurrence was increased in the core‐group only (PRcore = 2.5, PRnon‐core = 0.8). Among the non‐HPV vaccinated 18‐year‐olds, the HPV51/52 PRs were higher in the core‐group (PRcore = 3.8/1.8, PRnon‐core = 1.2/1.1). The 22‐year‐olds yielded no corresponding observations. Monitoring of the sexual risk‐taking core‐group may detect early tendencies for HPV type replacement.

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“…Therefore, intravaginal vaccination has been explored as an option to prevent sexually transmitted infections [180]. One reason this method of vaccination has not been explored as extensively as others could be that it only has the ability to immunize females in a population in which, increasingly, it is being shown that it does not provide sufficient herd immunity, especially when considering the impact of immunocompromised females who are unable to receive the vaccinations [182,183]. One reason this method of vaccination has not been explored as extensively as others could be that it only has the ability to immunize females in a population in which, increasingly, it is being shown that it does not provide sufficient herd immunity, especially when considering the impact of immunocompromised females who are unable to receive the vaccinations [182,183].…”

Section: Mucosal Administrationmentioning

confidence: 99%

Novel approaches for the design, delivery and administration of vaccine technologies

Wallis

Shenton

Carlisle

2019

Clinical and Experimental Immunology

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Summary It is easy to argue that vaccine development represents humankind’s most important and successful endeavour, such is the impact that vaccination has had on human morbidity and mortality over the last 200 years. During this time the original method of Jenner and Pasteur, i.e. that of injecting live‐attenuated or inactivated pathogens, has been developed and supplemented with a wide range of alternative approaches which are now in clinical use or under development. These next‐generation technologies have been designed to produce a vaccine that has the effectiveness of the original live‐attenuated and inactivated vaccines, but without the associated risks and limitations. Indeed, the method of development has undoubtedly moved away from Pasteur’s three Is paradigm (isolate, inactivate, inject) towards an approach of rational design, made possible by improved knowledge of the pathogen–host interaction and the mechanisms of the immune system. These novel vaccines have explored methods for targeted delivery of antigenic material, as well as for the control of release profiles, so that dosing regimens can be matched to the time‐lines of immune system stimulation and the realities of health‐care delivery in dispersed populations. The methods by which vaccines are administered are also the subject of intense research in the hope that needle and syringe dosing, with all its associated issues regarding risk of injury, cross‐infection and patient compliance, can be replaced. This review provides a detailed overview of new vaccine vectors as well as information pertaining to the novel delivery platforms under development.

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Gender‐neutral vaccination provides improved control of human papillomavirus types 18/31/33/35 through herd immunity: Results of a community randomized trial (III)

Cited by 47 publications

References 40 publications

Anogenital human papillomavirus virus DNA and sustained response to the quadrivalent HPV vaccine in women living with HIV-1

Anogenital human papillomavirus virus DNA and sustained response to the quadrivalent HPV vaccine in women living with HIV-1

Occurrence of human papillomavirus (HPV) type replacement by sexual risk‐taking behaviour group: Post‐hoc analysis of a community randomized clinical trial up to 9 years after vaccination (IV)

Novel approaches for the design, delivery and administration of vaccine technologies

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