Department of Paediatric Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.
Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control Netherlands, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands Department of Pathology, VU University Medical Centre, Amsterdam, The Netherlands.
Ann Rheum Dis. 2014 Aug;73(8):1500-7. doi: 10.1136/annrheumdis-2013-203429. Epub 2013 May 30.
To compare the immunogenicity and safety of the bivalent human papillomavirus (HPV)16/18 vaccine between female patients with juvenile idiopathic arthritis (JIA) and healthy female adolescents.
68 patients and 55 healthy girls aged 12-18 years were included in a prospective controlled observational cohort and were vaccinated at 0, 1 and 6 months. Primary outcomes were immunogenicity expressed as seropositivity rate after three vaccine doses at 7 and 12 months and HPV-specific geometric mean antibody concentrations. Secondary outcomes were HPV16/18-specific memory B cell responses in a subset of participants and safety, defined as adverse events and the effect of vaccination on JIA disease activity.
All participants were seropositive for HPV16 and HPV18 at 7 months. One patient turned seronegative at 12 months for HPV16/18. No significant differences were found between patients and controls in HPV-specific antibody concentrations; however, antibody concentrations were consistently lower in patients. No effect of methotrexate on HPV16 antibodies (p=0.79) or HPV18 antibodies (p=0.37) was detected. All patients on anti-TNFα treatment were seropositive after vaccination. The kinetics of HPV16/18 memory B cell responses was comparable between patients and controls, but the magnitude of B cell responses at 7 and 12 months appeared lower in patients. No relevant differences in adverse events were found. HPV vaccination did not aggravate JIA disease.
The bivalent HPV16/18 vaccine is immunogenic and well tolerated in JIA patients. However, HPV-specific antibodies and B cell responses tended to be lower in patients compared with healthy controls.
NCT00815282.
比较双价人乳头瘤病毒（HPV）16/18 疫苗在幼年特发性关节炎（JIA）女性患者和健康女性青少年中的免疫原性和安全性。
将 68 例 12-18 岁的患者和 55 例健康女孩纳入前瞻性对照观察队列，并在 0、1 和 6 个月时进行疫苗接种。主要结局为 3 剂疫苗接种后 7 和 12 个月的血清阳性率和 HPV 特异性几何平均抗体浓度。次要结局为部分参与者的 HPV16/18 特异性记忆 B 细胞反应和安全性（定义为不良事件以及疫苗接种对 JIA 疾病活动的影响）。
所有参与者在 7 个月时均对 HPV16 和 HPV18 呈血清阳性。1 例患者在 12 个月时 HPV16/18 转为血清阴性。患者与对照组之间 HPV 特异性抗体浓度无显著差异；然而，患者的抗体浓度始终较低。未发现甲氨蝶呤对 HPV16 抗体（p=0.79）或 HPV18 抗体（p=0.37）有影响。所有接受抗 TNFα 治疗的患者在接种疫苗后均呈血清阳性。HPV16/18 记忆 B 细胞反应的动力学在患者和对照组之间是可比的，但患者在 7 和 12 个月时的 B 细胞反应幅度较低。未发现不良事件的相关差异。HPV 疫苗接种不会加重 JIA 疾病。
双价 HPV16/18 疫苗在 JIA 患者中具有免疫原性且耐受性良好。然而，与健康对照组相比，患者的 HPV 特异性抗体和 B 细胞反应往往较低。
NCT00815282。
