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对先前已接种两剂四价人乳头瘤病毒疫苗的女孩接种一剂四价或二价人乳头瘤病毒疫苗加强针的效果。

The effect of a booster dose of quadrivalent or bivalent HPV vaccine when administered to girls previously vaccinated with two doses of quadrivalent HPV vaccine.

作者信息

Gilca Vladimir, Sauvageau Chantal, Boulianne Nicole, De Serres Gatson, Crajden Mel, Ouakki Manale, Trevisan Andrea, Dionne Marc

机构信息

a Quebec Public Health Institute; Laval University; Quebec University Research Hospital Center ; Quebec , Canada.

出版信息

Hum Vaccin Immunother. 2015;11(3):732-8. doi: 10.1080/21645515.2015.1011570.

Abstract

This randomized, blinded study evaluated the immunogenicity and safety of a booster dose of Gardasil (qHPV) or Cervarix (bHPV) when administered to 12-13 year-old girls who were vaccinated at the age of 9-10 with 2 doses of qHPV (0-6 months). 366 out of 416 eligible girls participated in this follow-up study. Antibody titers were measured just before and one month post-booster. A Luminex Total IgG assay was used for antibody assessment and results are presented in Liminex Units (LU). Three years post-primary vaccination, 99-100% of subjects had detectable antibodies to 4HPV genotypes included in the qHPV with GMTs varying from 50 to 322 LU depending on genotype. After a booster dose of qHPV, a ≥4 fold increase of antibody titers to genotypes included in the vaccine was observed in 88-98% of subjects. Post-booster GMTs varied from 1666 to 4536 LU depending on genotype. These GMTs were 1.1 to 1.8-fold higher when compared to those observed one month post-second dose. After a booster of bHPV, a ≥4 fold increase of antibody titers to HPV16 and HPV18 was observed in 93-99% of subjects. The anti-HPV16 and HPV18 GMTs were 5458 and 2665 LU, respectively. These GMTs were 1.2 and 1.8 higher than those observed in the qHPV group (both P < 0.01). In bHPV group a 1.4-1.6-fold increase of antibody GMTs to HPV6 and HPV11was also observed (P < 0.001). The safety profile was acceptable for both vaccines. Both qHPV and bHPV increase antibody titers when given as a booster to girls previously vaccinated with 2 doses of qHPV. The magnitude of the immune response after booster is vaccine-dependent and has the same pattern as that reported after primary vaccination with qHPV or bHPV. When given as a booster, both vaccines have an acceptable safety profile. Longer follow-up studies are warranted to assess the need of booster doses.

摘要

这项随机、双盲研究评估了在9至10岁时接种2剂重组人乳头瘤病毒四价重组疫苗(qHPV)(0月至6月)的12至13岁女孩中,给予一剂加强剂量的加德西(qHPV)或希瑞适(bHPV)后的免疫原性和安全性。416名符合条件的女孩中有366名参与了这项随访研究。在加强免疫前和加强免疫后1个月测量抗体滴度。采用Luminex总IgG检测法进行抗体评估,结果以Luminex单位(LU)表示。初次接种疫苗三年后,99%至100%的受试者对qHPV中包含的4种人乳头瘤病毒(HPV)基因型可检测到抗体,根据基因型不同,几何平均滴度(GMT)在50至322 LU之间。给予一剂加强剂量的qHPV后,88%至98%的受试者对疫苗中包含的基因型的抗体滴度增加了≥4倍。加强免疫后的GMT根据基因型不同在1666至4536 LU之间。与第二次接种后1个月观察到的GMT相比,这些GMT高1.1至1.8倍。给予一剂加强剂量的bHPV后,93%至99%的受试者对HPV16和HPV18的抗体滴度增加了≥4倍。抗HPV16和HPV18的GMT分别为5458和2665 LU。这些GMT比qHPV组观察到的值高1.2倍和1.8倍(P均<0.01)。在bHPV组中,对HPV6和HPV11的抗体GMT也观察到增加了1.4至1.6倍(P<0.001)。两种疫苗的安全性均可接受。对于先前接种过2剂qHPV的女孩,给予一剂加强剂量的qHPV和bHPV均可增加抗体滴度。加强免疫后的免疫反应强度取决于疫苗,且与初次接种qHPV或bHPV后报道的模式相同。作为加强剂量使用时,两种疫苗的安全性均可接受。需要进行更长时间的随访研究以评估加强剂量的必要性。

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