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九价人乳头瘤病毒疫苗的免疫原性和安全性

Immunogenicity and Safety of a 9-Valent HPV Vaccine.

作者信息

Van Damme Pierre, Olsson Sven Eric, Block Stanley, Castellsague Xavier, Gray Glenda E, Herrera Teobaldo, Huang Li-Min, Kim Dong Soo, Pitisuttithum Punnee, Chen Joshua, Christiano Susan, Maansson Roger, Moeller Erin, Sun Xiao, Vuocolo Scott, Luxembourg Alain

机构信息

Center for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium;

Karolinska Institute at Danderyd Hospital, Uppsala, Sweden;

出版信息

Pediatrics. 2015 Jul;136(1):e28-39. doi: 10.1542/peds.2014-3745.

Abstract

OBJECTIVES

Prophylactic vaccination of youngwomen aged 16 to 26 years with the 9-valent (6/11/16/18/31/33/45/52/58) human papillomavirus (HPV) virus-like particle (9vHPV) vaccine prevents infection and disease. We conducted a noninferiority immunogenicity study to bridge the findings in young women to girls and boys aged 9 to 15 years.

METHODS

Subjects (N = 3066) received a 3-dose regimen of 9vHPV vaccine administered at day 1, month 2, and month 6. Anti-HPV serologic assays were performed at day 1 and month 7. Noninferiority required that the lower bound of 2-sided 95% confidence intervals of geometric mean titer ratios (boys:young women or girls:young women) be >0.67 for each HPV type. Systemic and injection-site adverse experiences (AEs) and serious AEs were monitored.

RESULTS

At 4 weeks after dose 3, >99% of girls, boys, and young women seroconverted for each vaccine HPV type. Increases in geometric mean titers to HPV types 6/11/16/18/31/33/45/52/58 were elicited in all vaccine groups. Responses in girls and boys were noninferior to those of young women. Persistence of anti-HPV responses was demonstrated through 2.5 years after dose 3. Administration of the 9vHPV vaccine was generally well tolerated. A lower proportion of girls (81.9%) and boys (72.8%) than young women (85.4%) reported injection-site AEs, most of which were mild to moderate in intensity.

CONCLUSIONS

These data support bridging the efficacy findings with 9vHPV vaccine in young women 16 to 26 years of age to girls and boys 9 to 15 years of age and implementing gender-neutral HPV vaccination programs in preadolescents and adolescents.

摘要

目的

对16至26岁的年轻女性接种9价(6/11/16/18/31/33/45/52/58)人乳头瘤病毒(HPV)病毒样颗粒(9vHPV)疫苗可预防感染和疾病。我们开展了一项非劣效性免疫原性研究,以将年轻女性中的研究结果推广至9至15岁的女孩和男孩。

方法

受试者(N = 3066)接受9vHPV疫苗3剂次接种程序,分别在第1天、第2个月和第6个月接种。在第1天和第7个月进行抗HPV血清学检测。非劣效性要求每种HPV型别的几何平均滴度比(男孩:年轻女性或女孩:年轻女性)的双侧95%置信区间下限>0.67。监测全身和注射部位不良事件(AE)以及严重AE。

结果

在第3剂接种后4周,每种疫苗HPV型别的女孩、男孩和年轻女性血清转化率均>99%。所有疫苗组中,HPV 6/11/16/18/31/33/45/52/58型别的几何平均滴度均升高。女孩和男孩的反应不劣于年轻女性。在第3剂接种后2.5年内均显示出抗HPV反应的持续性。9vHPV疫苗的接种总体耐受性良好。报告注射部位AE的女孩(81.9%)和男孩(72.8%)比例低于年轻女性(85.4%),其中大多数为轻至中度。

结论

这些数据支持将9vHPV疫苗在16至26岁年轻女性中的疗效研究结果推广至9至15岁的女孩和男孩,并在青春期前和青少年中实施中性别的HPV疫苗接种计划。

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