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四价人乳头瘤病毒疫苗接种间隔对 HIV 感染者免疫反应的影响。

Impact of quadrivalent HPV vaccine dose spacing on immunologic response in women living with HIV.

机构信息

Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.

School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, Vancouver, BC, Canada.

出版信息

Vaccine. 2020 Mar 30;38(15):3073-3078. doi: 10.1016/j.vaccine.2020.02.075. Epub 2020 Mar 5.

Abstract

HPV vaccination schedules have changed as evidence has supported reduced dosing and extended intervals. Women living with HIV (WLWH) represent an important population with no data on alternative dosing. Girls and WLWH received quadrivalent HPV (qHPV) vaccine in a pan-Canadian study of immunogenicity and efficacy. Serology was performed at months 0/2/7/12/18/24. Medical and sexual history was collected throughout. Linear regression was used to determine if spacing of doses was associated with peak antibody titer. Multivariable analyses demonstrated significant relationships between peak antibody titer and time to blood draw post last vaccine dose, naivety to the relevant HPV type, and HIV viral load for all qHPV types. There was a significant relationship between peak HPV16/18 antibody titer and age. Taking age, time to serology, CD4 cell count, CD4 nadir, HIV viral load, and HPV naivety into account, spacing of the three qHPV vaccine doses did not significantly impact peak antibody titers.

摘要

HPV 疫苗接种计划已发生变化,因为有证据表明减少剂量和延长间隔时间是有效的。HIV 感染者(WLWH)是一个重要的人群,目前尚无替代剂量的数据。在一项针对免疫原性和疗效的全加免疫接种研究中,女孩和 WLWH 接种了四价 HPV(qHPV)疫苗。在接种后 0/2/7/12/18/24 个月进行血清学检测。整个过程中收集了医疗和性行为史。线性回归用于确定剂量间隔是否与峰值抗体滴度相关。多变量分析显示,所有 qHPV 型别中,最后一剂疫苗后采血时间、对相关 HPV 型别的初免以及 HIV 病毒载量与峰值抗体滴度之间存在显著关系。HPV16/18 抗体滴度峰值与年龄之间存在显著关系。考虑到年龄、血清学检测时间、CD4 细胞计数、CD4 最低点、HIV 病毒载量和 HPV 初免,三种 qHPV 疫苗剂量的间隔时间不会显著影响峰值抗体滴度。

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