Humoral, mucosal, and cell-mediated immunity against vaccine and nonvaccine genotypes after administration of quadrivalent human papillomavirus vaccine to HIV-infected children

Abstract

Objectives.To characterize the immunogenicity of a quadrivalent human papillomavirus vaccine (QHPV) in human immunodeficiency virus (HIV)-infected children, we studied their immune responses to 3 or 4 doses.Methods.HIV-infected children aged 7-12 years with a CD4 cell percentage of ≥15 of lymphocytes, received 3 doses of QHPV with or without a fourth dose after 72 weeks. Type-specific and cross-reactive antibodies and cell-mediated immunity were measured.Results.Type-specific antibodies to HPV6, 11, and 16 were detected in 100 and ≥94 of children at 4 and 72 weeks, respectively, after the third QHPV dose. Corresponding numbers for HPV18 were 97 and 76, respectively. A fourth QHPV dose increased seropositivity to ≥96 for all vaccine genotypes. Four weeks after the third QHPV dose, 67 of vaccinees seroconverted to HPV31, an HPV16-related genotype not in the vaccine; 69 and 39 of vaccinees developed mucosal HPV16 and 18 immunoglobulin G antibodies, respectively; and 60 and 52 of vaccinees developed cytotoxic T lymphocytes (CTLs) for HPV16 and 31, respectively.Conclusions.Three QHPV doses generated robust and persistent antibodies to HPV6, 11, and 16 but comparatively weaker responses to HPV18. A fourth dose increased antibodies against all vaccine genotypes in an anamnestic fashion. CTLs and mucosal antibodies against vaccine genotypes, as well as cross-reactive antibodies and CTL against nonvaccine genotypes, were detected. © 2012 The Author.