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Ng K, Morais S, Wissing MD, Burchell AN, Tellier PP, Coutlée F, Waterboer T, El-Zein M, Franco EL. Empirical sample-specific approaches to define HPV16 and HPV18 seropositivity in unvaccinated, young, sexually active women. Microbiol Spectr 2024; 12:e0022924. [PMID: 38687066 PMCID: PMC11324019 DOI: 10.1128/spectrum.00229-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024] Open
Abstract
Given low seroconversion rates following human papillomavirus (HPV) infection, fixed external cutoffs may lead to errors in estimating HPV seroprevalence. We evaluated finite mixture modeling (FMM) and group-based trajectory modeling (GBTM) among unvaccinated, sexually active, HPV-exposed women to determine study-specific HPV16 and HPV18 seropositivity thresholds. We included 399 women (aged 18-24 years) enrolled in the HPV Infection and Transmission Among Couples Through Heterosexual Activity (HITCH) cohort study between 2005 and 2011 in Montreal, Canada. Participants' blood samples from up to six visits spanning 2 years were tested by multiplex serology for antibodies [median fluorescence intensity (MFI)] specific to bacterially expressed HPV16 and HPV18 L1 glutathione S-transferase fusion proteins. We applied FMM and GBTM to baseline and longitudinal antibody titer measurements, respectively, to define HPV type-specific seronegative and seropositive distributions. Study-specific thresholds were generated as five standard deviations above the mean seronegative antibody titers, mimicking cutoffs (HPV16: 422 MFI; HPV18: 394 MFI) derived from an external population of sexually inactive, HPV DNA-negative Korean women (aged 15-29 years). Agreement (kappa) of study-specific thresholds was evaluated against external cutoffs. Seroprevalence estimates using FMM (HPV16: 27.5%-43.2%; HPV18: 21.7%-49.5%) and GBTM (HPV16: 11.8%-11.8%; HPV18: 9.9%-13.4%) thresholds exceeded those of external cutoffs (HPV: 10.2%; HPV18: 9.7%). FMM thresholds showed slight-to-moderate agreement with external cutoffs (HPV16: 0.26%-0.46%; HPV18: 0.20%-0.56%), while GBTM thresholds exhibited high agreement (HPV16: 0.92%-0.92%; HPV18: 0.82%-0.99%). Kappa values suggest that GBTM, used for longitudinal serological data, and otherwise FMM, for cross-sectional data, are robust methods for determining the HPV serostatus without prior classification rules.IMPORTANCEWhile human papillomavirus (HPV) seropositivity has been employed as an epidemiologic determinant of the natural history of genital HPV infections, only a fraction of women incidentally infected with HPV respond by developing significant antibody levels. HPV seropositivity is often determined by a dichotomous fixed cutoff based on the seroreactivity of an external population of women presumed as seronegative, given the lack of evidence of HPV exposure. However, considering the variable nature of seroreactivity upon HPV infection, which arguably varies across populations, such externally defined cutoffs may lack specificity to the population of interest, causing inappropriate assessment of HPV seroprevalence and related epidemiologic uses of that information. This study demonstrates that finite mixture modeling (FMM) and group-based trajectory modeling (GBTM) can be used to independently estimate seroprevalence or serve as the basis for defining study-specific seropositivity thresholds without requiring prior subjective assumptions, consequently providing a more apt internally valid discrimination of seropositive from seronegative individuals.
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Affiliation(s)
- Kristy Ng
- Division of Cancer
Epidemiology, McGill University,
Montreal, Quebec,
Canada
| | - Samantha Morais
- Division of Cancer
Epidemiology, McGill University,
Montreal, Quebec,
Canada
| | - Michel D. Wissing
- Division of Cancer
Epidemiology, McGill University,
Montreal, Quebec,
Canada
| | - Ann N. Burchell
- Department of Family
and Community Medicine and MAP Centre for Urban Health Solutions, Li Ka
Shing Knowledge Institute, St. Michael’s Hospital, Unity Health
Toronto, Toronto,
Ontario, Canada
- Department of Family
and Community Medicine, Faculty of Medicine, University of
Toronto, Toronto,
Ontario, Canada
| | | | - François Coutlée
- Division of Cancer
Epidemiology, McGill University,
Montreal, Quebec,
Canada
- Laboratoire de
Virologie Moléculaire, Centre de recherche du Centre Hospitalier
de l'Université de
Montréal, Montreal,
Quebec, Canada
- Départements de
Microbiologie, Infectiologie et Immunologie, et de
Gynécologie‐Obstétrique, Université de
Montréal, Montreal,
Quebec, Canada
- Départements de
Médecine, de Médecine clinique de Laboratoire et
d'Obstétrique‐Gynécologie, Centre Hospitalier de
l'Université de Montréal,
Montreal, Quebec,
Canada
| | - Tim Waterboer
- Infections and Cancer
Epidemiology Division, German Cancer Research
Center, Heidelberg,
Germany
| | - Mariam El-Zein
- Division of Cancer
Epidemiology, McGill University,
Montreal, Quebec,
Canada
| | - Eduardo L. Franco
- Division of Cancer
Epidemiology, McGill University,
Montreal, Quebec,
Canada
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Trevisan A, Candeias JMG, Thomann P, Villa LL, Franco EL, Trottier H. Naturally developed HPV16 antibodies and risk of newly detected cervical HPV infection outcomes. J Med Virol 2024; 96:e29608. [PMID: 38623750 DOI: 10.1002/jmv.29608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024]
Abstract
Little is known about the protection conferred by antibodies from natural human papillomavirus (HPV) infection. Our objective was to evaluate the association between HPV16 seroreactivity and HPV16 redetection, newly detected HPV infections, and loss of HPV DNA detection during follow-up. We analyzed data from 2462 unvaccinated Brazilian women. HPV16 IgG and neutralizing antibodies at baseline were assessed by enzyme-linked immunosorbent assay (n = 1975) and by the pseudovirus-based papillomavirus neutralization assay (n = 487). HPV detection, genotyping, and viral load were assessed by PCR-based methods. The associations were analyzed by Cox proportional hazards models. We observed a positive association between HPV16 IgG seroreactivity and redetection of HPV16 infections. Age-adjusted hazard ratios (HR) with 95% confidence intervals (CI) ranged from 2.45 (1.04-5.74) to 5.10 (1.37-19.00). Positive associations were also observed between HPV16 IgG antibodies and (1) newly detected HPV infections by genotypes unrelated to HPV16 (age-adjusted HR [95% CI] = 1.32 [1.08-1.2]) and (2) loss of detection of HPV infections by genotypes unrelated to HPV16 (age-adjusted HR [95% CI] = 1.24 [1.03-1.50]). Naturally developed HPV16 antibodies do not prevent recurrent HPV infections. Overall HPV16 IgG and neutralizing antibodies seem to be serological markers for latent or past infections.
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Affiliation(s)
- Andrea Trevisan
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Sainte-Justine Hospital Research Center, Université de Montréal, Montreal, Quebec, Canada
| | - João M G Candeias
- Department of Microbiology and Immunology, Institute of Biosciences, Universidade Estadual Paulista, Botucatu, Brazil
| | | | - Luisa L Villa
- Instituto do Cancer do Estado de São Paulo, Universidade de São Paulo, Sao Paulo, Brazil
- Department of Radiology and Oncology, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Helen Trottier
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Sainte-Justine Hospital Research Center, Université de Montréal, Montreal, Quebec, Canada
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Kamuyu G, Coelho da Silva F, Tenet V, Schussler J, Godi A, Herrero R, Porras C, Mirabello L, Schiller JT, Sierra MS, Kreimer AR, Clifford GM, Beddows S. Global evaluation of lineage-specific human papillomavirus capsid antigenicity using antibodies elicited by natural infection. Nat Commun 2024; 15:1608. [PMID: 38383518 PMCID: PMC10881982 DOI: 10.1038/s41467-024-45807-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024] Open
Abstract
Human Papillomavirus (HPV) type variants have been classified into lineages and sublineages based upon their whole genome sequence. Here we have examined the specificity of antibodies generated following natural infection with lineage variants of oncogenic types (HPV16, 18, 31, 33, 45, 52 and 58) by testing serum samples assembled from existing archives from women residing in Africa, The Americas, Asia or Europe against representative lineage-specific pseudoviruses for each genotype. We have subjected the resulting neutralizing antibody data to antigenic clustering methods and created relational antigenic profiles for each genotype to inform the delineation of lineage-specific serotypes. For most genotypes, there was evidence of differential recognition of lineage-specific antigens and in some cases of a sufficient magnitude to suggest that some lineages should be considered antigenically distinct within their respective genotypes. These data provide compelling evidence for a degree of lineage specificity within the humoral immune response following natural infection with oncogenic HPV.
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Affiliation(s)
- Gathoni Kamuyu
- Virus Reference Department, Public Health Microbiology Division, UK Health Security Agency, London, UK
| | - Filomeno Coelho da Silva
- Virus Reference Department, Public Health Microbiology Division, UK Health Security Agency, London, UK
| | - Vanessa Tenet
- International Agency for Research on Cancer (IARC/WHO) Early Detection, Prevention and Infections Branch, Lyon, France
| | - John Schussler
- Information Management Services Inc, Silver Spring, MD, USA
| | - Anna Godi
- Virus Reference Department, Public Health Microbiology Division, UK Health Security Agency, London, UK
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) formerly Proyecto Epidemiológico Guanacaste, Fundación INCIENSA (FUNIN), San José, Costa Rica
| | - Carolina Porras
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) formerly Proyecto Epidemiológico Guanacaste, Fundación INCIENSA (FUNIN), San José, Costa Rica
| | - Lisa Mirabello
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - John T Schiller
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Mónica S Sierra
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Aimée R Kreimer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Gary M Clifford
- International Agency for Research on Cancer (IARC/WHO) Early Detection, Prevention and Infections Branch, Lyon, France
| | - Simon Beddows
- Virus Reference Department, Public Health Microbiology Division, UK Health Security Agency, London, UK.
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency, London, UK.
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Yokoji K, Giguère K, Malagón T, Rönn MM, Mayaud P, Kelly H, Delany-Moretlwe S, Drolet M, Brisson M, Boily MC, Maheu-Giroux M. Association of naturally acquired type-specific HPV antibodies and subsequent HPV re-detection: systematic review and meta-analysis. Infect Agent Cancer 2023; 18:70. [PMID: 37941016 PMCID: PMC10631102 DOI: 10.1186/s13027-023-00546-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/13/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Understanding the role of naturally acquired (i.e., infection-induced) human papillomavirus (HPV) antibodies against reinfection is important given the high incidence of this sexually transmitted infection. However, the protective effect of naturally acquired antibodies in terms of the level of protection, duration, and differential effect by sex remains incompletely understood. We conducted a systematic review and a meta-analysis to (1) strengthen the evidence on the association between HPV antibodies acquired through past infection and subsequent type-specific HPV detection, (2) investigate the potential influence of type-specific HPV antibody levels, and (3) assess differential effects by HIV status. METHODS We searched Embase and Medline databases to identify studies which prospectively assessed the risk of type-specific HPV detection by baseline homologous HPV serostatus among unvaccinated individuals. Random-effect models were used to pool the measures of association of naturally acquired HPV antibodies against subsequent incident detection and persistent HPV positivity. Sources of heterogeneity for each type were assessed through subgroup analyses stratified by sex, anatomical site of infection, male sexual orientation, age group, and length of follow-up period. Evidence of a dose-response relationship of the association between levels of baseline HPV antibodies and type-specific HPV detection was assessed. Finally, we pooled estimates from publications reporting associations between HPV serostatus and type-specific HPV detection by baseline HIV status. RESULTS We identified 26 publications (16 independent studies, with 62,363 participants) reporting associations between baseline HPV serostatus and incident HPV detection, mainly for HPV-16 and HPV-18, the most detected HPV type. We found evidence of protective effects of baseline HPV seropositivity and subsequent detection of HPV DNA (0.70, 95% CI 0.61-0.80, NE = 11) and persistent HPV positivity (0.65, 95% CI 0.42-1.01, NE = 5) mainly for HPV-16 among females, but not among males, nor for HPV-18. Estimates from 8 studies suggested a negative dose-response relationship between HPV antibody level and subsequent detection among females. Finally, we did not observe any differential effect by baseline HIV status due to the limited number of studies available. CONCLUSION We did not find evidence that naturally acquired HPV antibodies protect against subsequent HPV positivity in males and provide only modest protection among females for HPV-16. One potential limitation to the interpretation of these findings is potential misclassification biases due to different causes.
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Affiliation(s)
- Kana Yokoji
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, 2001 Avenue McGill College, Suite 1200, Montreal, QC, H3A 1G1, Canada
| | - Katia Giguère
- Institut national de santé publique du Québec, Quebec City, Canada
| | - Talía Malagón
- Division of Cancer Epidemiology, Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada
| | - Minttu M Rönn
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Philippe Mayaud
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Helen Kelly
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Mélanie Drolet
- Centre de recherche du CHU de Québec - Université Laval, Quebec City, Canada
| | - Marc Brisson
- Centre de recherche du CHU de Québec - Université Laval, Quebec City, Canada
| | - Marie-Claude Boily
- MRC Center for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, 2001 Avenue McGill College, Suite 1200, Montreal, QC, H3A 1G1, Canada.
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Yu S, Zhu Y, He H, Hu Y, Zhu X, Diao W, Li S, Shan G, Chen X. Prevalence and risk factors of oral human papillomavirus infection among 4212 healthy adults in Hebei, China. BMC Infect Dis 2023; 23:773. [PMID: 37940841 PMCID: PMC10634102 DOI: 10.1186/s12879-023-08759-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is an essential cause of oropharyngeal squamous cell carcinoma that is increasing in incidence worldwide. However, little is known about the epidemiology of oral HPV infection among healthy adults in China. METHODS A study in northern China was conducted in 2021 as baseline data of Diverse Life-Course Cohort (DLCC). Residents who aged above 20 were eligible to participate. Oral swab specimens and questionnaires were collected from 4226 participants. HPV DNA in oral exfoliated cells was tested by Nested Polymerase Chain Reaction approach and sequencing. Univariate and multivariate analyses were performed to assess the associations between exposure factors and oral HPV infection. RESULTS Overall prevalence of oral HPV infection was 4.08% (95%CI, 3.69%-4.68%). The most prevalent HPV type detected was HPV-81 (1.35%; 95% CI, 1.00%-1.70%), followed by HPV-16 (0.64%; 95% CI, 0.40%-0.88%). Oral HPV infection presented a bimodal pattern with respect to age in male and female participants. Oral HPV prevalence of male participants was significantly higher than prevalence of female participants (5.0% versus 3.6%, P = 0.041). Prevalence of oral HPV was higher among current smokers (OR = 1.59; 95% CI, 1.11-2.29; P = 0.039) and current drinkers (OR = 1.60; 95% CI, 1.14-2.25; P = 0.023). Current alcohol consumption was independently associated with oral HPV infection (OR = 1.74; 95% CI, 1.22-2.50; P = 0.010). CONCLUSIONS Among healthy adults aged above 20 in Hebei, China, the prevalence of high-risk HPV infection was 1.92% (95%CI, 1.51%-2.34%). Oral HPV prevalence was independently associated with alcohol consumption. More tailored prevention strategies are needed to prevent oral HPV infection through smoking cessation, reduction of alcohol consumption, and HPV vaccination.
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Affiliation(s)
- Shuting Yu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China
| | - Yingying Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China
| | - Yaoda Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China
| | - Xiaoli Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China
| | - Wenwen Diao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China
| | - Shuguang Li
- Department of Music Artificial Intelligence and Music Information Technology, Central Conservatory of Music, 43 Baojiajie, Xicheng District, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China.
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China.
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Reuschenbach M, Doorbar J, Del Pino M, Joura EA, Walker C, Drury R, Rauscher A, Saah AJ. Prophylactic HPV vaccines in patients with HPV-associated diseases and cancer. Vaccine 2023; 41:6194-6205. [PMID: 37704498 DOI: 10.1016/j.vaccine.2023.08.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 09/15/2023]
Abstract
Individuals with human papillomavirus (HPV)-related disease remain at risk for subsequent HPV infection and related disease after treatment of specific lesions. Prophylactic HPV vaccines have shown benefits in preventing subsequent HPV-related disease when administered before or soon after treatment. Based on our understanding of the HPV life cycle and vaccine mechanism of action, prophylactic HPV vaccination is not expected to clear active persistent HPV infection or unresected HPV-associated dysplastic tissue remaining after surgery. However, vaccination may reasonably be expected to prevent new HPV infections caused by a different HPV type as well as re-infection with the same HPV type, whether from a new exposure to an infected partner or through autoinoculation from an adjacent or distant productively infected site. In this review, we describe the evidence for using prophylactic HPV vaccines in patients with HPV-associated disease before, during, or after treatment and discuss potential mechanisms by which individuals with HPV-associated disease may or may not benefit from prophylactic vaccines. We also consider how precise terminology relating to the use of prophylactic vaccines in this population is critical to avoid the incorrect implication that prophylactic vaccines have direct therapeutic potential, which would be counter to the vaccine's mechanism of action, as well as considered off-label. In other words, the observed effects occur through the known mechanism of action of prophylactic HPV vaccines, namely by preventing virus of the same or a different HPV type from infecting the patient after the procedure.
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Affiliation(s)
- Miriam Reuschenbach
- Merck & Co., Inc., 2025 E Scott Ave, Rahway, NJ, USA; MSD Sharp & Dohme GmbH, Levelingstraße 4a, 81673 Munich, Germany.
| | - John Doorbar
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, United Kingdom
| | - Marta Del Pino
- Hospital Clínic de Barcelona, Universitat de Barcelona, Gran Via de les Corts Catalanes, 585, 08007 Barcelona, Spain
| | - Elmar A Joura
- Medical University of Vienna, Department of Gynecology and Obstetrics, Comprehensive Cancer Center, BT86/E 01, Spitalgasse 23, 1090 Vienna, Austria
| | - Caroline Walker
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, United Kingdom
| | | | | | - Alfred J Saah
- Merck & Co., Inc., 2025 E Scott Ave, Rahway, NJ, USA
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Park I, Kemp TJ, Pinto LA. The HPV Serology Laboratory leads an initiative to standardize and harmonize human papillomavirus serology assays. PLoS Pathog 2023; 19:e1011403. [PMID: 37384602 DOI: 10.1371/journal.ppat.1011403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
The HPV Serology Laboratory is leading a global partnership initiative aiming for standardization and harmonization of current serology assay platforms being used to assess immune responses to HPV vaccines. Serology standardization is particularly important given the increasing number of immunobridging trials relying on serology data for approval of new vaccine dosing schedules or vaccine formulations. The initiative was established in 2017 to enable comparisons of data between different vaccines and relevant studies as well as expedite the implementation of new vaccines and vaccine indications. The HPV Serology Laboratory has held or attended several meetings with partnering laboratories, including international meetings in 2017, 2018, and 2021.
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Affiliation(s)
- Isabel Park
- HPV Serology Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Troy J Kemp
- HPV Serology Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Ligia A Pinto
- HPV Serology Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
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King LM, Lewnard JA, Niccolai LM. Clinical and Public Health Considerations for HPV Vaccination in Midadulthood: A Narrative Review. Open Forum Infect Dis 2023; 10:ofad004. [PMID: 36726535 PMCID: PMC9887268 DOI: 10.1093/ofid/ofad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/10/2022] [Indexed: 01/13/2023] Open
Abstract
Human papillomavirus (HPV) is an important cause of anogenital and oropharyngeal cancers, anogenital warts, and recurrent respiratory papillomatosis. Beginning in 2019, US guidelines recommended shared clinical decision-making (SCDM) for HPV vaccination among midadults (27-45 years). We conducted a narrative review of existing literature on HPV vaccination in midadults. The available evidence demonstrates that HPV vaccination in midadults is safe, efficacious, and likely to benefit both HPV-naïve midadults and those with previous infections. However, gaps in knowledge related to HPV vaccination have been identified among clinicians and midadult patients. Universal midadult HPV vaccination in the United States could avert 20 934-37 856 cancer cases over 100 years, costing $141 000-$1 471 000 per quality-adjusted life-year gained. Wide variation in these estimates reflects uncertainties in sexual behavior, HPV natural history, and naturally acquired immunity. Greater awareness among clinicians and midadult patients and broad implementation of SCDM may accelerate progress toward eliminating HPV-associated cancers and other diseases.
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Affiliation(s)
- Laura M King
- Correspondence: Laura M. King, MPH, 2121 Berkeley Way, Berkeley, CA 94704 (); or Joseph A. Lewnard, PhD, 2121 Berkeley Way, Berkeley, CA 94704 ()
| | - Joseph A Lewnard
- Correspondence: Laura M. King, MPH, 2121 Berkeley Way, Berkeley, CA 94704 (); or Joseph A. Lewnard, PhD, 2121 Berkeley Way, Berkeley, CA 94704 ()
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Suksiri P, Sansanaphongpricha K, Muangsin N, Krusong K. Development of positively-charged cycloamylose, CAQ as efficient nanodelivery system for siRNA. Biochem Eng J 2022. [DOI: 10.1016/j.bej.2022.108767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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10
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Yao X, He W, Wu X, Gu J, Zhang J, Lin B, Bi Z, Su Y, Huang S, Hu Y, Wu T, Zhang J, Xia N. Long-Term immunopersistence and safety of the Escherichia coli-produced HPV-16/18 bivalent vaccine in Chinese adolescent girls. Hum Vaccin Immunother 2022; 18:2061248. [PMID: 35417301 PMCID: PMC9897638 DOI: 10.1080/21645515.2022.2061248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The study assessed long-term immunopersistence and safety of the Escherichia coli (E. coli)-produced HPV-16/18 bivalent vaccine. In total, 979 participants in the initial immunogenicity noninferiority study, including girls aged 9-14 years who were randomized in a 1:1 ratio to receive 2 doses at months 0 and 6 (n = 301) or 3 doses at months 0, 1 and 6 (n = 304); girls aged 15-17 years (n = 149) and women aged 18-26 years (n = 225) who received 3 doses of the vaccine, were invited to participate in follow-up to 30 months post vaccination (NCT03206255). Serum samples were collected at months 18 and 30, and anti-HPV-16/18 IgG antibodies were measured by enzyme-linked immunosorbent assay. Serious adverse events (SAEs) occurred from month 7 through month 30 were recorded. At month 30, in the per-protocol set, all participants remained seropositive, except for one girl in the 9-14 years (2 doses) group who seroconverted to negative for HPV-18. HPV-16 and HPV-18 antibody levels were higher in girls aged 9-17 years who received 3 doses (125.3 and 60.2 IU/ml) than in women aged 18-26 years who received 3 doses (72.6 and 28.3 IU/ml), and those in girls aged 9-14 years who received 2 doses (73.2 and 24.9 IU/ml) were comparable to those in women aged 18-26 years who received 3 doses. No SAEs were reported to be causally related to vaccination. The E. coli-produced bivalent HPV-16/18 vaccine is safe and induces persistent protective antibodies for up to 30 months after vaccination in girls aged 9-17 years receiving 2 or 3 doses.
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Affiliation(s)
- Xingmei Yao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Wengang He
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Xianghong Wu
- Integrated Business Department, Sheyang Center for Disease Control and Prevention, Yancheng, Jiangsu, China
| | - Jianxiang Gu
- Integrated Business Department, Sheyang Center for Disease Control and Prevention, Yancheng, Jiangsu, China
| | - Jing Zhang
- Integrated Business Department, Sheyang Center for Disease Control and Prevention, Yancheng, Jiangsu, China
| | - Bizhen Lin
- Quality Research Department, Xiamen Innovax Biotech Company, Xiamen, Fujian, China
| | - Zhaofeng Bi
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Shoujie Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Yuemei Hu
- Department of Vaccine Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China,CONTACT Ting Wu State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiang’an South Road, Xiamen, Fujian, China
| | - Ting Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China,Yuemei Hu Jiangsu Provincial Center for Disease Control and Prevention, No 172 Jiangsu Road, Gulou District, Nanjing, Jiangsu, China
| | - Jun Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China,The Research Unit of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen, Fujian, China
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11
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Gardella B, Gritti A, Soleymaninejadian E, Pasquali MF, Riemma G, La Verde M, Schettino MT, Fortunato N, Torella M, Dominoni M. New Perspectives in Therapeutic Vaccines for HPV: A Critical Review. Medicina (B Aires) 2022; 58:medicina58070860. [PMID: 35888579 PMCID: PMC9315585 DOI: 10.3390/medicina58070860] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/19/2022] [Accepted: 06/24/2022] [Indexed: 12/21/2022] Open
Abstract
Human Papillomavirus is the main cause of cervical cancer, including squamous cell carcinoma of the oropharynx, anus, rectum, penis, vagina, and vulva. In recent years, considerable effort has been made to control HPV-induced diseases using either prophylactic or therapeutic approaches. A critical review of the literature about the therapeutic Human Papillomavirus vaccine was performed to analyze its efficacy in the treatment of female lower genital tract lesions and its possible perspective application in clinical practice. The most important medical databases were consulted, and all papers published from 2000 until 2021 were considered. We retrieved a group of seven papers, reporting the role of anti HPV therapeutic vaccines against the L2 protein in the order of their efficacy and safety in female lower genital tract disease. In addition, the immune response due to vaccine administration was evaluated. The development of therapeutic vaccines represents an interesting challenge for the treatment of HPV infection of the lower genital tract. Literature data underline that the L2 protein may be an interesting and promising target in the development of therapeutic HPV vaccines, but the possible strengths and the unclear longevity of L2 immune responses are factors to be considered before clinical use.
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Affiliation(s)
- Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy; (B.G.); (M.F.P.); (M.D.)
- Department of Obstetrics and Gynecology, IRCCS Fundation Policlinico San Matteo, 27100 Pavia, Italy;
| | - Andrea Gritti
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy; (B.G.); (M.F.P.); (M.D.)
- Department of Obstetrics and Gynecology, IRCCS Fundation Policlinico San Matteo, 27100 Pavia, Italy;
- Correspondence: ; Tel.: +39-00382-503722
| | - Ehsan Soleymaninejadian
- Department of Obstetrics and Gynecology, IRCCS Fundation Policlinico San Matteo, 27100 Pavia, Italy;
| | - Marianna Francesca Pasquali
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy; (B.G.); (M.F.P.); (M.D.)
- Department of Obstetrics and Gynecology, IRCCS Fundation Policlinico San Matteo, 27100 Pavia, Italy;
| | - Gaetano Riemma
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (G.R.); (M.L.V.); (M.T.S.); (N.F.); (M.T.)
| | - Marco La Verde
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (G.R.); (M.L.V.); (M.T.S.); (N.F.); (M.T.)
| | - Maria Teresa Schettino
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (G.R.); (M.L.V.); (M.T.S.); (N.F.); (M.T.)
| | - Nicola Fortunato
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (G.R.); (M.L.V.); (M.T.S.); (N.F.); (M.T.)
| | - Marco Torella
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (G.R.); (M.L.V.); (M.T.S.); (N.F.); (M.T.)
| | - Mattia Dominoni
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy; (B.G.); (M.F.P.); (M.D.)
- Department of Obstetrics and Gynecology, IRCCS Fundation Policlinico San Matteo, 27100 Pavia, Italy;
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12
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Bonneault M, Poletto C, Flauder M, Guillemot D, Delarocque-Astagneau E, Thiébaut AC, Opatowski L. Contact patterns and HPV-genotype interactions yield heterogeneous HPV-vaccine impacts depending on sexual behaviors: An individual-based model. Epidemics 2022; 39:100584. [DOI: 10.1016/j.epidem.2022.100584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/16/2021] [Accepted: 05/16/2022] [Indexed: 11/03/2022] Open
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13
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Prabhu PR, Carter JJ, Galloway DA. B Cell Responses upon Human Papillomavirus (HPV) Infection and Vaccination. Vaccines (Basel) 2022; 10:vaccines10060837. [PMID: 35746445 PMCID: PMC9229470 DOI: 10.3390/vaccines10060837] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
Infection with human papillomavirus (HPV) is the necessary cause of cervical cancer. Availability of vaccines against HPV makes it a highly preventable disease. HPV vaccines act through type-specific neutralizing antibodies produced by antigen-specific plasma cells known as long-lived plasma cells (LLPC). However, just as any other vaccine, success of HPV vaccine is attributed to the immunologic memory that it builds, which is largely attained through generation and maintenance of a class of B cells named memory B cells (Bmem). Both LLPCs and Bmems are important in inducing and maintaining immune memory and it is therefore necessary to understand their role after HPV vaccination to better predict outcomes. This review summarizes current knowledge of B-cell responses following HPV vaccination and natural infection, including molecular signatures associated with these responses.
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14
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GroEL—A Versatile Chaperone for Engineering and a Plethora of Applications. Biomolecules 2022; 12:biom12050607. [PMID: 35625535 PMCID: PMC9138447 DOI: 10.3390/biom12050607] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 12/16/2022] Open
Abstract
Chaperones play a vital role in the life of cells by facilitating the correct folding of other proteins and maintaining them in a functional state, being themselves, as a rule, more stable than the rest of cell proteins. Their functional properties naturally tempt investigators to actively adapt them for biotechnology needs. This review will mostly focus on the applications found for the bacterial chaperonin GroE and its counterparts from other organisms, in biotechnology or for research purposes, both in their engineered or intact versions.
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15
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Kawakita D, Oze I, Iwasaki S, Matsuda T, Matsuo K, Ito H. Trends in the incidence of head and neck cancer by subsite between 1993 and 2015 in Japan. Cancer Med 2022; 11:1553-1560. [PMID: 35029329 PMCID: PMC8921930 DOI: 10.1002/cam4.4539] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/05/2021] [Accepted: 11/26/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Daisuke Kawakita
- Division of Cancer Epidemiology and Prevention Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
- Department of Otorhinolaryngology, Head and Neck Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
| | - Shinichi Iwasaki
- Department of Otorhinolaryngology, Head and Neck Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Tomohiro Matsuda
- Division of International Collaborative Research Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
- Department of Epidemiology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Hidemi Ito
- Division of Cancer Information and Control Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
- Division of Descriptive Cancer Epidemiology Nagoya University Graduate School of Medicine Nagoya Japan
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16
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Mac Eochagain C, Power R, Parker I, Brennan D. HPV vaccination among seropositive, DNA negative cohorts: a systematic review & meta-analysis. J Gynecol Oncol 2022; 33:e24. [PMID: 35128855 PMCID: PMC9024181 DOI: 10.3802/jgo.2022.33.e24] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/01/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022] Open
Abstract
Objective Vaccine efficacy among previously exposed, but currently uninfected women, i.e., those who have serological evidence of a prior human papillomavirus (HPV) infection without corresponding detectable HPV DNA, remains incompletely defined. This meta-analysis assessed the serotype-specific efficacy of prophylactic HPV vaccination against HPV16/18 persistent infection (PI) and cervical intraepithelial neoplasia (CIN) among seropositive, DNA negative (SPDN) women enrolled to randomized controlled trials (RCTs) of HPV L1-based vaccines. Methods Searches were conducted on 08/16/20 on MEDLINE, Embase, Scopus and CENTRAL. RCTs of L1-based prophylactic bivalent or quadrivalent HPV vaccines, reporting serotype-specific clinical efficacy endpoints in the HPV16/18 seropositive, DNA-negative populations were included. Relative risks (RRs) of 6-month PI (6mPI), 12-month PI (12mPI), CIN1+ and CIN2+ were pooled using a random-effects model. Results A total of 1,727 citations were reviewed. 8 studies, with a total of 9,569 SPDN participants, met all eligibility criteria. The RR of 6mPI (RR=0.22; 95% confidence interval [CI]=0.08–0.61; p=0.018), 12mPI (RR=0.20; 95% CI=0.05–0.80; p=0.035), CIN1+ (RR=0.13; 95% CI=0.05–0.30; p=0.003) and CIN2+ (RR=0.15; 95% CI=0.04–0.59; p=0.022) was significantly reduced in the vaccinated compared to the unvaccinated group. Conclusion Our findings suggest high serotype-specific efficacy for HPV vaccination among cohorts of women with evidence of prior HPV16/18 infections, including 87% efficacy (95% CI=70%–95%; p=0.003) against HPV16/18 cervical dysplasia. HPV vaccination is highly effective among uninfected women, regardless of prior exposure history. Trial Registration PROSPERO Identifier: CRD42020206888
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Affiliation(s)
| | | | | | - Donal Brennan
- Department of Gynaecological Oncology, University College Dublin, Dublin, Ireland
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17
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Yao X, Chen W, Zhao C, Wei L, Hu Y, Li M, Lin Z, Lin B, Liu X, Hong Y, Li Q, Pan Q, Zhang X, Li M, Zhao Y, Zhang L, Xu H, Hu F, Zhao J, Huang Y, Sheng W, Zheng Y, Hu S, Su Y, Huang S, Pan H, Zhao F, Qiao Y, Wu T, Zhang J, Xia N. Naturally acquired HPV antibodies against subsequent homotypic infection: A large-scale prospective cohort study. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 13:100196. [PMID: 34527987 PMCID: PMC8403914 DOI: 10.1016/j.lanwpc.2021.100196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/30/2021] [Accepted: 06/06/2021] [Indexed: 11/23/2022]
Abstract
Background Although recent studies have suggested that naturally acquired Human papillomavirus (HPV) antibodies are partly protective against subsequent homotypic infection, the extent of protection remains indecisive. Here, we evaluate the protective effect of neutralizing and IgG antibodies simultaneously. Methods In a cohort of 3634 women aged 18-45 years from the control arm of a phase III trial of the HPV-16/18 bivalent vaccine, participants were tested for neutralizing antibodies by pseudovirion-based neutralization assay (PBNA) and IgG antibodies by enzyme-linked immunosorbent assay (ELISA) at baseline. HPV-16/18 incident and persistent infections were identified using cervical specimens periodically collected during the 5·5 years of follow-up. The protective effects of HPV-16/18 neutralizing and IgG antibodies against homotypic infection were assessed using a Cox proportional hazard model. Findings For the persistent infection (PI) endpoints of HPV-16/18 lasting for over 6/12 months, a prevalence of type-specific neutralizing antibodies was highly protective (6-month PI: hazard ratio (HR) = 0·16, 95% confidence interval (CI): 0·04, 0·65; 12-month PI: HR = 0·23, 95% CI: 0·06, 0·94), whereas a prevalence of IgG antibodies was associated with minor and non-significant protection (6-month PI: HR = 0·66, 95% CI: 0·40, 1·09; 12-month PI: HR = 0·66, 95% CI: 0·36, 1·20). After increasing the cut-off value to the median IgG level, the risk of 6-month PI was significantly lower in seropositive vs seronegative women (HR = 0·38, 95% CI: 0·18, 0·83). Interpretation Naturally acquired antibodies are associated with a substantially reduced risk of subsequent homotypic infection. Funding NSFC; The Fujian Province Health Education Joint Research Project; Xiamen Science and Technology Major Project; CIFMS; and Xiamen Innovax.
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Affiliation(s)
- Xingmei Yao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Wen Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chao Zhao
- Peking University People's Hospital, Beijing, China
| | - Lihui Wei
- Peking University People's Hospital, Beijing, China
| | - Yuemei Hu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Mingqiang Li
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, China
| | - Zhijie Lin
- Xiamen Innovax Biotech Company, Xiamen, Fujian, China
| | - Bizhen Lin
- Xiamen Innovax Biotech Company, Xiamen, Fujian, China
| | - Xiaohui Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Ying Hong
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Qing Li
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Qinjing Pan
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xun Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingzhu Li
- Peking University People's Hospital, Beijing, China
| | - Yuqian Zhao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huifang Xu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fangfang Hu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Jun Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Yue Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Wei Sheng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Ya Zheng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Shangying Hu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Shoujie Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Huirong Pan
- Xiamen Innovax Biotech Company, Xiamen, Fujian, China
| | - Fanghui Zhao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- Chinese Academy of Medical Sciences/Peking Union Medical College School of Population Medicine and Public Health, Beijing, China
| | - Ting Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Jun Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China.,The Research Unit of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen, Fujian, China
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Global incidence trends in head and neck cancer for HPV-related and -unrelated subsites: A systematic review of population-based studies. Oral Oncol 2021; 115:105177. [PMID: 33561611 DOI: 10.1016/j.oraloncology.2020.105177] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/15/2022]
Abstract
In head and neck cancer (HNC), some subsites are associated with human papillomavirus (HPV) infection, whereas others are unrelated. Although studies have demonstrated the heterogeneity of HPV prevalence worldwide, its impacts on incidence trends in HNC are unknown. This systematic review examined the incidence trends for HPV-related HNC subsites, exploring patterns by geographic region, age group, sex, and race/ethnicity. We searched for publications on PubMed, Embase, and Scopus. Eligible articles included population-based studies that analyzed incidence trends for subsites classified as a proxy for HPV infection in HNC (hereafter referred to as HPV-related subsites). We retrieved 3,948 non-duplicate records, of which 31 were eligible articles, representing 18 countries and spanning almost fifty years. Overall, the incidence of HPV-related HNC subsites rose, while most of the HPV-unrelated subsites declined or remained stable. For HPV-related HNC subsites, incidence trends increased regardless of age group, highlighting a distinct global pattern between sexes. Also, similar peaks in increased risk were observed in recent cohorts from both Australia and the United States. There is a dramatic shift in the global trends of HNCs, characterized by the emerging burden in HNC for HPV-related subsites.
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Costa AP, Giraldo PC, Cobucci RN, Consolaro ML, Souza RP, Canário LB, Machado PR, Martins RR, Baptista PV, Jr JE, Gonçalves AK. Cross-Protective IgG and IgA Antibodies against Oncogenic and Non-Oncogenic HPV Genotypes. Asian Pac J Cancer Prev 2020; 21:2799-2804. [PMID: 32986383 PMCID: PMC7779425 DOI: 10.31557/apjcp.2020.21.9.2799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/26/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of the study was to describe the course of IgG/IgA immune response in women immunized with bivalent vaccine and in women non-vaccinated with HPV infection, as well as evaluating the cross-protection against non-vaccine HPV types. METHODS Serum and cervical mucus samples were collected from infected and vaccinated women for HPV detection/genotyping and for detection of IgG/IgA anti-HPV/VLP (Virus-like Particles) by ELISA. RESULTS The median absorbance detected in serum samples for anti-HPV-IgG antibodies was higher in vaccinated women when compared to HPV infected women (p <0.01), however, the median absorbance in cervical mucus samples for anti-HPV-IgA was higher in infected women when compared to vaccinated women (p <0.01). Additionally, our analyses also provided additional evidence for cross-protective efficacy of the HPV-16/18 vaccine against HPV-82, -6, -11, -13, -61, -72 and -74. CONCLUSION The IgG antibodies were significantly more detected in the serum of vaccinated women, while the IgA was found in greater quantities in cervical samples from those infected by the virus. In addition, there is evidence that the bivalent vaccine provides cross-protection against other non-oncogenic viral subtypes. .
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Affiliation(s)
- Ana Paula Costa
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Paulo César Giraldo
- Department of Gynecology, and Obstetrics, State University of Campinas, Campinas, Brazil.
| | | | - Márcia Lopes Consolaro
- Clinical Cytology and STD Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, PR, Brazil.
| | - Raquel Pantarotto Souza
- Clinical Cytology and STD Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, PR, Brazil.
| | - Luanda Barbara Canário
- Department of Clinical Analysis and Toxicology, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Paula Renata Machado
- Department of Clinical Analysis and Toxicology, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Rand Randall Martins
- Department of Pharmacy, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Pedro Vieira Baptista
- Hospital Lusíadas Porto and Unidade de Tracto Genital Inferior, Serviço de Ginecologia e Obstetrícia, Centro Hospitalar de São João, Porto, Portugal.
| | - José Eleutério Jr
- Department of Female, Child and Adolescent Health, Federal University of Ceará, Fortaleza, Brazil.
| | - Ana Katherine Gonçalves
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil.
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20
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Mboumba Bouassa RS, Péré H, Gubavu C, Prazuck T, Jenabian MA, Veyer D, Meye JF, Touzé A, Bélec L. Serum and cervicovaginal IgG immune responses against α7 and α9 HPV in non-vaccinated women at risk for cervical cancer: Implication for catch-up prophylactic HPV vaccination. PLoS One 2020; 15:e0233084. [PMID: 32421735 PMCID: PMC7233543 DOI: 10.1371/journal.pone.0233084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cervical cancer associated with high risk-human papillomavirus (HR-HPV) infection is becoming the one of the most common female cancer in many sub-Saharan African countries. First-generation immigrant African women living in Europe are at-risk for cervical cancer, in a context of social vulnerability, with frequent lack of cervical cancer screening and HPV vaccination. OBJECTIVE Our objective was to address immunologically the issue of catch-up prophylactic HPV vaccination in first-generation African immigrant women living in France. METHODS IgG immune responses and cross-reactivities to α7 (HPV-18, -45 and -68) and α9 (HPV-16, -31, -33, -35, -52 and -58) HPV types, including 7 HR-HPV targeted by the Gardasil-9® prophylactic vaccine, were evaluated in paired serum and cervicovaginal secretions (CVS) by HPV L1-virus-like particles-based ELISA. Genital HPV were detected by multiplex real time PCR (Seegene, Seoul, South Korea). RESULTS Fifty-one immigrant women (mean age, 41.7 years; 72.5% HIV-infected) were prospectively included. More than two-third (68.6%) of them carried genital HPV (group I) while 31.4% were negative (group II). The majority (90.2%) exhibited serum IgG to at least one α7/α9 HR-HPV. Serum HPV-specific IgG were more frequently detected in group I than group II (100% versus 68.7%; P = 0.002). The distribution of serum and genital HPV-specific IgG was similar, but mean number of IgG reactivities to α7/α9 HR-HPV was higher in serum than CVS (5.6 IgG per woman in serum versus 3.2 in CVS; P<0.001). Rates of IgG cross-reactivities against HPV different from detected cervicovaginal HPV were higher in serum and CVS in group I than group II. Finally, the majority of groups I and II women (68.6% and 68.7%, respectively) exhibited serum or cervicovaginal IgG to Gardasil-9® HR-HPV, with higher mean rates in group I than group II (6.1 Gardasil-9® HR-HPV per woman versus 1.4; P<0.01). One-third (31.2%) of group II women did not show any serum and genital HPV-specific IgG. CONCLUSIONS Around two-third of first-generation African immigrant women living in France showed frequent ongoing genital HPV infection and high rates of circulating and genital IgG to α7/α9 HPV, generally cross-reacting, avoiding the possibility of catch-up vaccination. Nevertheless, about one-third of women had no evidence of previous HPV infection, or showed only low levels of genital and circulating HR-HPV-specific IgG and could therefore be eligible for catch-up vaccination.
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Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Laboratoire de virologie, hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Ecole Doctorale Régionale en Infectiologie Tropicale, Franceville, Gabon
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
- INSERM UMR_S970, Immunothérapie et traitement anti-angiogénique en cancérologie, Paris Centre de Recherche Cardiovasculaire (PARCC), hôpital européen Georges Pompidou, AP-HP, Paris, France
| | - Hélène Péré
- Laboratoire de virologie, hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
- INSERM UMR_S970, Immunothérapie et traitement anti-angiogénique en cancérologie, Paris Centre de Recherche Cardiovasculaire (PARCC), hôpital européen Georges Pompidou, AP-HP, Paris, France
| | - Camélia Gubavu
- Service des maladies infectieuses et tropicales, Centre hospitalier régional d’Orléans and Centre Gratuit d’Information, de Dépistage et de Diagnostic (CEGIDD) d’Orléans, Orléans, France
| | - Thierry Prazuck
- Service des maladies infectieuses et tropicales, Centre hospitalier régional d’Orléans and Centre Gratuit d’Information, de Dépistage et de Diagnostic (CEGIDD) d’Orléans, Orléans, France
| | - Mohammad-Ali Jenabian
- Département des Sciences Biologiques et Centre de Recherche BioMed, Université du Québec à Montréal (UQAM), Montreal, Quebec, Canada
| | - David Veyer
- Laboratoire de virologie, hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Jean-François Meye
- Service de Gynécologie Obstétrique, Centre Hospitalo-Universitaire d’Agondjé et Faculté de Médecine de Libreville, Université des Sciences de la Santé, Libreville, Gabon
| | - Antoine Touzé
- UMRINRA ISP 1282, Equipe Biologie des infections à polyomavirus, Université de Tours, Tours, France
| | - Laurent Bélec
- Laboratoire de virologie, hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Ecole Doctorale Régionale en Infectiologie Tropicale, Franceville, Gabon
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
- INSERM UMR_S970, Immunothérapie et traitement anti-angiogénique en cancérologie, Paris Centre de Recherche Cardiovasculaire (PARCC), hôpital européen Georges Pompidou, AP-HP, Paris, France
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21
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Mboumba Bouassa RS, Péré H, Jenabian MA, Veyer D, Meye JF, Touzé A, Bélec L. Natural and vaccine-induced B cell-derived systemic and mucosal humoral immunity to human papillomavirus. Expert Rev Anti Infect Ther 2020; 18:579-607. [PMID: 32242472 DOI: 10.1080/14787210.2020.1750950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Human papillomavirus (HPV) are the causative agent of mucosal neoplasia. Both cervical, anal and oropharyngeal cancers incidence is constantly increasing, making the HPV infection, a significant worldwide concern. Together, the CD8+ T cytotoxic cell-mediated response and the HPV-specific antibody response control most of the HPV infections before the development of cancers.Areas covered: We searched the MEDLINE and EMBASE databases and identified 228 eligible studies from 1987 to 2019 which examines both naturally acquired and vaccine induced humoral immunity against HPV infection in female and male subjects from worldwide origin. Herein, we synthesize current knowledge on the features of systemic and mucosal humoral immunity against HPV. We discuss the issues of the balance between the viral clearance or the escape to the host immune response, the differences between natural and vaccine-induced HPV-specific antibodies and their neutralizing capability. We also discuss the protection afforded after natural infection or following prophylactic vaccination.Expert opinion: Understanding the antibody response induced by HPV infection has led to the design of first-generation prophylactic vaccines. Now, prophylactic vaccination induces protective and long-lasting antibody response which would also strengthened the natural moderate humoral response in people previously exposed to the virus.
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Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Laboratoire De Virologie, Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,Laboratoire de virologie, Ecole Doctorale Régionale En Infectiologie Tropicale, Franceville, Gabon.,INSERM UMR U970 (Immunothérapie Et Traitement Anti-angiogénique En cancérologie), Paris Centre De Recherche Cardiovasculaire (PARCC), Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Hélène Péré
- Laboratoire De Virologie, Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,INSERM UMR U970 (Immunothérapie Et Traitement Anti-angiogénique En cancérologie), Paris Centre De Recherche Cardiovasculaire (PARCC), Hôpital Européen Georges Pompidou, AP-HP, Paris, France.,Faculté de Médecine, Université Paris Descartes, Paris, France
| | - Mohammad-Ali Jenabian
- Département Des Sciences Biologiques Et Centre De Recherche BioMed, Université Du Québec À Montréal (UQAM), Montreal, QC, Canada
| | - David Veyer
- Laboratoire De Virologie, Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - Jean-François Meye
- Service De Gynécologie Obstétrique, Centre Hospitalo-Universitaire d'Agondjé Et Faculté De Médecine De Libreville, Université Des Sciences De La Santé, Libreville, Gabon
| | - Antoine Touzé
- UMRINRA ISP 1282, Equipe Biologie Des Infections À Polyomavirus, Université De Tours, Tours, France
| | - Laurent Bélec
- Laboratoire De Virologie, Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,INSERM UMR U970 (Immunothérapie Et Traitement Anti-angiogénique En cancérologie), Paris Centre De Recherche Cardiovasculaire (PARCC), Hôpital Européen Georges Pompidou, AP-HP, Paris, France.,Faculté de Médecine, Université Paris Descartes, Paris, France
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22
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Layman H, Rickert KW, Wilson S, Aksyuk AA, Dunty JM, Natrakul D, Swaminathan N, DelNagro CJ. Development and validation of a multiplex immunoassay for the simultaneous quantification of type-specific IgG antibodies to E6/E7 oncoproteins of HPV16 and HPV18. PLoS One 2020; 15:e0229672. [PMID: 32214362 PMCID: PMC7098588 DOI: 10.1371/journal.pone.0229672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 02/11/2020] [Indexed: 01/24/2023] Open
Abstract
More than 170 types of human papilloma viruses (HPV) exist with many causing proliferative diseases linked to malignancy in indications such as cervical cancer and head and neck squamous cell carcinoma. Characterization of antibody levels toward HPV serology is challenging due to complex biology of oncoproteins, pre-existing titers to multiple HPV types, cross-reactivity, and low affinity, polyclonal responses. Using multiplex technology from MSD, we have developed an assay that simultaneously characterizes antibodies against E6 and E7 oncoproteins of HPV16 and 18, the primary drivers of HPV-associated oncogenesis. We fusion tagged our E6 and E7 proteins with MBP via two-step purification, spot-printed an optimized concentration of protein into wells of MSD 96-well plates, and assayed various cynomolgus monkey, human and HPV+ cervical cancer patient serum to validate the assay. The dynamic range of the assay covered 4-orders of magnitude and antibodies were detected in serum at a dilution up to 100,000-fold. The assay was very precise (n = 5 assay runs) with median CV of human serum samples ~ 5.3% and inter-run variability of 11.4%. The multiplex serology method has strong cross-reactivity between E6 oncoproteins from human serum samples as HPV18 E6 antigens neutralized 5 of 6 serum samples as strongly as HPV16 E6. Moderate concordance (Spearman’s Rank = 0.775) was found between antibody responses against HPV16 E7 in the multiplex assay compared to standard ELISA serology methods. These results demonstrate the development of a high-throughput, multi-plex assay that requires lower sample quantity input with greater dynamic range to detect type-specific anti-HPV concentrations to E6 and E7 oncoproteins of HPV16 and 18.
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Affiliation(s)
- Hans Layman
- AstraZeneca plc, South San Francisco, California, United States of America
- * E-mail:
| | - Keith W. Rickert
- AstraZeneca plc, Gaithersburg, Maryland, United States of America
| | - Susan Wilson
- AstraZeneca plc, Gaithersburg, Maryland, United States of America
| | | | - Jill M. Dunty
- Meso Scale Diagnostics, LLC., Rockville, Maryland, United States of America
| | - Dusit Natrakul
- Meso Scale Diagnostics, LLC., Rockville, Maryland, United States of America
| | - Nithya Swaminathan
- AstraZeneca plc, South San Francisco, California, United States of America
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23
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Garbuglia AR, Lapa D, Sias C, Capobianchi MR, Del Porto P. The Use of Both Therapeutic and Prophylactic Vaccines in the Therapy of Papillomavirus Disease. Front Immunol 2020; 11:188. [PMID: 32133000 PMCID: PMC7040023 DOI: 10.3389/fimmu.2020.00188] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/24/2020] [Indexed: 12/30/2022] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted virus. The high-risk HPV types (i.e., HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) are considered to be the main etiological agents of genital tract cancers, such as cervical, vulvar, vaginal, penile, and anal cancers, and of a subset of head and neck cancers. Three prophylactic HPV vaccines are available that are bivalent (vs. HPV16, 18), tetravalent (vs. HPV6, 11, 16, 18), and non-avalent (vs. HPV6, 11, 16, 18, 31, 33,45, 52, 58). All of these vaccines are based on recombinant DNA technology, and they are prepared from the purified L1 protein that self-assembles to form the HPV type-specific empty shells (i.e., virus-like particles). These vaccines are highly immunogenic and induce specific antibodies. Therapeutic vaccines differ from prophylactic vaccines, as they are designed to generate cell-mediated immunity against transformed cells, rather than neutralizing antibodies. Among the HPV proteins, the E6 and E7 oncoproteins are considered almost ideal as targets for immunotherapy of cervical cancer, as they are essential for the onset and evolution of malignancy and are constitutively expressed in both premalignant and invasive lesions. Several strategies have been investigated for HPV therapeutic vaccines designed to enhance CD4+ and CD8+ T-cell responses, including genetic vaccines (i.e., DNA/ RNA/virus/ bacterial), and protein-based, peptide-based or dendritic-cell-based vaccines. However, no vaccine has yet been licensed for therapeutic use. Several studies have suggested that administration of prophylactic vaccines immediately after surgical treatment of CIN2 cervical lesions can be considered as an adjuvant to prevent reactivation or reinfection, and other studies have described the relevance of prophylactic vaccines in the management of genital warts. This review summarizes the leading features of therapeutic vaccines, which mainly target the early oncoproteins E6 and E7, and prophylactic vaccines, which are based on the L1 capsid protein. Through an analysis of the specific immunogenic properties of these two types of vaccines, we discuss why and how prophylactic vaccines can be effective in the treatment of HPV-related lesions and relapse.
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Affiliation(s)
- Anna Rosa Garbuglia
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Daniele Lapa
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Catia Sias
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Maria Rosaria Capobianchi
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Paola Del Porto
- Department of Biology and Biotechnology "C. Darwin," Sapienza University, Rome, Italy
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24
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Twisk DE, van der Sande MAB, van Eeden A, Heideman DAM, van der Klis FRM, de Vries HJC, Schim van der Loeff MF. Detection of Incident Anal High-Risk Human Papillomavirus DNA in Men Who Have Sex With Men: Incidence or Reactivation? J Infect Dis 2019; 218:1018-1026. [PMID: 29771378 DOI: 10.1093/infdis/jiy276] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/08/2018] [Indexed: 11/12/2022] Open
Abstract
Background We aimed to assess whether sexual exposure may explain all incident anal human papillomavirus (HPV) detections among men who have sex with men (MSM). Methods A longitudinal study among MSM was conducted between 2010 and 2013 with visits every 6 months and up to 24 months of follow-up. Risk-factor questionnaires, blood samples, and anal and penile self-swabs were collected at each visit. Self-swabs were used for detection and genotyping of HPV by the broad spectrum L1 based SPF10 PCR DNA/enzyme immunoassay LiPA25 system. Serum samples were tested for high-risk HPV (hrHPV) antibodies. Incident anal HPV detection rates among sexually non-, low, and highly exposed MSM were compared. Factors associated with incident anal hrHPV detection were assessed using multivariable Cox regression. Results Seven hundred fourteen men (median age, 40 years; 39% human immunodeficiency virus [HIV] infected) were included in the analysis. Incident anal detections of all hrHPV types were observed among both sexually nonexposed and exposed MSM. In multivariable analyses, being highly sexually exposed, being HIV infected, and having a penile HPV infection were positively associated with incident anal HPV detection; those reporting more sex partners had a nonsignificantly increased risk of HPV detection. Conclusions Incident anal hrHPV detection is common among recently nonexposed MSM, suggesting that a reactivated latent HPV infection instead of an incident infection may underlie incident HPV detection.
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Affiliation(s)
- Denise E Twisk
- Department of Infectious Diseases, Public Health Service Amsterdam, The Netherlands
| | - Marianne A B van der Sande
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.,Department Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Arne van Eeden
- Department of Internal Medicine, DC Klinieken Oud Zuid, Amsterdam
| | - Daniëlle A M Heideman
- Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam
| | - Fiona R M van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Henry J C de Vries
- Department of Infectious Diseases, Public Health Service Amsterdam, The Netherlands.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven.,Department of Dermatology, Academic Medical Center, The Netherlands
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service Amsterdam, The Netherlands.,Amsterdam Infection and Immunity Institute (AIII), Academic Medical Center, The Netherlands
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25
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Rosillon D, Baril L, Del Rosario-Raymundo MR, Wheeler CM, Skinner SR, Garland SM, Salmeron J, Lazcano-Ponce E, Vallejos CS, Stoney T, Ter Harmsel B, Lim TYK, Quek SC, Minkina G, McNeil SA, Bouchard C, Fong KL, Money D, Ilancheran A, Savicheva A, Cruickshank M, Chatterjee A, Fiander A, Martens M, Bozonnat MC, Struyf F, Dubin G, Castellsagué X. Risk of newly detected infections and cervical abnormalities in adult women seropositive or seronegative for naturally acquired HPV-16/18 antibodies. Cancer Med 2019; 8:4938-4953. [PMID: 31273942 PMCID: PMC6712465 DOI: 10.1002/cam4.1879] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/04/2018] [Accepted: 10/11/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Infections with human papillomavirus (HPV) types 16 and 18 account for ~70% of invasive cervical cancers but the degree of protection from naturally acquired anti-HPV antibodies is uncertain. We examined the risk of HPV infections as defined by HPV DNA detection and cervical abnormalities among women >25 years in the Human Papilloma VIrus Vaccine Immunogenicity ANd Efficacy trial's (VIVIANE, NCT00294047) control arm. METHODS Serum anti-HPV-16/18 antibodies were determined at baseline and every 12 months in baseline DNA-negative women (N = 2687 for HPV-16 and 2705 for HPV-18) by enzyme-linked immunosorbent assay (ELISA) from blood samples. HPV infections were identified by polymerase chain reaction (PCR) every 6-months, and cervical abnormalities were confirmed by cytology every 12 months. Data were collected over a 7-year period. The association between the risk of type-specific infection and cervical abnormalities and serostatus was assessed using Cox proportional hazard models. RESULTS Risk of newly detected HPV-16-associated 6-month persistent infections (PI) (hazard ratio [HR] = 0.56 [95%CI:0.32; 0.99]) and atypical squamous cells of undetermined significance (ASC-US+) (HR = 0.28 [0.12; 0.67]) were significantly lower in baseline seropositive vs baseline seronegative women. HPV-16-associated incident infections (HR = 0.81 [0.56; 1.16]) and 12-month PI (HR = 0.53 [0.24; 1.16]) showed the same trend. A similar trend of lower risk was observed in HPV-18-seropositive vs -seronegative women (HR = 0.95 [0.59; 1.51] for IIs, HR = 0.43 [0.16; 1.13] for 6-month PIs, HR = 0.31 [0.07; 1.36] for 12-month PIs, and HR = 0.61 [0.23; 1.61] for ASC-US+). CONCLUSIONS Naturally acquired anti-HPV-16 antibodies were associated with a decreased risk of subsequent infection and cervical abnormalities in women >25 years. This possible protection was lower than that previously reported in 15- to 25-year-old women.
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Affiliation(s)
| | | | | | | | - Susan Rachel Skinner
- Vaccines Trials Group, Telethon Kids Institute, Perth, Western Australia, Australia.,Sydney University Discipline of Paediatrics and Child Health, Children's Hospital Westmead, Sydney, New South Wales, Australia
| | - Suzanne Marie Garland
- The Royal Women's Hospital, The Royal Children's Hospital, Murdoch Childrens Research Institute, University of Melbourne, Parkville, Victoria, Australia
| | | | | | | | - Tanya Stoney
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Bram Ter Harmsel
- Department of Gynecology, Roosevelt Kliniek, Leiden, Delft, The Netherlands
| | | | - Swee Chong Quek
- ASC Clinic for Women, Gleneagles Hospital, Singapore City, Singapore
| | | | - Shelly Ann McNeil
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Celine Bouchard
- Clinique de Recherche en Santé des Femmes, Québec City, Québec, Canada
| | - Kah Leng Fong
- Singapore General Hospital, Singapore City, Singapore
| | - Deborah Money
- The Women's Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Arunachalam Ilancheran
- Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, National University Hospital, Singapore City, Singapore
| | - Alevtina Savicheva
- Laboratory of Microbiology, DO Ott Research Institute of Obstetrics, Gynaecology and Reproductology, St. Petersburg, Russia
| | - Margaret Cruickshank
- Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, NHS Grampian, Scotland, UK
| | - Archana Chatterjee
- Department of Pediatrics, University of South Dakota Sanford School of Medicine/Sanford Children's Specialty Clinic, Sioux Falls, South Dakota
| | - Alison Fiander
- Leading Safe Choices Programme, Royal College of Obstetricians and Gynaecologists, London, UK
| | | | | | | | | | - Xavier Castellsagué
- Institut Català d'Oncologia (ICO), IDIBELL, CIBER-ESP, L'Hospitalet de Llobregat, Catalonia, Spain
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26
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King E, Ottensmeier C, Pollock KGJ. Novel Approaches for Vaccination Against HPV-Induced Cancers. Curr Top Microbiol Immunol 2019; 405:33-53. [PMID: 25735921 DOI: 10.1007/82_2015_430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
To date, more than 5 % of all cancers are as a result of human papillomavirus (HPV) infection, and this incidence is increasing. Early recognition of disease is associated with good survival, but late presentation results in devastating consequences. Prevention is better than cure, and there are now successful prophylactic vaccination programmes in place. We discuss these and the prospect of therapeutic vaccinations in the near future to address a growing need for improved therapeutic options.
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Affiliation(s)
- Emma King
- University of Southampton, Southampton, UK.
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27
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Cellular immune responses against natural human papillomavirus infections among men in Kisumu, Kenya. Clin Immunol 2019; 212:108211. [PMID: 31054968 DOI: 10.1016/j.clim.2019.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/25/2019] [Accepted: 05/01/2019] [Indexed: 12/22/2022]
Abstract
Human papillomavirus (HPV) is associated with ano-genital and cervical cancer. Persistence of oncogenic HPV genotypes is a requirement for development and progression of malignancies. Although, >70% of women clear incident HPV infections, data on natural history and HPV immunology among men is limited. To evaluate cell-mediated immune responses to natural HPV infections among men, we assessed cytokine responses on PBMCs collected from men with persistent or cleared HPV. Men with HPV clearance and those with HPV persistence had increased odds (6-times and 3-times respectively) of mounting cytokine responses compared to HPV uninfected men. Th1 cytokines IFN-γ (5.1-fold) and IL-2 (4.2-fold) were significantly (p < 0.0001) upregulated among men with HPV clearance compared to HPV uninfected men. Among men with HPV clearance compared to those with persistent HPV infection, only IFN-γ (2.4-fold) and IL-2 (3.0-fold) were significantly (p < 0.0001) upregulated. Th1 cell-mediated cytokine response was associated with natural HPV clearance in men.
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28
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Chikandiwa A, Pisa PT, Sengayi M, Singh E, Delany-Moretlwe S. Patterns and trends of HPV-related cancers other than cervix in South Africa from 1994–2013. Cancer Epidemiol 2019; 58:121-129. [DOI: 10.1016/j.canep.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/21/2018] [Accepted: 12/06/2018] [Indexed: 01/27/2023]
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29
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Pinto LA, Dillner J, Beddows S, Unger ER. Immunogenicity of HPV prophylactic vaccines: Serology assays and their use in HPV vaccine evaluation and development. Vaccine 2018; 36:4792-4799. [PMID: 29361344 PMCID: PMC6050153 DOI: 10.1016/j.vaccine.2017.11.089] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/17/2017] [Indexed: 11/23/2022]
Abstract
When administered as standard three-dose schedules, the licensed HPV prophylactic vaccines have demonstrated extraordinary immunogenicity and efficacy. We summarize the immunogenicity of these licensed vaccines and the most commonly used serology assays, with a focus on key considerations for one-dose vaccine schedules. Although immune correlates of protection against infection are not entirely clear, both preclinical and clinical evidence point to neutralizing antibodies as the principal mechanism of protection. Thus, immunogenicity assessments in vaccine trials have focused on measurements of antibody responses to the vaccine. Non-inferiority of antibody responses after two doses of HPV vaccines separated by 6 months has been demonstrated and this evidence supported the recent WHO recommendations for two-dose vaccination schedules in both boys and girls 9-14 years of age. There is also some evidence suggesting that one dose of HPV vaccines may provide protection similar to the currently recommended two-dose regimens but robust data on efficacy and immunogenicity of one-dose vaccine schedules are lacking. In addition, immunogenicity has been assessed and reported using different methods, precluding direct comparison of results between different studies and vaccines. New head-to-head vaccine trials evaluating one-dose immunogenicity and efficacy have been initiated and an increase in the number of trials relying on immunobridging is anticipated. Therefore, standardized measurement and reporting of immunogenicity for the up to nine HPV types targeted by the current vaccines is now critical. Building on previous HPV serology assay standardization and harmonization efforts initiated by the WHO HPV LabNet in 2006, new secondary standards, critical reference reagents and testing guidelines will be generated as part of a new partnership to facilitate harmonization of the immunogenicity testing in new HPV vaccine trials.
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MESH Headings
- Adolescent
- Antibodies, Neutralizing/blood
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Child
- Clinical Trials as Topic
- Female
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/administration & dosage
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/immunology
- Humans
- Immunization Schedule
- Immunogenicity, Vaccine
- Male
- Mass Vaccination/standards
- Neutralization Tests/standards
- Papillomavirus Infections/prevention & control
- Papillomavirus Vaccines/administration & dosage
- Papillomavirus Vaccines/immunology
- Treatment Outcome
- Uterine Cervical Neoplasms/prevention & control
- World Health Organization
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Affiliation(s)
- Ligia A Pinto
- Vaccine, Cancer and Immunity Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, USA.
| | - Joakim Dillner
- Department of Laboratory Medicine, Karolinska Institutet, 141 86 Stockholm, Sweden.
| | - Simon Beddows
- Virus Reference Department, Public Health England, London, UK.
| | - Elizabeth R Unger
- Chronic Viral Diseases Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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St Laurent J, Luckett R, Feldman S. HPV vaccination and the effects on rates of HPV-related cancers. Curr Probl Cancer 2018; 42:493-506. [PMID: 30041818 DOI: 10.1016/j.currproblcancer.2018.06.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/05/2018] [Indexed: 02/07/2023]
Abstract
Globally, human papillomavirus (HPV) infection is one of the most common sexually transmitted infection. HPV is linked to at least five malignancies including vulvar, vaginal, anal penile, oropharyngeal, and cervical cancer. Three HPV vaccines are currently available: bivalent (HPV 16,18), quadrivalent (HPV 6,11,16,18), and nonavalent (6,11,16,18,31,33,45,52,58) targeting between 2 and 7 oncogenic HPV serotypes. This review highlights the currently epidemiologic burden of HPV-related cancers, efficacy of current HPV vaccines, and speculates about the benefits of widespread HPV vaccination. At present, all three vaccines are effective in reducing cervical disease and anogenital dysplasia in industry sponsored clinical trials and in limited study of clinical effectiveness. Models predict elimination of HPV infection with global vaccination rates of 80% and benefits in reducing malignancy at 20% global coverage. Large population-based clinical efficacy studies of these vaccines will be necessary to assess the true impact of vaccination. HPV vaccines provide a promising primary approach to preventing malignancy and barriers to vaccine access must be addressed to meet vaccination goals.
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Affiliation(s)
- Jessica St Laurent
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Rebecca Luckett
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Sarah Feldman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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Safaeian M, Castellsagué X, Hildesheim A, Wacholder S, Schiffman MH, Bozonnat MC, Baril L, Rosillon D. Risk of HPV-16/18 Infections and Associated Cervical Abnormalities in Women Seropositive for Naturally Acquired Antibodies: Pooled Analysis Based on Control Arms of Two Large Clinical Trials. J Infect Dis 2018; 218:84-94. [PMID: 29718393 PMCID: PMC5989610 DOI: 10.1093/infdis/jiy112] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 04/11/2018] [Indexed: 11/12/2022] Open
Abstract
Background Studies on the role of antibodies produced after infection with human papillomavirus 18 (HPV-18) and subsequent protection from HPV-18 infection have been conflicting, mainly due to inadequate sample size. Methods We pooled data from the control arms of the Costa Rica Vaccine Trial and the PATRICIA trial. Using Poisson regression we compared the risk of newly detected 1-time HPV-18 infection, HPV-18 1-year persistent infection (12MPI), and HPV-18-associated atypical squamous cells of undetermined significance or greater (ASC-US+) lesions between HPV-18 seropositive and seronegative women. Results High HPV-18 antibodies at enrollment was associated with reduced subsequent HPV-18 detection (P trend = 0.001; relative rate [RR] = 0.69; 95% confidence interval [CI], 0.47-1.01 for the third quartile; RR = 0.63; 95% CI, 0.43-0.94 for the fourth quartile, compared to seronegative). The risk of 12MPI showed a decreasing trend with increasing antibodies (P trend = 0.06; RR = 0.72; 95% CI, 0.29-1.77; RR = 0.42; 95% CI, 0.13-1.32 for the third and fourth quartiles, respectively). Lastly, we observed a significant decreased risk of HPV-18 ASC-US+ with increasing antibody (P trend = 0.01; RR = 0.46; 95% CI, 0.21-0.97 for the fourth quartile). We also observed a significant decreased risk of HPV-16 infection, 12MPI, and ASC-US+ with increasing HPV-16 antibody level. Conclusions High HPV-18 naturally acquired antibodies were associated with partial protection from future HPV-18 infections and associated lesions. Clinical Trials Registration NCT00128661 and NCT001226810.
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Affiliation(s)
- Mahboobeh Safaeian
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Xavier Castellsagué
- Cancer Epidemiology Research Program, Catalan Institute of Oncology, Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
- Centros de Investigación Biomédica en Red, Epidemiología y Salud Pública, Madrid, Spain
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Sholom Wacholder
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mark H Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Beachler DC, Pinto LA, Kemp TJ, Nyitray AG, Hildesheim A, Viscidi R, Schussler J, Kreimer AR, Giuliano AR. An Examination of HPV16 Natural Immunity in Men Who Have Sex with Men (MSM) in the HPV in Men (HIM) Study. Cancer Epidemiol Biomarkers Prev 2018; 27:496-502. [PMID: 29475967 PMCID: PMC5884716 DOI: 10.1158/1055-9965.epi-17-0853] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/11/2017] [Accepted: 02/02/2018] [Indexed: 01/10/2023] Open
Abstract
Background: Evidence suggests that natural antibodies developed after HPV16 infection may protect some women but not men against subsequent HPV16 reacquisition. Less is known whether antibodies developed following HPV16 infection are protective among men who have sex with men (MSM).Methods: Four hundred seventy-five MSM from the Human Papillomavirus Infection in Men (HIM) study were tested for serum antibodies to HPV16 L1 using enzyme-linked immunosorbent assays, and for anal and genital HPV16 DNA using PCR consensus primer system (PGMY 09/11). Adjusted Cox regression was used to evaluate whether baseline HPV16 seropositivity impacts subsequent genital or anal HPV16 DNA.Results: The risk of subsequent genital HPV16 [aHR = 1.05, 95% confidence interval (CI) = 0.66-1.68] and anal HPV16 infections among MSM (aHR = 2.34, 95% CI = 0.92-5.98) was similar or nonsignificantly higher in HPV16-seropositive than HPV16-seronegative MSM. The risk of genital HPV16 was also similar between HPV16-seronegative and HPV16-seropositive MSM in the highest tertile of HPV16 antibody levels and when restricting to those with new sex partners during follow-up (P > 0.20). Among the 118 MSM who were HPV16 seropositive, 90% remained HPV16 seropositive up to 4 years later. When tested together, MSM with the highest antibody titers (top tertile) had similar levels to females (mean = 130.3 vs. 134.5 EU/mL, P = 0.84).Conclusions: Despite years of HPV16 seropositivity persistence and antibody titers comparable with females, this study suggested no evidence of HPV16 natural antibodies protecting against subsequent genital or anal HPV16 infection in MSM.Impact: This could help partially explain the high incidence of genital and anal HPV16 infection and related anal cancer seen in middle-aged and older MSM. Cancer Epidemiol Biomarkers Prev; 27(4); 496-502. ©2018 AACR.
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Affiliation(s)
- Daniel C Beachler
- Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, Maryland.
- Safety and Epidemiology Research, HealthCore Inc., Wilmington, Delaware
| | - Ligia A Pinto
- HPV Immunology Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Troy J Kemp
- HPV Immunology Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Alan G Nyitray
- Division of Epidemiology, Human Genetics, and Environmental Science, University of Texas School of Public Health, Houston, Texas
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, Maryland
| | - Raphael Viscidi
- Department of Pediatrics and Neurovirology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Aimée R Kreimer
- Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, Maryland
| | - Anna R Giuliano
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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Marra E, Kroone N, Freriks E, van Dam CL, Alberts CJ, Hogewoning AA, Bruisten S, van Dijk A, Kroone MM, Waterboer T, Schim van der Loeff MF. Vaginal and anal human papillomavirus infection and seropositivity among female sex workers in Amsterdam, the Netherlands: Prevalence, concordance and risk factors. J Infect 2017; 76:393-405. [PMID: 29289562 DOI: 10.1016/j.jinf.2017.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 12/15/2017] [Accepted: 12/20/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND We studied prevalence, risk factors and concordance of vaginal and anal HPV infection and L1 seropositivity among female sex workers (FSW) in Amsterdam. METHODS In 2016, FSW aged ≥18 years having a sexually transmitted infections (STI) consultation were invited to participate. Participation entailed taking vaginal and anal self-swabs. Demographics and sexual behaviour data were collected. HPV DNA was analysed using the SPF10-PCR-DEIA-LiPA25-system-v1. Serum was tested for HPV L1 antibodies using multiplex serology assays. Determinants of vaginal and anal high risk HPV (hrHPV) infection and L1 seropositivity were assessed with logistic regression analyses. RESULTS We included 304 FSW; median age was 29 years (IQR 25-37). Vaginal and anal hrHPV prevalence were 46% and 55%, respectively. HrHPV L1 seropositivity was 37%. Vaginal-anal hrHPV concordance was strong, but no significant association between vaginal or anal hrHPV infection and seropositivity was found. Having had anal sexual contact was not associated with anal hrHPV infection (P = 0.119). DISCUSSION Vaginal and anal hrHPV prevalence is high among FSW in Amsterdam, the Netherlands. Promotion of HPV vaccination, preferably at the beginning of the sex (work) career, may be a useful prevention method against hrHPV infection and disease.
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Affiliation(s)
- E Marra
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - N Kroone
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - E Freriks
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - C L van Dam
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - C J Alberts
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - A A Hogewoning
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands; Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - S Bruisten
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands; Amsterdam Infection and Immunity Institute (AIII), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A van Dijk
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - M M Kroone
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - T Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands; Amsterdam Infection and Immunity Institute (AIII), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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Recurring infection with ecologically distinct HPV types can explain high prevalence and diversity. Proc Natl Acad Sci U S A 2017; 114:13573-13578. [PMID: 29208707 DOI: 10.1073/pnas.1714712114] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The high prevalence of human papillomavirus (HPV), the most common sexually transmitted infection, arises from the coexistence of over 200 genetically distinct types. Accurately predicting the impact of vaccines that target multiple types requires understanding the factors that determine HPV diversity. The diversity of many pathogens is driven by type-specific or "homologous" immunity, which promotes the spread of variants to which hosts have little immunity. To test for homologous immunity and to identify mechanisms determining HPV transmission, we fitted nonlinear mechanistic models to longitudinal data on genital infections in unvaccinated men. Our results provide no evidence for homologous immunity, instead showing that infection with one HPV type strongly increases the risk of infection with that type for years afterward. For HPV16, the type responsible for most HPV-related cancers, an initial infection increases the 1-year probability of reinfection by 20-fold, and the probability of reinfection remains 14-fold higher 2 years later. This increased risk occurs in both sexually active and celibate men, suggesting that it arises from autoinoculation, episodic reactivation of latent virus, or both. Overall, our results suggest that high HPV prevalence and diversity can be explained by a combination of a lack of homologous immunity, frequent reinfections, weak competition between types, and variation in type fitness between host subpopulations. Because of the high risk of reinfection, vaccinating boys who have not yet been exposed may be crucial to reduce prevalence, but our results suggest that there may also be large benefits to vaccinating previously infected individuals.
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Leung TF, Liu APY, Lim FS, Thollot F, Oh HML, Lee BW, Rombo L, Tan NC, Rouzier R, De Simoni S, Suryakiran P, Hezareh M, Thomas F, Folschweiller N, Struyf F. Comparative immunogenicity and safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine and 4vHPV vaccine administered according to two- or three-dose schedules in girls aged 9-14 years: Results to month 36 from a randomized trial. Vaccine 2017; 36:98-106. [PMID: 29174109 DOI: 10.1016/j.vaccine.2017.11.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/26/2017] [Accepted: 11/13/2017] [Indexed: 12/20/2022]
Abstract
This observer-blind study (clinicaltrials.gov NCT01462357) compared the immunogenicity and safety of two doses (2D) of the HPV-16/18 AS04-adjuvanted vaccine (2D of AS04-HPV-16/18) vs. two or three doses of the 4vHPV vaccine [2D or 3D of 4vHPV] in 1075 healthy girls aged 9-14 years. Girls were randomized (1:1:1) to receive 2D of AS04-HPV-16/18 at months (M) 0, 6 (N = 359), 2D of 4vHPV at M0, 6 (N = 358) or 3D of 4vHPV at M0, 2, 6 (N = 358). 351, 339 and 346 girls, respectively, returned for the concluding visit at M36. Superiority was demonstrated at M7 and M12; comparison of the immune response to both vaccine antigens was made between 2D of AS04-HPV-16/18 and 2D or 3D of 4vHPV at subsequent time points in the according-to-protocol immunogenicity cohort (ATP-I; N = 958 at M36) and the total vaccinated cohort (TVC: N = 1036 at M36). HPV-16/18-specific T-cell- and B-cell-mediated immune responses and safety were also investigated. At M36, anti-HPV-16/18 ELISA responses in the 2D AS04-HPV-16/18 group remained superior to those of the 2D and 3D 4vHPV groups. In the M36 TVC, geometric mean titers were 2.78-fold (HPV-16) and 6.84-fold (HPV-18) higher for 2D of AS04-HPV-16/18 vs. 2D of 4vHPV and 2.3-fold (HPV-16) and 4.14-fold (HPV-18) higher vs. 3D of 4vHPV. Results were confirmed by vaccine pseudovirion-based neutralisation assay. Numbers of circulating CD4+ T cells and B cells appeared similar across groups. Safety was in line with the known safety profiles of both vaccines. In conclusion, superior HPV-16/18 antibody responses were elicited by 2D of the AS04-HPV-16/18 compared with 2D or 3D of the 4vHPV vaccine in girls aged 9-14 years. CLINICAL TRIAL REGISTRATION NCT0146235.
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Affiliation(s)
- Ting Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Anthony Pak-Yin Liu
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Fong Seng Lim
- National Healthcare Group Polyclinics and National University of Singapore, Singapore
| | - Franck Thollot
- Association Française de Pédiatrie Ambulatoire (AFPA), Essey Les Nancy, France
| | - Helen May Lin Oh
- Division of Infectious Disease, Changi General Hospital, Singapore
| | - Bee Wah Lee
- Mount Elizabeth Medical Centre and National University of Singapore, Singapore
| | - Lars Rombo
- Centre for Clinical Research, Sormland County Council, Uppsala University and Karolinska Institute, Stockholm, Sweden
| | - Ngiap Chuan Tan
- SingHealth Polyclinics and DUKE-NUS Graduate Medical School, Singapore, Singapore
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Eldridge RC, Pawlita M, Wilson L, Castle PE, Waterboer T, Gravitt PE, Schiffman M, Wentzensen N. Smoking and subsequent human papillomavirus infection: a mediation analysis. Ann Epidemiol 2017; 27:724-730.e1. [PMID: 29107447 DOI: 10.1016/j.annepidem.2017.10.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/24/2017] [Accepted: 10/02/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE Smoking is an established risk factor for a human papillomavirus (HPV) infection advancing to cervical precancer and cancer, but its role earlier in the natural history is less clear. Smoking is inversely associated with possessing HPV antibodies from a past infection suggesting that smoking may influence acquiring subsequent infections. METHODS In a cohort of 1976 U.S. women, we evaluate whether reduced antibodies to HPV-16 is a mechanism for smoking's role on acquiring a subsequent HPV-16 infection, through the analytic technique of causal mediation analysis. We posit a causal model and estimate two counterfactually defined effects: a smoking impaired antibody-mediated indirect effect and a nonmediated direct effect representing all other potential mechanisms of smoking. RESULTS Compared to never smokers, current smokers had increased odds of HPV-16 infection by the antibody-mediated indirect effect (odds ratio [OR] = 1.29; 95% confidence interval [CI]: 1.11, 1.73); the estimated direct effect was very imprecise (OR = 0.57; 95% CI, 0.26-1.13). We observed a stronger estimated indirect effect among women who smoked at least half a pack of cigarettes daily (OR = 1.61, 95% CI, 1.27-2.15) than among women who smoked less than that threshold (OR = 1.09; 95% CI, 0.94-1.44). CONCLUSIONS This is the first study to directly test the mechanism underlying smoking as an HPV cofactor. The results support current smoking as a risk factor earlier in the natural history of HPV and are consistent with the hypothesis that smoking increases the risk of a subsequent infection by reducing immunity.
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Affiliation(s)
- Ronald C Eldridge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
| | | | - Lauren Wilson
- National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | | | | | | | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Natural History of HPV Infection across the Lifespan: Role of Viral Latency. Viruses 2017; 9:v9100267. [PMID: 28934151 PMCID: PMC5691619 DOI: 10.3390/v9100267] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 12/15/2022] Open
Abstract
Large-scale epidemiologic studies have been invaluable for elaboration of the causal relationship between persistent detection of genital human papillomavirus (HPV) infection and the development of invasive cervical cancer. However, these studies provide limited data to adequately inform models of the individual-level natural history of HPV infection over the course of a lifetime, and particularly ignore the biological distinction between HPV-negative tests and lack of infection (i.e., the possibility of latent, undetectable HPV infection). Using data from more recent epidemiological studies, this review proposes an alternative model of the natural history of genital HPV across the life span. We argue that a more complete elucidation of the age-specific probabilities of the alternative transitions is highly relevant with the expanded use of HPV testing in cervical cancer screening. With routine HPV testing in cervical cancer screening, women commonly transition in and out of HPV detectability, raising concerns for the patient and the provider regarding the source of the positive test result, its prognosis, and effective strategies to prevent future recurrence. Alternative study designs and analytic frameworks are proposed to better understand the frequency and determinants of these transition pathways.
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Damm O, Horn J, Mikolajczyk RT, Kretzschmar MEE, Kaufmann AM, Deleré Y, Ultsch B, Wichmann O, Krämer A, Greiner W. Cost-effectiveness of human papillomavirus vaccination in Germany. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2017; 15:18. [PMID: 28878573 PMCID: PMC5583986 DOI: 10.1186/s12962-017-0080-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 08/23/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the cost-effectiveness of human papillomavirus (HPV) vaccination in addition to the current cervical cancer screening programme in Germany using a dynamic transmission model. METHODS Based on a mathematical model simulating the transmission dynamics and the natural history of HPV infection and associated diseases (cervical intraepithelial neoplasia, cervical cancer, and genital warts), we estimated the epidemiological and economic consequences of HPV vaccination with both the quadrivalent and bivalent vaccines. In our base case analysis, we assessed the cost-effectiveness of vaccinating 12-year-old girls with a 3-dose schedule. In sensitivity analysis, we also evaluated the use of a 2-dose schedule and assessed the impact of vaccinating boys. RESULTS From a health care payer perspective, incremental cost-effectiveness ratios (ICERs) of a 3-dose schedule were €34,249 per quality-adjusted life year (QALY) for the bivalent and €14,711 per QALY for the quadrivalent vaccine. Inclusion of indirect costs decreased ICERs by up to 40%. When adopting a health care payer perspective, ICERs of a 2-dose approach decreased to €19,450 per QALY for the bivalent and to €3645 per QALY for the quadrivalent vaccine. From a societal perspective, a 2-dose approach using the quadrivalent vaccine was a cost-saving strategy while using the bivalent vaccine resulted in an ICER of €13,248 per QALY. Irrespective of the perspective adopted, additional vaccination of boys resulted in ICERs exceeding €50,000 per QALY, except for scenarios with low coverage (20%) in girls. CONCLUSIONS Our model results suggest that routine HPV vaccination of 12-year-old girls with three doses is likely to be cost-effective in Germany. Due to the additional impact on genital warts, the quadrivalent vaccine appeared to be more cost-effective than the bivalent vaccine. A 2-dose schedule of the quadrivalent vaccine might even lead to cost savings when adopting a societal perspective. The cost-effectiveness of additional vaccination of boys was highly dependent on the coverage in girls.
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Affiliation(s)
- Oliver Damm
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Johannes Horn
- Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Rafael T. Mikolajczyk
- Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Centre for Infection Research, Site Hannover-Braunschweig, Hannover/Braunschweig, Germany
| | - Mirjam E. E. Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Centre for Infectious Disease Control, RIVM, Bilthoven, The Netherlands
| | - Andreas M. Kaufmann
- Gynecologic Tumor Immunology, Clinic for Gynecology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Ole Wichmann
- Immunisation Unit, Robert Koch Institute, Berlin, Germany
| | - Alexander Krämer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Wolfgang Greiner
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615 Bielefeld, Germany
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Sudenga SL, Torres BN, Botha MH, Zeier M, Abrahamsen ME, Glashoff RH, Engelbrecht S, Schim Van der Loeff MF, Van der Laan LE, Kipping S, Taylor D, Giuliano AR. HPV SEROSTATUS PRE- AND POST-VACCINATION IN A RANDOMIZED PHASE II PREPAREDNESS TRIAL AMONG YOUNG WESTERN CAPE, SOUTH AFRICAN WOMEN: THE EVRI TRIAL. PAPILLOMAVIRUS RESEARCH 2017; 3:50-56. [PMID: 28480334 PMCID: PMC5417542 DOI: 10.1016/j.pvr.2017.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background HPV antibodies are a marker of past exposure to the virus. Our objective was to assess HPV serostatus pre- and post-vaccination among HIV-negative women. Methods Women aged 16–24 years old were randomized in a placebo controlled trial utilizing the 4-valent HPV (4vHPV) vaccine (NCT01489527, clinicaltrials.gov). Participants (n=389) received the 4vHPV vaccine or placebo following a three dose schedule. Sera were collected at Day 1 and Month 7 for assessment of HPV 6, 11, 16, and 18 neutralizing antibody levels using a multiplex competitive Luminex immunoassay (Merck) based on detecting the L1 capsid antigen for each HPV type. Results Seroprevalence was 73% for HPV6, 47% for HPV11, 33% for HPV16, and 44% for HPV18. Seroprevalence for any HPV type did not significantly differ by age or lifetime number of partners. The majority of participants (64%) had two or more 4vHPV antibodies present at enrollment and 12% had antibodies to all four. Among women in the vaccine arm, those that were seropositive for HPV16 at enrollment had higher titers at month 7 compared to women that were seronegative for HPV16 at enrollment; this trend holds for the other HPV types as well. Seroconversion among baseline seronegative participants in the placebo group ranged from 5% for HPV16 to 23% for HPV6. Conclusion HPV seroprevalence was high in this population, emphasizing the need to vaccinate prior to sexual debut.
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Affiliation(s)
- Staci L Sudenga
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - B Nelson Torres
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Matthys H Botha
- Department of Obstetrics and Gynaecology and Unit for Gynaecological Oncology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - Michele Zeier
- Department of Medicine and Centre for Infectious Diseases, Stellenbosch University, Cape Town, South Africa
| | - Martha E Abrahamsen
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Richard H Glashoff
- Division of Medical Virology, Stellenbosch University and NHLS Tygerberg, Cape Town, South Africa
| | - Susan Engelbrecht
- Division of Medical Virology, Stellenbosch University and NHLS Tygerberg, Cape Town, South Africa
| | | | - Louvina E Van der Laan
- Department of Obstetrics and Gynaecology and Unit for Gynaecological Oncology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - Siegfried Kipping
- Department of Obstetrics and Gynaecology and Unit for Gynaecological Oncology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | | | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
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Van Effelterre TP, Hogea C, Taylor SM. Projected impact of Cervarix™ vaccination on oncogenic human papillomavirus infection and cervical cancer in the United Kingdom. Hum Vaccin Immunother 2016; 12:8-19. [PMID: 26090944 PMCID: PMC5155626 DOI: 10.1080/21645515.2015.1054584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
We developed a dynamic compartmental model to assess the impact of HPV Universal Mass
Vaccination (UMV) with Cervarix™, which offers protection against
HPV16/18 and cross-protection against other cancer-causing types, using up-to-date
efficacy data. Analyses were performed in the UK because of the large amount of high
quality epidemiological data available. For each HPV type/group of types considered, the
model was calibrated to 14 epidemiological datasets (prevalence of HPV infection, cervical
intraepithelial neoplasia (CIN): CIN1, CIN2, CIN3 pre-screening and cervical cancer (CC)
incidence over 10 y post-screening). Impacts of cross-protection, female catch-up
vaccination, and additional male vaccination on oncogenic infections, high-grade CIN
(CIN2+) and CC were evaluated. Our results show that female UMV with 80%
coverage and cross-protection against high-risk types resulted in 81% CIN2+
and 88% CC reductions vs. 57% and 75%, respectively, without
cross-protection. Vaccinating 40% of males and 80% of females was equivalent
to 90% female-only coverage regarding CIN2+ (87% and 87%,
respectively) and CC (93% and 94%, respectively) reductions. Female-only
coverage of 80% substantially reduced male HPV16 and 18 infection due to herd
protection (74% and 89%, respectively). Increasing female coverage to
90% reduced HPV16 and HPV18 infections in males relatively similarly to 80%
female combined with 40% male coverage. Model outcomes strengthen previous
conclusions about the significant added value of Cervarix™
cross-protection for CC prevention, the primary HPV vaccination public health priority.
Regarding female CC prevention and male HPV16/18 infection, small increases in female
coverage induce similar benefits to those achieved by additionally vaccinating men with
40% coverage.
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Affiliation(s)
| | - Cosmina Hogea
- b GSK Vaccines; Global Epidemiology ; King of Prussia , PA USA
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Race is Associated With Sexual Behaviors and Modifies the Effect of Age on Human Papillomavirus Serostatus Among Perimenopausal Women. Sex Transm Dis 2016; 43:231-7. [PMID: 26967299 DOI: 10.1097/olq.0000000000000426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) causes oropharyngeal and cervical cancers. Oropharyngeal cancer primarily affects whites, but cervical cancer is more common among blacks. Reasons for this distinct epidemiology are unclear. METHODS Serum was collected from women aged 35 to 60 years in the HPV in Perimenopause cohort and evaluated for antibodies to 8 HPV types. Demographic and behavioral data were collected by telephone questionnaire. Associations between sexual behaviors, race, age, HPV serostatus, and strength of serologic response to HPV were evaluated. RESULTS There were 781 women in this analysis, including 620 white (79%) and 161 (21%) black women. Whites were less likely to report 5+ vaginal sex partners (prevalence ratio [PR], 0.86; 95% confidence interval [CI], 0.77-0.97), but more likely to report 5+ oral sex partners (PR, 2.38; 95% CI, 1.62-3.49) compared with blacks. Seropositivity to most individual HPV types and at least 3 types was significantly lower in whites than in blacks (PR, 0.62; 95% CI, 0.47-0.80). Human papillomavirus seropositivity was independently associated with younger age among blacks, but with sexual exposures among whites. Furthermore, strength of serologic response to most HPV types significantly decreased with older age among blacks, but not among whites. CONCLUSIONS Racial differences in immune markers of HPV exposure and the epidemiology of HPV-related cancers may be linked to differences in patterns of sexual behaviors.
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Gender and age-specific seroprevalence of human papillomavirus 16 and 18 in general population in Tehran, Iran. Med Microbiol Immunol 2016; 206:105-110. [PMID: 27858157 DOI: 10.1007/s00430-016-0487-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 11/10/2016] [Indexed: 12/13/2022]
Abstract
The assessment of the gender and age-specific seroprevalence of human papillomavirus (HPV) is essential for planning of HPV vaccine implementation into the preventive programs. In this study, we aimed to determine the age-specific seroprevalence of HPV-16 and 18 in both males and females in Tehran, Iran. Three hundred and seventy-eight women (10-35 years) and 162 men (10-25 years) from Tehran, Iran, were enrolled. Anti-HPV IgG antibodies against HPV-16 and HPV-18 were detected by ELISA using papillomavirus type 16 and 18 L1-capsids as antigen. HPV-16 antibody was detected in 15.6 and 13.6% of women and men, respectively. Antibody against HPV-18 was found positive in 12.7 and 8% of women and men, respectively. The highest seroprevalence of HPV-16 and 18 were seen in women aged 26-30 years (22.2 and 19.4%, respectively), and the lowest HPV-16 and 18 seropositivity rates were seen in males and females aged 10-15 years (9.3 and 1.9%, respectively). In our cohort of study, in males, both anti-HPV-16 and 18 increased after age 15 years, peaking in men aged 21-25 years. In women, both HPV-16 and 18 seropositivity increased after 15 years, declined at 21-25 years, peaked in women aged 26-30 years and again decreased after 30 years. Our data showed increasing exposure rate to high-risk HPV vaccine types in our studied population over 15 years of age. In order to prevent the HPV-related cancers, implementation of HPV vaccine into the national immunization program in Iran and vaccination of females and males less than 15 years of age are suggested.
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Ermel AC, Fife KH. Human Papillomavirus DNA Detection in Older Women-Implications for Cancer Screening and Prevention. J Infect Dis 2016; 214:657-8. [PMID: 27009603 DOI: 10.1093/infdis/jiw075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 02/19/2016] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Kenneth H Fife
- Department of Medicine Department of Microbiology and Immunology Department of Pathology, Indiana University School of Medicine, Indianapolis
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Hettmann A, Demcsák A, Decsi G, Bach Á, Pálinkó D, Rovó L, Nagy K, Takács M, Minarovits J. Infectious Agents Associated with Head and Neck Carcinomas. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 897:63-80. [PMID: 26563307 DOI: 10.1007/5584_2015_5005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In addition to traditional risk factors such as smoking habits and alcohol consumption, certain microbes also play an important role in the generation of head and neck carcinomas. Infection with high-risk human papillomavirus types is strongly associated with the development of oropharyngeal carcinoma, and Epstein-Barr virus appears to be indispensable for the development of non-keratinizing squamous cell carcinoma of the nasopharynx. Other viruses including torque teno virus and hepatitis C virus may act as co-carcinogens, increasing the risk of malignant transformation. A shift in the composition of the oral microbiome was associated with the development of oral squamous cell carcinoma, although the causal or casual role of oral bacteria remains to be clarified. Conversion of ethanol to acetaldehyde, a mutagenic compound, by members of the oral microflora as well as by fungi including Candida albicans and others is a potential mechanism that may increase oral cancer risk. In addition, distinct Candida spp. also produce NBMA (N-nitrosobenzylmethylamine), a potent carcinogen. Inflammatory processes elicited by microbes may also facilitate tumorigenesis in the head and neck region.
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Affiliation(s)
- Andrea Hettmann
- Division of Virology, National Center for Epidemiology, Albert F. ut 2-6, H-1097, Budapest, Hungary
| | - Anett Demcsák
- Faculty of Dentistry, Department of Oral Biology and Experimental Dental Research, University of Szeged, Szeged, Hungary
| | - Gábor Decsi
- Department of Oral Surgery, University of Szeged, Tisza Lajos krt. 64, H-6720, Szeged, Hungary
| | - Ádám Bach
- Faculty of Medicine, Department of Oto-Rhino-Laryngology and Head-Neck Surgery, University of Szeged, Tisza L. krt. 111, H-6725, Szeged, Hungary
| | - Dóra Pálinkó
- Faculty of Medicine, Department of Oto-Rhino-Laryngology and Head-Neck Surgery, University of Szeged, Tisza L. krt. 111, H-6725, Szeged, Hungary
| | - László Rovó
- Faculty of Medicine, Department of Oto-Rhino-Laryngology and Head-Neck Surgery, University of Szeged, Tisza L. krt. 111, H-6725, Szeged, Hungary
| | - Katalin Nagy
- Department of Oral Surgery, University of Szeged, Tisza Lajos krt. 64, H-6720, Szeged, Hungary
| | - Mária Takács
- Division of Virology, National Center for Epidemiology, Albert F. ut 2-6, H-1097, Budapest, Hungary
| | - Janos Minarovits
- Faculty of Dentistry, Department of Oral Biology and Experimental Dental Research, University of Szeged, Szeged, Hungary.
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Pamnani SJ, Sudenga SL, Viscidi R, Rollison DE, Torres BN, Ingles DJ, Abrahamsen M, Villa LL, Lazcano-Ponce E, Salmeron J, Quiterio M, Huang Y, Borenstein A, Giuliano AR. Impact of Serum Antibodies to HPV Serotypes 6, 11, 16, and 18 to Risks of Subsequent Genital HPV Infections in Men: The HIM Study. Cancer Res 2016; 76:6066-6075. [PMID: 27535333 DOI: 10.1158/0008-5472.can-16-0224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 07/18/2016] [Indexed: 11/16/2022]
Abstract
Naturally induced serum antibodies against human papillomavirus (HPV) may affect risks of subsequent incident genital infections by HPV 6, 11, 16, or 18 in men. In this study, we examined the hypothesis by following 4,123 healthy men every 6 months (median follow-up time, 4.1 years). HPV antibodies were measured at baseline using a virus-like particle-based ELISA assay. Genital HPV genotypes were detected using Roche Linear Array. Incidence proportions and 6-month persistence proportions were calculated at 6-month intervals. Kaplan-Meier curves and Cox models were used to assess genotype-specific cumulative incidence and HRs, respectively. HPV 6, 11, 16, and 18 seroprevalence was 8.1%, 13.9%, 12.7%, and 10.8%, respectively. Significantly higher rates of incident infections were observed for HPV 16 among baseline-seropositive men [adjusted HR, 1.37; 95% confidence interval (CI), 1.01-1.86], with similar but nonsignificant HRs for 6-month persistent infections. Risk of persistent HPV 18 infection was significantly lower among seropositive men in the unadjusted model (HR, 0.22; 95% CI, 0.06-0.91), but not in the adjusted model (HR, 0.19; 95% CI, 0.03-1.37). Incident and 6-month persistent infections for HPV 6 and 11 did not differ by baseline serostatus. Baseline serostatus among men was not associated with a reduction in subsequent incident genital HPV 6, 11, and 16 infections. However, protection against persistent HPV18 infections was observed in unadjusted models. Our research suggests a need of further studies to examine the potentially protective effects of naturally induced HPV18 antibodies in men. Cancer Res; 76(20); 6066-75. ©2016 AACR.
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Affiliation(s)
- Shitaldas J Pamnani
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida. Department of Epidemiology and Biostatistics, University of South Florida, Tampa, Florida
| | - Staci L Sudenga
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Raphael Viscidi
- Department of Pediatrics and Neurovirology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Dana E Rollison
- Department of Epidemiology and Biostatistics, University of South Florida, Tampa, Florida. Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - B Nelson Torres
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Donna J Ingles
- Vanderbilt Institute for Global Health, Nashville, Tennessee
| | - Martha Abrahamsen
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Luisa L Villa
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Yangxin Huang
- Department of Epidemiology and Biostatistics, University of South Florida, Tampa, Florida
| | - Amy Borenstein
- Department of Epidemiology and Biostatistics, University of South Florida, Tampa, Florida
| | - Anna R Giuliano
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
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Fu TCJ, Carter JJ, Hughes JP, Feng Q, Hawes SE, Schwartz SM, Xi LF, Lasof T, Stern JE, Galloway DA, Koutsky LA, Winer RL. Re-detection vs. new acquisition of high-risk human papillomavirus in mid-adult women. Int J Cancer 2016; 139:2201-12. [PMID: 27448488 DOI: 10.1002/ijc.30283] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/29/2016] [Accepted: 07/11/2016] [Indexed: 01/24/2023]
Abstract
To understand high-risk (hr) human papillomavirus (HPV) epidemiology in mid-adulthood, we assessed whether associations between incident detection of hrHPV DNA and recent sexual behavior differed according to whether or not there was serologic evidence of prior infection. From 2011 to 2012, we enrolled 409 women aged 30-50 years into a 6-month longitudinal study. We collected health and sexual behavior histories, enrollment sera for HPV antibody testing, and monthly self-collected vaginal swabs for HPV DNA genotyping. Generalized estimating equations logistic regression identified risk factors for type-specific incident hrHPV DNA, stratified by type-specific hrHPV serostatus at enrollment. Population attributable risks of hrHPV due to prior and recent exposure were estimated. When type-specific hrHPV serology was negative, recent sexual risk behavior was positively associated with incident hrHPV DNA (odds ratio in women reporting ≥3 recent sexual risk behaviors [e.g., new or multiple partners] vs. no recent sexual activity = 9.8, 95% CI: 2.4-40.6). No associations with recent sexual behavior were observed with positive type-specific hrHPV serology. Thirty percent of incident hrHPV DNA detection was attributable to prior infection (with positive serology) and 40% was attributable to recent sexual risk behavior (with negative serology). The proportion of incident hrHPV DNA detection attributable to recent sexual risk behavior decreased with increasing age. Among women with serologic evidence of prior infection, re-detection of the same hrHPV type is likely due to reactivation or intermittent detection of persistent infection. Without serologic evidence of prior infection, new detection is likely due to new acquisition or to intermittent detection of persisting infection.
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Affiliation(s)
| | | | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, 98195
| | | | - Stephen E Hawes
- Department of Epidemiology, University of Washington, Seattle, WA, 98195
| | - Stephen M Schwartz
- Department of Epidemiology, University of Washington, Seattle, WA, 98195.,Fred Hutchinson Cancer Research Center, Seattle, WA, 98109
| | - Long Fu Xi
- Department of Pathology, University of Washington, Seattle, WA, 98195
| | - Taylor Lasof
- University of California San Diego, La Jolla, CA, 92093
| | - Joshua E Stern
- Department of Global Health, University of Washington, Seattle, WA, 98195
| | - Denise A Galloway
- Fred Hutchinson Cancer Research Center, Seattle, WA, 98109.,Department of Microbiology, University of Washington, Seattle, WA, 98195
| | - Laura A Koutsky
- Department of Epidemiology, University of Washington, Seattle, WA, 98195
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA, 98195.
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47
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Passmore JAS, Williamson AL. Host Immune Responses Associated with Clearance or Persistence of Human Papillomavirus Infections. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2016. [DOI: 10.1007/s13669-016-0163-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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48
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Scherer EM, Smith RA, Gallego DF, Carter JJ, Wipf GC, Hoyos M, Stern M, Thurston T, Trinklein ND, Wald A, Galloway DA. A Single Human Papillomavirus Vaccine Dose Improves B Cell Memory in Previously Infected Subjects. EBioMedicine 2016; 10:55-64. [PMID: 27423190 PMCID: PMC5006801 DOI: 10.1016/j.ebiom.2016.06.042] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 06/24/2016] [Accepted: 06/27/2016] [Indexed: 02/06/2023] Open
Abstract
Although licensed human papillomavirus (HPV) vaccines are most efficacious in persons never infected with HPV, they also reduce infection and disease in previously infected subjects, indicating natural immunity is not entirely protective against HPV re-infection. The aim of this exploratory study was to examine the B cell memory elicited by HPV infection and evaluate whether vaccination merely boosts antibody (Ab) levels in previously infected subjects or also improves the quality of B cell memory. Toward this end, the memory B cells (Bmem) of five unvaccinated, HPV-seropositive subjects were isolated and characterized, and subject recall responses to a single HPV vaccine dose were analyzed. Vaccination boosted Ab levels 24- to 930-fold (median 77-fold) and Bmem numbers 3- to 27-fold (median 6-fold). In addition, Abs cloned from naturally elicited Bmem were generally non-neutralizing, whereas all those isolated following vaccination were neutralizing. Moreover, Ab and plasmablast responses indicative of memory recall responses were only observed in two subjects. These results suggest HPV vaccination augments both the magnitude and quality of natural immunity and demonstrate that sexually active persons could also benefit from HPV vaccination. This study may have important public policy implications, especially for the older 'catch-up' group within the vaccine's target population.
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Affiliation(s)
- Erin M Scherer
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Robin A Smith
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Daniel F Gallego
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Joseph J Carter
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Gregory C Wipf
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Manuela Hoyos
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Michael Stern
- Department of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Tate Thurston
- Panoply Bio, a division of Active Motif, Carlsbad, CA 92008, USA
| | | | - Anna Wald
- Department of Medicine, University of Washington, Seattle, WA 98195, USA; Department of Laboratory Medicine, University of Washington, Seattle, WA 98195, USA; Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Denise A Galloway
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Department of Microbiology, University of Washington, Seattle, WA 98195, USA.
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Madeleine MM, Johnson LG, Doody DR, Tipton ER, Carter JJ, Galloway DA. Natural Antibodies to Human Papillomavirus 16 and Recurrence of Vulvar High-Grade Intraepithelial Neoplasia (VIN3). J Low Genit Tract Dis 2016; 20:257-60. [PMID: 27224532 PMCID: PMC4920724 DOI: 10.1097/lgt.0000000000000227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Approximately 30% of women treated for squamous high-grade intraepithelial neoplasia (VIN3), often associated with human papillomavirus (HPV), have recurrent disease. In this study, we assess predictors of recurrence that may provide targets for early prevention or treatment. MATERIALS AND METHODS Women with VIN3 who participated in a previous population-based case-control study with blood and tumor samples completed a follow-up telephone interview an average of 5 years after initial diagnosis. The risk of recurrence was determined by proportional hazards modeling. RESULTS Women with VIN3 in the follow-up study (n = 65) were similar to women with VIN3 in the parent study (n = 215) with regard to age at primary diagnosis, level of current cigarette smoking (>60%), and lifetime number of partners. We found that 22 (33.8%) of 65 participants had a vulvar recurrence and that 73.4% recurred within 3 years of treatment. Recurrences occurred more often among women with common warts in the decade before diagnosis (hazard ratio [HR] = 2.5, 95% CI = 1.1-5.8) and among those with a previous anogenital cancer (HR = 2.7, 95% CI = 1.2-6.3). Interestingly, recurrence was less frequent among women who mounted a natural antibody response to HPV16 (HR = 0.4, 95% CI = 0.2-0.9). CONCLUSIONS These data provide strong preliminary evidence that VIN3 recurrence was less frequent among those with HPV16 antibodies. Vaccination with the currently licensed HPV vaccine as part of adjunctive therapy for VIN3 would increase antibody response and may decrease risk of recurrence. Randomized controlled trials are needed to determine whether HPV vaccination is effective against VIN3 recurrence.
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Affiliation(s)
- Margaret M. Madeleine
- Public Health Science, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA; Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Microbiology, University of Washington, Seattle, WA
| | - Lisa G. Johnson
- Public Health Science, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA; Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Microbiology, University of Washington, Seattle, WA
| | - David R. Doody
- Public Health Science, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA; Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Microbiology, University of Washington, Seattle, WA
| | - Elaine R. Tipton
- Public Health Science, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA; Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Microbiology, University of Washington, Seattle, WA
| | - Joseph J. Carter
- Public Health Science, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA; Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Microbiology, University of Washington, Seattle, WA
| | - Denise A. Galloway
- Public Health Science, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA; Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Microbiology, University of Washington, Seattle, WA
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50
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Leung TF, Liu APY, Lim FS, Thollot F, Oh HML, Lee BW, Rombo L, Tan NC, Rouzier R, Friel D, De Muynck B, De Simoni S, Suryakiran P, Hezareh M, Folschweiller N, Thomas F, Struyf F. Comparative immunogenicity and safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine and HPV-6/11/16/18 vaccine administered according to 2- and 3-dose schedules in girls aged 9-14 years: Results to month 12 from a randomized trial. Hum Vaccin Immunother 2016; 11:1689-702. [PMID: 26062002 PMCID: PMC4514190 DOI: 10.1080/21645515.2015.1050570] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This observer-blind study (clinicaltrials.gov NCT01462357) compared the immunogenicity and safety of 2 doses of the HPV-16/18 AS04-adjuvanted vaccine (HPV-16/18(2D)) vs. 2 or 3 doses of the HPV-6/11/16/18 vaccine (HPV-6/11/16/18(2D) and HPV-6/11/16/18(3D)) in healthy girls aged 9–14 y. Girls were randomized (1:1:1) to receive HPV-16/18(2D) at months (M) 0,6 (N = 359), HPV-6/11/16/18(2D) at M0,6 (N = 358) or HPV-6/11/16/18(3D) at M0,2,6 (N = 358). The primary objective was non-inferiority/superiority of HPV-16/18 antibodies by ELISA for HPV-16/18(2D) vs. HPV-6/11/16/18(2D) at M7 in the according-to-protocol immunogenicity cohort (ATP-I) and total vaccinated cohort, respectively. Secondary objectives included non-inferiority/superiority of HPV-16/18(2D) vs. HPV-6/11/16/18(3D) at M7, non-inferiority/superiority at M12, HPV-16/18 neutralizing antibodies, frequencies of T-cells/B-cells, reactogenicity and safety. Antibody responses at M7 for HPV-16/18(2D) were superior to those for HPV-6/11/16/18(2D) and HPV-6/11/16/18(3D) (lower limit of 95% confidence interval for geometric mean titer ratio (GMR) was >1): HPV-16/18(2D)/HPV-6/11/16/18(2D) GMRs were 1.69 [1.49–1.91] for anti-HPV-16 and 4.52 [3.97–5.13] for anti-HPV-18; HPV-16/18(2D)/HPV-6/11/16/18(3D) GMRs were 1.72 [1.54–1.93] for anti-HPV-16 and 3.22 [2.82–3.68] for anti-HPV-18; p = 0.0001 for all comparisons. Non-inferiority/superiority was also demonstrated at M12. Among initially seronegative girls in the ATP-I, neutralizing antibody titers were at least 1.8-fold higher for HPV-16/18(2D) vs. HPV-6/11/16/18(2D) and HPV-6/11/16/18(3D) at M7 and M12. Frequencies of HPV-16/18-specific T-cells and B-cells were in similar ranges between groups. Reactogenicity and safety were in line with the known profile of each vaccine. In conclusion, superior HPV-16/18 antibody responses were elicited by 2 doses of the HPV-16/18 AS04-adjuvanted vaccine compared with 2 or 3 doses of the HPV-6/11/16/18 vaccine in girls (9–14 years).
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Key Words
- 2D, 2-dose
- 3D, 3-dose
- AAHS, aluminum hydroxyphosphate sulfate
- ANOVA, analysis of variance
- AS04, Adjuvant System containing 50 µg 3-O-desacyl-4 ′-monophosphoryl lipid A (MPL) adsorbed on aluminum salt (500 µg Al3+)
- ATP-I, according-to-protocol immunogenicity cohort
- CI, confidence interval
- CMI, cell-mediated immunity
- ED50, effective dose producing 50% response
- ELISA, enzyme-linked immunosorbent assay
- ELISPOT, enzyme-linked immunosorbent spot assay
- EU, ELISA unit
- GMR, geometric mean titer ratio
- GMT, geometric mean antibody titer
- HPV, human papillomavirus
- HPV-16/18(2D), 2-dose schedule of the HPV-16/18 vaccine
- HPV-6/11/16/18(2D), 2-dose schedule of the HPV-6/11/16/18 vaccine
- HPV-6/11/16/18(3D), 3-dose schedule of the HPV-6/11/16/18 vaccine
- IFNγ, interferon
- IgG, immunoglobulin G
- M, month(s)
- PBMC, peripheral blood mononuclear cells
- PBNA, pseudovirion-based neutralisation assay
- SAE, serious adverse event
- TVC, total vaccinated cohort
- VLP, virus-like particle
- administration schedule
- female adolescents
- human papillomavirus (HPV) vaccines
- immunogenicity
- pIMD, potential immune-mediated disease
- safety
- y, year(s)
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Affiliation(s)
- Ting Fan Leung
- a Department of Paediatrics ; The Chinese University of Hong Kong ; Shatin , Hong Kong
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