1
|
Amoah S, Yartey AN, Fosu Adjei P, Owusu-Akyaw M, Boachie J, Simpong DL, Adu P. HBV Infection Is an Intermediate-Risk Disease, Whereas Anaemia Is a Mild-to-Moderate Public Health Problem in Young Ghanaian Adults: A Four-Year Retrospective Analysis of Students' Medical Records. BIOMED RESEARCH INTERNATIONAL 2023; 2023:9318984. [PMID: 37475793 PMCID: PMC10356218 DOI: 10.1155/2023/9318984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/22/2023]
Abstract
Background In sub-Saharan Africa, malaria, chronic viral diseases, nutritional deficiencies, and haemoglobinopathies are common causes of anaemia. Continual surveillance data is required to situate the anaemia and infectious disease burden within a given population. This study determined the 4-year trends of anaemia, hepatitis B virus (HBV), and HCV infections and factors associated with anaemia in young Ghanaian adults. Methods This retrospective study analysed the medical records of 21,716 fresh students at the University of Cape Coast. Data was presented as percentages and line graphs to show the yearly trends in anaemia, HBV, and HCV infections. Binary logistic regression was used to determine the increased odds of anaemia in participants. Results Although the 4-year anaemia prevalence was 14.2% (95% CI: 0.1403-0.1498), anaemia prevalence in women and men were 24.1% (95% CI: 0.2387-0.2562) and 6.6% (95% CI:0.0616-0.0705), respectively. Anaemia prevalence consistently remained mild (males) and moderate (females) public health problem over the four-year period. Adolescents were more represented in the anaemic group (18.7% prevalence), 70.9% of them being females. The prevalence of HBV and HCV infections were 5.4% (95% CI:0.0506-0.0567) and 0.9% (95% CI: 0.0082-0.0108), respectively; only 0.1% of participants had HBV and HCV coinfection. Males were more represented in both HBV (71.2%) and HCV (63.7%) infection groups. Moreover, 15.8% of the participants who were seropositive for HBsAg self-reported having previously been vaccinated, suggesting a breakthrough infection and/or vaccine nonresponse. Furthermore, female (COR: 4.545; p < 0.001), teenagers (COR: 1.697; p < 0.001), 20-29 years (COR: 1.221; p = 0.035), and positive sickling slide test (COR: 1.176; p = 0.003) were statistically significantly associated with increased odds of anaemia. Conclusion Intentional preventative public health campaigns regarding anaemia, HBV, and HCV infection should, respectively, target females and young adult males to increase chances of making real change in behavioural attitudes in these at-risk groups.
Collapse
Affiliation(s)
- Samuel Amoah
- University of Cape Coast Hospital Laboratory, Cape Coast, Ghana
| | | | - Praise Fosu Adjei
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
| | - Margaret Owusu-Akyaw
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
| | - Joseph Boachie
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
| | - David Larbi Simpong
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
| |
Collapse
|
2
|
Trevisan A, Wissing MD, Dagenais C, Forest P, Ramanakumar AV, Burchell AN, Franco EL, Coutlée F, Couillard M. Development and evaluation of a new non-competitive Luminex immunoassay detecting antibodies against human papillomavirus types 6, 11, 16 and 18. J Gen Virol 2021; 102. [PMID: 34043499 DOI: 10.1099/jgv.0.001610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Serum antibody levels can be used to measure the humoral immune response against human papillomaviruses (HPV). We developed and validated a rapid, technically simple and relatively inexpensive multiplex non-competitive Luminex-based immunoassay (ncLIA) to measure total IgG antibody levels against four HPV types. For the assay's solid phase, virus-like particles (VLPs) of HPV6, 11, 16 and 18 were bound to heparin-coated beads. HPV serum antibody levels binding to the VLPs were quantified using a phycoerithrin-conjugated secondary polyclonal donkey anti-human IgG antibody. Standardization and validation of the ncLIA were performed using 96 paired serum and genital samples from participants in the HITCH cohort study, including young women (aged 18-24 years) and their male sexual partners (aged 18+) in Montreal, Canada. Results from the ncLIA were compared to a validated Luminex immunoassay from PPD laboratories using Pearson's correlation coefficients, receiver operating characteristic curves and logistic regression. Our assay had good inter- and intra-assay variability. The correlation of serum antibody levels between the ncLIA and validation assay was highest for HPV16 and HPV11 (r=0.90), followed by HPV6 (r=0.86) and HPV18 (r=0.67). The ncLIA was better able to predict HPV DNA positivity in genital samples than the validation assay for HPV16 [area under the curve (AUC) 0.65 versus 0.52, P=0.001] and HPV18 [AUC 0.71 versus 0.57, P=0.024]. AUCs for HPV6 and HPV11 were similar between the two assays (0.70 versus 0.71, P=0.59, and 0.88 versus 0.96, P=0.08, respectively). The developed ncLIA is useful for measuring total IgG antibody response following natural infection or vaccination against four HPV VLPs included in the quadrivalent vaccine.
Collapse
Affiliation(s)
- Andrea Trevisan
- Laboratoire de santé publique du Québec, Institut national de santé publique Québec, 20045 Sainte-Marie Road, Sainte-Anne-de-Bellevue, Quebec, Canada.,Sainte-Justine Hospital Research Center, Université de Montréal, 3175 Côte Sainte-Catherine, Montreal, Quebec, Canada
| | - Michel D Wissing
- Division of Cancer Epidemiology, McGill University, 5100 Boulevard de Maisonneuve West, Suite 720, Quebec H4A 3T2, Montreal, Canada
| | - Carole Dagenais
- Laboratoire de santé publique du Québec, Institut national de santé publique Québec, 20045 Sainte-Marie Road, Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Pierre Forest
- Laboratoire de virologie moléculaire, centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 Saint Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Agnihotram V Ramanakumar
- Division of Cancer Epidemiology, McGill University, 5100 Boulevard de Maisonneuve West, Suite 720, Quebec H4A 3T2, Montreal, 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, 30 Bond Street, Toronto M5B 1T8, Ontario
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, 5100 Boulevard de Maisonneuve West, Suite 720, Quebec H4A 3T2, Montreal, Canada
| | - François Coutlée
- Laboratoire de virologie moléculaire, centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 Saint Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Michel Couillard
- Laboratoire de santé publique du Québec, Institut national de santé publique Québec, 20045 Sainte-Marie Road, Sainte-Anne-de-Bellevue, Quebec, Canada
| |
Collapse
|
3
|
Upadhyay SK, Dan S, Girdhar M, Rastogi K. Recent Advancement in SARS-CoV-2 Diagnosis, Treatment, and Vaccine Formulation: a New Paradigm of Nanotechnology in Strategic Combating of COVID-19 Pandemic. ACTA ACUST UNITED AC 2021; 7:1-14. [PMID: 33552875 PMCID: PMC7854874 DOI: 10.1007/s40495-021-00250-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2021] [Indexed: 02/07/2023]
Abstract
Purpose of Review The coronavirus disease-2019 (COVID-19) is a global pandemic which has not been seen in recent history, leaving behind deep socioeconomic damages and huge human losses with the disturbance in the healthcare sector. Despite the tremendous international effort and the launch of various clinical trials for the containment of this pandemic, no effective therapy has been proven yet. Recent Findings This review has highlighted the different traditional therapeutic techniques, along with the potential contribution of nanomedicine against the severe acute respiratory syndrome corovirus-2 (SARS-CoV-2). Repositioning of the drugs, such as remdesivir and chloroquine, is a rapid process for the reach of safe therapeutics, and the related clinical trials have determined effects against COVID-19. Various protein-based SARS-CoV-2 vaccine candidates have successfully entered clinical phases, determining positive results. The self-assembled and metallic nanovaccines mostly based on the antigenic properties of spike (S) protein are also approachable, feasible, and promising techniques for lowering the viral burden. Summary There are number of NP-based diagnostic systems have been reported for coronaviruses (CoVs) and specifically for SARS-CoV-2. However, extensive studies are still necessary and required for the nanoparticle (NP)-based therapy.
Collapse
Affiliation(s)
- Sushil Kumar Upadhyay
- Department of Biotechnology, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, HR 133207 India
| | - Siddhartha Dan
- Department of Biotechnology, I.K. Gujral Punjab Technical University, Jalandhar, Punjab India
| | - Mansi Girdhar
- Department of Biotechnology, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, HR 133207 India
| | - Kartikey Rastogi
- Department of Pharmacology, KIET Group of Institutions, Ghaziabad, Delhi-NCR 201206 India
| |
Collapse
|
4
|
Lebossé F, Zoulim F. [Hepatitis B vaccine and liver cancer]. Bull Cancer 2020; 108:90-101. [PMID: 33358507 DOI: 10.1016/j.bulcan.2020.10.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 02/06/2023]
Abstract
Hepatitis B Virus (HBV) chronic infection contributes to a high risk of hepatocellular cancer (HCC) development. HBV is a strong cancer inducer, due to natural history of infection, virological characteristics and viral DNA integrations events in host genome. Prolonged infection and high viral loads, particularly frequent in patients infected in childhood, are risk factors of HCC development for patients with HBV chronic infection. A HBV vaccine, based on immunization against the surface protein HBs, showed a strong efficacy to prevent chronic HBV infection. The development of universal neonatal vaccination programmes contributed to the decrease of HBV chronic infection incidence in children of high endemic areas. Although HBs antibodies levels diminished years after vaccination, HBV neonatal vaccination programmes led to a lower incidence of chronic HBV infection among young adults. The decrease of HBV chronic infection incidence was associated to a reduction of HCC incidence in children and young adults from areas with a high prevalence of HBV infection.
Collapse
Affiliation(s)
- Fanny Lebossé
- Hôpital de la Croix-Rousse, hospices civils de Lyon, service d'hépatologie, Lyon, France; Centre de recherche en cancérologie de Lyon, Lyon, France; Université Claude-Bernard Lyon 1, Lyon, France.
| | - Fabien Zoulim
- Hôpital de la Croix-Rousse, hospices civils de Lyon, service d'hépatologie, Lyon, France; Centre de recherche en cancérologie de Lyon, Lyon, France; Université Claude-Bernard Lyon 1, Lyon, France
| |
Collapse
|
5
|
Palestino G, García-Silva I, González-Ortega O, Rosales-Mendoza S. Can nanotechnology help in the fight against COVID-19? Expert Rev Anti Infect Ther 2020; 18:849-864. [PMID: 32574081 DOI: 10.1080/14787210.2020.1776115] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The current COVID-19 pandemic caused by the SARS-CoV-2 virus demands the development of strategies not only to detect or inactivate the virus, but to treat it (therapeutically and prophylactically). COVID-19 is not only a critical threat for the population with risk factors, but also generates a dramatic economic impact in terms of morbidity and the overall interruption of economic activities. AREAS COVERED Advanced materials are the basis of several technologies that could diminish the impact of COVID-19: biosensors might allow early virus detection, nanosized vaccines are powerful agents that could prevent viral infections, and nanosystems with antiviral activity could bind the virus for inactivation or destruction upon application of an external stimulus. Herein all these methods are discussed under the light of cutting-edge technologies and the previously reported prototypes targeting enveloped viruses similar to SARS-CoV-2. This analysis was derived from an extensive scientific literature search (including pubmed) performed on April 2020. EXPERT OPINION Perspectives on how biosensors, vaccines, and antiviral nanosystems can be implemented to fight COVID-19 are envisioned; identifying the approaches that can be implemented in the short term and those that deserve long term research to cope with respiratory viruses-related pandemics in the future.
Collapse
Affiliation(s)
- Gabriela Palestino
- Facultad De Ciencias Químicas, Universidad Autónoma De San Luis Potosí , San Luis Potosí, México.,Sección De Biotecnología, Centro De Investigación En Ciencias De La Salud Y Biomedicina, Universidad Autónoma De San Luis Potosí , San Luis Potosí, México
| | - Ileana García-Silva
- Facultad De Ciencias Químicas, Universidad Autónoma De San Luis Potosí , San Luis Potosí, México.,Sección De Biotecnología, Centro De Investigación En Ciencias De La Salud Y Biomedicina, Universidad Autónoma De San Luis Potosí , San Luis Potosí, México
| | - Omar González-Ortega
- Facultad De Ciencias Químicas, Universidad Autónoma De San Luis Potosí , San Luis Potosí, México
| | - Sergio Rosales-Mendoza
- Facultad De Ciencias Químicas, Universidad Autónoma De San Luis Potosí , San Luis Potosí, México.,Sección De Biotecnología, Centro De Investigación En Ciencias De La Salud Y Biomedicina, Universidad Autónoma De San Luis Potosí , San Luis Potosí, México
| |
Collapse
|
6
|
Li Y, Zhu P, Wu M, Zhang Y, Li L. Immunogenicity and safety of human papillomavirus vaccine coadministered with other vaccines in individuals aged 9-25 years: A systematic review and meta-analysis. Vaccine 2020; 38:119-134. [PMID: 31831220 DOI: 10.1016/j.vaccine.2019.10.092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/09/2019] [Accepted: 10/28/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Adolescents and young adults are at a high risk of developing human papillomavirus (HPV) infections, which can be prevented with the use of vaccines. Moreover, a combined immunization strategy for administration of HPV vaccines with other routine vaccines may lead to better compliance. We aim to comprehensively evaluate immunogenicity and safety in the case of concomitantly administered HPV vaccine in individuals aged 9-25 years. METHODS Relevant studies, published up to December 27, 2018, were identified through searches of Medline/PubMed, EMBASE, Web of Knowledge. The pooled relative risk (RR) of immunogenicity and safety information pertaining to the concomitant administration of HPV vaccines with other routine vaccines in healthy participants aged 9-25 years were evaluated. RESULTS A total of 13 papers (11,657 participants) were included in this meta-analysis. The analyses showed that, between the concomitant and nonconcomitant administration groups, the seroconversion rate for the specific antibodies against all HPV types (type 16-, 18-, 6-, 11-, 31-, 33-, 45-, 52-, and 58) were the same (the pooled RR = 1.00, 95% confidence interval (CI) of 1.00-1.00); for the bivalent HPV (2vHPV) vaccine, the risks of local adverse events showed no significant difference (the pooled RR = 1.00, 95%CI: 0.97-1.04), and the risks of systemic adverse events were almost similar (the pooled RR = 1.10, 95% CI: 1.03-1.18); for the non-bivalent HPV (4vHPV and 9vHPV) vaccines, the risks of local adverse events were slightly higher in the concomitant administration groups (the pooled RR = 1.31, 95%CI: 1.17-1.47), and the risks of systemic adverse events were higher in the concomitant administration groups (the pooled RR = 2.09, 95% CI: 1.69-2.59). CONCLUSIONS We believe that the concomitant administration of other vaccines along with HPV vaccine is acceptable and there is no interference with the immune response to HPV vaccine. Concomitant vaccine administration has the potential to minimize the number of vaccination visits, leading to increased compliance, hence more effective disease prevention.
Collapse
Affiliation(s)
- Yaowei Li
- Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Ministry of Education, Nanning, Guangxi, China; Department of Gynecology and Obstetrics, Shangyu People's Hospital, Shangyu, Zhejiang, China
| | - Pengfei Zhu
- Department of Gynecology and Obstetrics, Shangyu People's Hospital, Shangyu, Zhejiang, China
| | - Meifen Wu
- Department of Gynecology and Obstetrics, Shangyu People's Hospital, Shangyu, Zhejiang, China
| | - Yiqing Zhang
- Department of Gynecology and Obstetrics, Shangyu People's Hospital, Shangyu, Zhejiang, China
| | - Li Li
- Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Ministry of Education, Nanning, Guangxi, China.
| |
Collapse
|
7
|
Goodman EA, Goodpasture M. Human Papilloma Virus Vaccination After Pediatric Sexual Abuse Evaluations in the Outpatient Child Sexual Abuse Subspecialty Clinic: A Quality Improvement Project. JOURNAL OF FORENSIC NURSING 2020; 16:16-21. [PMID: 31567656 DOI: 10.1097/jfn.0000000000000251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The nonavalent human papilloma virus (HPV) vaccination prophylactically contributes to the prevention of nine types of HPV-associated oral and genital cancers. HPV vaccination rates remain lower than the national Healthy People 2020 goal of 80%. Victims of pediatric sexual abuse are at a higher risk for acquiring and developing HPV-related outcomes. Current research supports vaccination after sexual abuse as soon as eligible and suggests utilizing multiple types of medical encounters to increase vaccination rates.An institutional-review-board-approved quality improvement project was developed to determine the impact of promoting and providing HPV vaccination during the medical encounter after pediatric sexual abuse in a child protection team (CPT) clinic. Twenty percent of the 111 total clinic patients evaluated in the preintervention period and 21% of the 99 patients evaluated in the postintervention period were HPV vaccine eligible, illustrating a significant opportunity for impact. During the intervention period, 62% of patients who were vaccine eligible and presented for their CPT clinic visit received HPV vaccine. Barriers to vaccination in the outpatient CPT clinic setting included high appointment no-show rates, high social and medical visit complexity, and absence of an appropriate consenting caretaker. Implications for forensic nursing practice are discussed.
Collapse
Affiliation(s)
- Elizabeth A Goodman
- Author Affiliations: East Carolina University
- Department of Pediatrics, Wake Forest Baptist Medical Center
| | | |
Collapse
|
8
|
Abstract
Introduction: The randomized control trials (RCTs) that resulted in licensure of HPV VLP vaccines used a traditional prime, prime-boost schedule for a subunit protein vaccine. These vaccines delivered predominantly to 9-14-year-old females with this schedule have been shown to be highly effective against vaccine HPV-type disease (CIN and genital warts) and infection. A two-dose prime-boost schedule is immunologically non-inferior to 3 doses in 9-14-year-olds and is currently widely adopted. However, even with a reduced dosage schedule, these vaccines are expensive to buy and expensive and logistically complex to deliver especially in low resource countries that bear the major burden of cervical cancer the most prevalent of HPV caused cancers.Areas covered: Observational studies and post hoc analysis of RCTs show that 1 dose, although immunologically inferior to 2 and 3 doses, is as effective at preventing persistent infection with vaccine HPV types at least for 7-10 years. To address the issue of alternative dosage schedules that include 1 dose either as a single dose or extended 1 + 1 with the second dose 3-5 years post-first dose are under investigation in RCTs.Expert opinion: Since, in the short term, vaccine supplies are constrained and will impact on the ability of countries to implement HPV vaccine programs: the challenges and opportunities of the alternative approaches in this scenario are discussed.
Collapse
|
9
|
Gilca V, Sauvageau C, Panicker G, De Serres G, Schiller J, Ouakki M, Unger ER. Long intervals between two doses of HPV vaccines and magnitude of the immune response: a post hoc analysis of two clinical trials. Hum Vaccin Immunother 2019; 15:1980-1985. [PMID: 31017850 DOI: 10.1080/21645515.2019.1605278] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The objective of this analysis was to compare the anti-HPV GMTs and their distribution after a 6-month or a 3-8 -y interval between two HPV vaccine doses. The results from two clinical trials, conducted by the same team in the same region, with serological assays performed at the same laboratory using the same ELISA methodology were compared. In the first study, 173 9-10-y-old girls and boys received two doses of 9vHPV vaccine at a 6-month interval; in the second study, 31 girls vaccinated with one dose of 4vHPV at the age of 9-14 y received a dose of 9vHPV 3-8 y later (mean 5.4 y). In both studies, blood samples were collected before and 1 month post second dose. Despite large differences in the time since the first dose, all subjects (100%) were seropositive to the common 4 HPV types (6, 11, 16 and 18) to both vaccines, with comparable GMTs and titer distributions before the second dose. One month post second dose, the GMTs increased 40-91-fold for those with a 6-month interval between doses and 60-82-fold for those with a 3-8-y interval. Titer distributions after the booster dose were comparable in the two studies. These results indicate that 2-dose HPV vaccination schedules with an interval of several years could be used for pre-adolescents. Intervals longer than 6 months may facilitate logistics for immunization programs and could be useful during periods of vaccine shortage or as a transition while the effectiveness of a one-dose schedule is being evaluated.
Collapse
Affiliation(s)
- Vladimir Gilca
- a Division of Biological Risks, Quebec Public Health Institute , Quebec , Canada.,b Division of Infectious Disease and Immunity, Laval University Research Hospital Center , Quebec , Canada
| | - Chantal Sauvageau
- a Division of Biological Risks, Quebec Public Health Institute , Quebec , Canada.,b Division of Infectious Disease and Immunity, Laval University Research Hospital Center , Quebec , Canada
| | - Gitika Panicker
- c Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention , Atlanta , Georgia , USA
| | - Gaston De Serres
- a Division of Biological Risks, Quebec Public Health Institute , Quebec , Canada.,b Division of Infectious Disease and Immunity, Laval University Research Hospital Center , Quebec , Canada
| | - John Schiller
- d Laboratory of Cellular Oncology, National Cancer Institute , Bethesda , USA
| | - Manale Ouakki
- a Division of Biological Risks, Quebec Public Health Institute , Quebec , Canada
| | - Elisabeth R Unger
- c Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention , Atlanta , Georgia , USA
| |
Collapse
|
10
|
Gilca V, Salmerón-Castro J, Sauvageau C, Ogilvie G, Landry M, Naus M, Lazcano-Ponce E. Early use of the HPV 2-dose vaccination schedule: Leveraging evidence to support policy for accelerated impact. Vaccine 2018; 36:4800-4805. [PMID: 29887322 PMCID: PMC6078939 DOI: 10.1016/j.vaccine.2018.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/16/2018] [Accepted: 02/01/2018] [Indexed: 02/07/2023]
Abstract
Although human papillomavirus (HPV) vaccines were initially licensed based on efficacy after three-dose regimens in women aged 15-26 years, it was recognized early in clinical development that comparable immunogenicity could be obtained after just two doses when administered to younger girls. In both Canada and Mexico, public health authorities made the decision to administer two doses 6 months apart with a planned additional dose at 60 months, while simultaneously doing further study to determine if the third dose would confer meaningful additional benefit. This delayed third dose approach permitted a more cost-effective program with opportunities for improved compliance while minimizing injections and leaving open the opportunity to provide a full three-dose vaccination series. It required close cooperation across many governmental and civil society leadership bodies and real-time access to emerging data on HPV vaccine effectiveness. Although still limited, there is increasing evidence that even one-dose vaccination is sufficient to provide prolonged protection against HPV infection and associated diseases. Ongoing clinical trials and ecological studies are expected to consolidate existing data regarding one dose schedule use. However, to accelerate the preventive effect of HPV vaccination some jurisdictions, in particular those with limited resources may already consider the initiation of a one dose vaccination with the possibility of giving the second dose later in life if judged necessary. Such an approach would facilitate vaccination implementation and might permit larger catch-up vaccination programs in older girls (or as appropriate, girls and boys), thereby accelerating the impact on cervical cancer and other HPV-associated diseases.
Collapse
Affiliation(s)
- Vladimir Gilca
- Quebec Public Health Institute, Quebec, Canada; Laval University Research Hospital Center, Quebec, Canada.
| | - Jorge Salmerón-Castro
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico; Unidad Académica en Investigación Epidemiológica, Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico
| | - Chantal Sauvageau
- Quebec Public Health Institute, Quebec, Canada; Laval University Research Hospital Center, Quebec, Canada
| | - Gina Ogilvie
- University of British Columbia, Vancouver, Canada; BC Women's Hospital and Health Centre, Vancouver, Canada
| | - Monique Landry
- Quebec Ministry of Health and Social Services, Montreal, Canada
| | - Monica Naus
- University of British Columbia, Vancouver, Canada; British Columbia Centre for Disease Control, Vancouver, Canada
| | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| |
Collapse
|
11
|
Toh ZQ, Cheow KWB, Russell FM, Hoe E, Reyburn R, Fong J, Tuivaga E, Ratu FT, Nguyen CD, Matanitobua S, Reitsma A, Tabrizi SN, Garland SM, Mulholland EK, Licciardi PV. Cellular Immune Responses 6 Years Following 1, 2, or 3 Doses of Quadrivalent HPV Vaccine in Fijian Girls and Subsequent Responses to a Dose of Bivalent HPV Vaccine. Open Forum Infect Dis 2018; 5:ofy147. [PMID: 30019002 PMCID: PMC6041981 DOI: 10.1093/ofid/ofy147] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/18/2018] [Indexed: 12/19/2022] Open
Abstract
Background This study examined the cellular immunity of 0, 1, 2, and 3 doses of Gardasil vaccine (4vHPV) in girls after 6 years and their responses to a subsequent dose of Cervarix vaccine (2vHPV). Methods A subset of girls (n = 59) who previously received 0, 1, 2, or 3 doses of 4vHPV 6 years earlier were randomly selected from a cohort study of Fijian girls (age 15-19 years). Blood was collected before and 28 days after a dose of 2vHPV. The HPV16- and HPV18-specific cellular immune response was determined by IFNγ-ELISPOT and by measurement of cytokines in peripheral blood mononuclear cell supernatants. Results Six years after 4vHPV vaccination, HPV18-specific responses were significantly lower in the 1- (1D) or 2-dose (2D) recipients compared with 3-dose recipients (2D: IFNγ-ELISPOT: P = .008; cytokines, IFNγ: P = .002; IL-2: P = .022; TNFα: P = .016; IL-10: P = .018; 1D: IL-2: P = .031; IL-10: P = .014). These differences were no longer significant post-2vHPV. No significant differences in HPV16 responses (except IL-2, P < .05) were observed between the 2- or 1-dose recipients and 3-dose recipients. Conclusions These data suggest that cellular immunity following reduced-dose schedules was detectable after 6 years, although the responses were variable between HPV types and dosage groups. The clinical significance of this is unknown. Further studies on the impact of reduced dose schedules are needed, particularly in high-disease burden settings.
Collapse
Affiliation(s)
- Zheng Quan Toh
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | | | - Fiona M Russell
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Edwin Hoe
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Rita Reyburn
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - James Fong
- Ministry of Health and Medical Services, Suva, Fiji
| | | | | | - Cattram D Nguyen
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Andrea Reitsma
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Sepehr N Tabrizi
- Department of Obstetrics and Gynecology, The University of Melbourne, The Royal Women's Hospital and Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Regional HPV Labnet Reference Laboratory, Department of Microbiology and Infectious Disease, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Suzanne M Garland
- Department of Obstetrics and Gynecology, The University of Melbourne, The Royal Women's Hospital and Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Regional HPV Labnet Reference Laboratory, Department of Microbiology and Infectious Disease, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Edward K Mulholland
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom.,Department of Child Health, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Paul V Licciardi
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
12
|
Basu P, Bhatla N, Ngoma T, Sankaranarayanan R. Less than 3 doses of the HPV vaccine - Review of efficacy against virological and disease end points. Hum Vaccin Immunother 2016; 12:1394-402. [PMID: 26933961 PMCID: PMC4964672 DOI: 10.1080/21645515.2016.1146429] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/07/2016] [Accepted: 01/21/2016] [Indexed: 01/06/2023] Open
Abstract
World Health Organization (WHO) recommended 2 doses of the Human Papillomavirus (HPV) vaccine for girls below 15 y on the basis of the immune-bridging studies demonstrating non-inferior immune response of 2 doses in the adolescent girls compared to 3 doses in the young adult women in whom the efficacy against disease is established. The biological nature of the antigens (virus-like particles) constituting the HPV vaccine is responsible for the vigorous antibody response that may make the third dose redundant. The protection offered by 2 doses has been demonstrated in non-randomized clinical trials to be comparable to that offered by 3 doses against incident and persistent infections of vaccine targeted HPV types. However, results emerging from the ecological and nested case-control studies embedded in the population based screening programs of different countries indicate reduced efficacy of 2 doses against virological and disease end points. Some recent studies observed the protective effect of single dose of the vaccine against incident and persistent infections of the vaccine targeted HPV types to be similar to 3 doses in spite of immunological inferiority. The sample size, duration of follow-ups and number of events were limited in these studies. Longer follow ups of the less than 3 doses cohorts in the ongoing studies as well as appropriately designed and ethically justifiable randomized studies are needed to establish the protection offered by the alternative schedules at least beyond 10 y of vaccination.
Collapse
Affiliation(s)
- Partha Basu
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Neerja Bhatla
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Twalib Ngoma
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Rengaswamy Sankaranarayanan
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| |
Collapse
|
13
|
Affiliation(s)
- Andreas Dietrich
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität, Ludwig-Maximilians-Universität München, München, Deutschland
| | | | | |
Collapse
|
14
|
Gilca V, Sauvageau C, Boulianne N, De Serres G, Crajden M, Ouakki M, Trevisan A, Dionne M. The effect of a booster dose of quadrivalent or bivalent HPV vaccine when administered to girls previously vaccinated with two doses of quadrivalent HPV vaccine. Hum Vaccin Immunother 2015; 11:732-8. [PMID: 25714044 PMCID: PMC4514370 DOI: 10.1080/21645515.2015.1011570] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 11/10/2014] [Accepted: 11/21/2014] [Indexed: 10/23/2022] Open
Abstract
This randomized, blinded study evaluated the immunogenicity and safety of a booster dose of Gardasil (qHPV) or Cervarix (bHPV) when administered to 12-13 year-old girls who were vaccinated at the age of 9-10 with 2 doses of qHPV (0-6 months). 366 out of 416 eligible girls participated in this follow-up study. Antibody titers were measured just before and one month post-booster. A Luminex Total IgG assay was used for antibody assessment and results are presented in Liminex Units (LU). Three years post-primary vaccination, 99-100% of subjects had detectable antibodies to 4HPV genotypes included in the qHPV with GMTs varying from 50 to 322 LU depending on genotype. After a booster dose of qHPV, a ≥4 fold increase of antibody titers to genotypes included in the vaccine was observed in 88-98% of subjects. Post-booster GMTs varied from 1666 to 4536 LU depending on genotype. These GMTs were 1.1 to 1.8-fold higher when compared to those observed one month post-second dose. After a booster of bHPV, a ≥4 fold increase of antibody titers to HPV16 and HPV18 was observed in 93-99% of subjects. The anti-HPV16 and HPV18 GMTs were 5458 and 2665 LU, respectively. These GMTs were 1.2 and 1.8 higher than those observed in the qHPV group (both P < 0.01). In bHPV group a 1.4-1.6-fold increase of antibody GMTs to HPV6 and HPV11was also observed (P < 0.001). The safety profile was acceptable for both vaccines. Both qHPV and bHPV increase antibody titers when given as a booster to girls previously vaccinated with 2 doses of qHPV. The magnitude of the immune response after booster is vaccine-dependent and has the same pattern as that reported after primary vaccination with qHPV or bHPV. When given as a booster, both vaccines have an acceptable safety profile. Longer follow-up studies are warranted to assess the need of booster doses.
Collapse
MESH Headings
- Adolescent
- Antibodies, Viral/blood
- Child
- Female
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/administration & dosage
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/adverse effects
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/immunology
- Humans
- Immunization, Secondary/adverse effects
- Immunization, Secondary/methods
- Immunoglobulin G/blood
- Papillomavirus Infections/prevention & control
- Papillomavirus Vaccines/administration & dosage
- Papillomavirus Vaccines/adverse effects
- Papillomavirus Vaccines/immunology
Collapse
Affiliation(s)
- Vladimir Gilca
- Quebec Public Health Institute; Laval University; Quebec University Research Hospital Center; Quebec, Canada
| | - Chantal Sauvageau
- Quebec Public Health Institute; Laval University; Quebec University Research Hospital Center; Quebec, Canada
| | - Nicole Boulianne
- Quebec Public Health Institute; Laval University; Quebec University Research Hospital Center; Quebec, Canada
| | - Gatson De Serres
- Quebec Public Health Institute; Laval University; Quebec University Research Hospital Center; Quebec, Canada
| | - Mel Crajden
- BC Center for Disease Control; Public Health Microbiology and Reference Laboratory; Vancouver, British Columbia, Canada
| | - Manale Ouakki
- Quebec Public Health Institute; Laval University; Quebec University Research Hospital Center; Quebec, Canada
| | - Andrea Trevisan
- Quebec Public Health Institute; Laval University; Quebec University Research Hospital Center; Quebec, Canada
| | - Marc Dionne
- Quebec Public Health Institute; Laval University; Quebec University Research Hospital Center; Quebec, Canada
- BC Center for Disease Control; Public Health Microbiology and Reference Laboratory; Vancouver, British Columbia, Canada
| |
Collapse
|