HPV vaccination in HIV infection

Charles JN. Lacey
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引用次数: 41

Abstract

Persons with HIV are at increased risk of HPV infection, HPV disease, and HPV-related cancers compared to HIV negative persons. In persons with HIV, immune responses to vaccination are often sub-optimal, and while these improve with ART, they often remain lower and decline more rapidly than in HIV-negative individuals. Although the evidence base to support the immunogenicity of HPV vaccines in HIV + ve persons is reasonable, the evidence base to support the efficacy of HPV vaccines in HIV + ve individuals is inconsistent. There is one study in HIV + ve men who have sex with men (MSM) which showed no effect, and two other studies, one in HIV + ve women and one in HIV + ve adolescents that showed reduced effectiveness. All these effectiveness studies used Gardasil 4 (G4). Two studies in HIV + ve persons have shown superior immunogenicity of Cervarix (which uses a TLR4 agonist adjuvant) compared to G4. Studies of Hepatitis B vaccines in HIV + ve persons have shown that either (i) increased number of doses (ii) increased vaccine dose, or (iii) TLR agonist adjuvanted vaccines, all produce increased immunogenicity compared to standard vaccine regimes. Therefore, questions remain as to optimal HPV vaccine regimes in HIV and further clinical trials with different HPV vaccine regimes are needed.

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人乳头瘤病毒疫苗在HIV感染
与艾滋病毒阴性者相比,艾滋病毒感染者感染HPV、HPV疾病和HPV相关癌症的风险更高。在艾滋病毒感染者中,对疫苗接种的免疫反应往往不是最理想的,虽然抗逆转录病毒疗法改善了免疫反应,但与艾滋病毒阴性个体相比,免疫反应往往仍然较低,而且下降得更快。尽管支持HPV疫苗在HIV + ve人群中免疫原性的证据基础是合理的,但支持HPV疫苗在HIV + ve人群中有效性的证据基础是不一致的。有一项针对男男性行为者(MSM)的HIV阳性男性的研究显示没有效果,另外两项针对HIV阳性女性和HIV阳性青少年的研究显示效果有所降低。所有这些有效性研究都使用了Gardasil 4 (G4)。两项针对HIV阳性人群的研究显示,与G4相比,Cervarix(使用TLR4激动剂佐剂)具有更好的免疫原性。在HIV + 5人群中进行的乙肝疫苗研究表明,与标准疫苗方案相比,(i)增加剂量(ii)增加疫苗剂量,或(iii) TLR激动剂佐剂疫苗均可产生增强的免疫原性。因此,问题仍然是艾滋病毒的最佳HPV疫苗方案,需要进一步的不同HPV疫苗方案的临床试验。
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审稿时长
14 weeks
期刊介绍: The official Journal of the International Papillomavirus Society Papillomavirus Research (PVR), the Journal of HPV and other Small DNA Tumor Viruses publishes innovative papers related to all aspects of papillomaviruses and other small DNA tumor viruses. The official journal of the International Papillomavirus Society, PVR is an open access publication that aims to bring together virologists, immunologists, epidemiologists and clinicians working in the booming field of HPV and animal papillomaviruses, polyomaviruses and other small DNA tumor viruses and their associated diseases, in order to foster and facilitate interdisciplinary communication. The journal welcomes original research articles, reviews, short communications, opinion articles and regional update reports on papillomaviruses and other tumor viruses in the following sections: a. Biology of papillomaviruses and related viruses from life cycle to cancer b. Epidemiology etiology and natural history studies c. Natural and induced immunity including vaccine research d. Intervention studies and strategies including i. Clinical studies and trials ii. HPV treatments iii. HPV vaccination programs iv. Diagnostics and screening e. Infection and disease prevention, modeling studies f. Guidelines and public health recommendations g. HPV Studies in special populations Regional and local studies on these viruses.
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