Protecting HIV-positive adolescents against high-risk HPV types

The Gardasil quadrivalent human papillomavirus (HPV) vaccine can protect HIV-positive adolescents from HPV types 16, 18, 6, and 11, according to a recent study published in Viruses.

HPV is linked to approximately 5% of cancers, including vulva, vagina, penis, cervix, oropharynx, and anus cancers. The most common of these is cervical cancer, with an incidence above 527,624 cases. HPV vaccination has been highlighted as a method of reducing cervical cancer incidence, with the goal of administering the vaccine to 90% of girls aged under 15 years by 2030.

HIV-infected individuals are at an increased risk of HPV infection, with the World Health Organization recommending 3 HIV vaccine doses in patients with confirmed HIV. Investigators conducted a cross-sectional study to determine if 3 HPV vaccine doses can protect against HPV infection in HIV-infected adolescents.

The trial occurred at a referral clinic where the quadrivalent Gardasil vaccine was administered to adolescents from December 2015 onward. Participants included individuals vaccinated for 5 or more years during the study period of January 2021 to March 2022.

An electronic point of care database was used to obtain sociodemographic data. Risk factors were identified through questionnaire interviews, and all participant data was collected in a REDCap database.

HPV genotyping was performed on vaginal or penile swabs in 2 mL of Digene transport media. DNA was isolated using the HPV Direct Flow CHIP Kit, allowing detection of 35 HPV types. The HybriSoft software version 2.2.0 R00 (Vitro Master Diagnóstica, Sevilla, Spain) was used to analyze results.

There were 98 patients with genotyping results included in the final analysis, 69% of whom were HPV-positive, 39% presenting with both high- and low-risk HPV types, and 31% with low-risk HPV DNA type positive or high-risk HPV DNA type positive. HPV type 18 was reported in 12 individuals, 6 in 3, and 16 and 11 each in 1.

Sociodemographic characteristics did not significantly differ between HPV-positive and HPV-negative participants except for HPV-negativity being more likely in male patients than female patients. HPV types 40, 84, and 62/81 were the most common low-risk HPV types, at 27.6%, 19.4%, and 20%, respectively.

Of high-risk HPV types, the most common were types 45, -56, -58, -52, -18, -39, -73, and -35, in 14.3%, 14.3%, 13.3%, 12.2%, 12.2%, 9.2%, 9.2%, and 6.19%, respectively. There were 34 HPV types detected. Of these, only HPV types 16, 18, 6, and 11 were vaccine types. This indicated a higher prevalence of non-vaccine types compared to vaccine types.

Vaccine-type (VT) HPVs were reported in 17% of participants. The VT subgroup was aged a mean 20.7 years, and 88% of the subgroup was sexually active. These patients received vaccination when aged a mean 15.5 years.

These results indicated efficacy in preventing VT HPVs. Investigators recommended future studies be conducted on HPV effectiveness among people living with HIV.

Reference

Murahwa AT, Mudzviti T, Mandishora RSD, et al. Vaccine and non-vaccine HPV types presence in adolescents with vertically acquired HIV five years post gardasil quadrivalent vaccination: The ZIMGARD cohort. Viruses. 2024;16(1). doi:10.3390/v16010162