Prospective Observational Immunogenicity Trial of Gardasil-9 HPV Vaccine in People Living With Adequately Managed HIV
Louisiana State University Health Sciences Center in New Orleans
Summary
The primary objective of this study is to determine the magnitude and breadth of the serum antibody response to the nonavalent HPV vaccine (Gardasil-9) in adults with well-controlled HIV infection. The secondary objectives of the study are to observe short term clinical outcomes of prevalent HPV genotype-specific anogenital infections in adults living with HIV who complete the three-dose Gardasil-9 vaccine series, and to determine the protection afforded by Gardasil vaccine over time in previously vaccinated adults living with HIV. The clinical hypothesis is that adults with virologically controlled HIV mount a serum antibody response to the nonavalent HPV vaccine that is comparable to HIV negative counterparts. We also postulate that HPV vaccination will provide short-term clinical benefit against HPV infections and disease associated with vaccine genotypes and continuing protection against vaccine genotypes of HPV over time.
Description
BACKGROUND AND SIGNIFICANCE HPV is the etiological agent for most if not all cervical and anal cancer and for over 50% of head and neck squamous cell carcinomas. HPV infection, pre-cancerous and cancerous lesions are more prevalent in people living with HIV (PLWHIV), including those with HIV infection that is well-controlled with anti-retroviral therapy. HPV vaccines have been developed based on expression of the L1 major capsid protein to make virus-like particles and demonstrate impressive efficacy, with type-specific protection against persistent infection and incident pre-cancer (cervical…
Eligibility
- Age range
- 18–65 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * HIV seropositive * immune intact (CD4+ T cell count in peripheral blood \>200 cells/ml) * HIV controlled (peripheral blood HIV viral load \<1,000 genome copies/mL) * Stable on antiretroviral regimen for ≥3 months * Gardasil-9 naive and age ≤45 OR * documented receipt of 3 doses of Gardasil-4 or Gardasil-9 HPV vaccine Exclusion Criteria: * Medical contraindication for vaccination (vaccine-naive arm only) * Women who are pregnant * Acute illness * Taking chronic steroids, \>0.5mg/kg prednisone or equivalent * Taking immune modulating medications * Received blood transfus…
Interventions
- BiologicalHuman papillomavirus 9-valent vaccine, recombinant
Subunit vaccine against 9 genotypes of human papillomavirus (6, 11, 16, 18, 31, 33, 45, 52, 58)
- Biologicalhuman papillomavirus vaccine, recombinant
Subunit vaccine against four (6, 11, 16, 18) or nine (6, 11, 16, 18, 31, 33, 45, 52, 58) genotypes of human papillomavirus. Administered as part of participant's clinical care prior to study enrollment (intervention not delivered as part of study design).
Location
- University Medical Center New OrleansNew Orleans, Louisiana