Immunogenicity of Human Papillomavirus Recombinant Vaccine in Children with CKD

Clinical journal of the American Society of Nephrology : CJASN - Tập 11 Số 5 - Trang 776-784 - 2016
Delphine Nelson1, Alicia M. Neu1, Alison G. Abraham2, Sandra Amaral3, Donald L. Batisky4, Jeffrey J. Fadrowski1
1Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland;
2Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
3Division of Pediatric Nephrology, University of Pennsylvania School of Medicine and the Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
4Division of Pediatric Nephrology, Emory University School of Medicine, Atlanta, Georgia

Tóm tắt

Background and objectives

There is a disproportionate burden of human papillomavirus (HPV) –related genital tract disease in patients with CKD and kidney transplantation; therefore, the potential effect of the quadrivalent HPV vaccine (Gardasil; Merck GmbH, Darmstadt, Germany) is profound. Immune abnormalities associated with CKD and immunosuppression may prevent optimal vaccine response. Our objective was to determine antibody response to the HPV vaccine in adolescent girls with CKD.

 Design, setting, participants, & measurements

This cohort study conducted from 2008 to 2012 included 57 girls aged 9–21 years old with CKD (n=25), on dialysis (n=9), or with status postkidney transplantation (n=23) who received the standard three–dose vaccine series of the HPV vaccine recruited from two pediatric nephrology clinics. Antibody levels to HPV genotypes 6, 11, 16, and 18 were measured before vaccine dose 1 (baseline), <12 months after vaccine dose 3 (blood draw 2), and ≥12 months after vaccine dose 3 (blood draw 3). Seropositivity was defined as antibody level above an established threshold for each HPV genotype. Not all participants completed three blood draws.

 Results

Antibody response to all four HPV genotypes was 100% in the CKD and dialysis groups with samples drawn at <12 and ≥12 months after dose 3 of the HPV vaccine. Among patients with transplants, the percentages of patients achieving seropositivity were significantly lower at blood draw 2 for HPV genotypes 6 (63.6%; P=0.003), 11 (63.6%; P=0.003), and 18 (72.7%; P=0.02) and blood draw 3 for HPV genotypes 6 (62.5%; P=0.02), 11 (50%; P=0.001), 16 (75%; P=0.04), and 18 (50%; P=0.001).

 Conclusions

Antibody response to the quadrivalent recombinant HPV vaccine was robust and sustained in girls and young women with CKD and on dialysis. A less robust response to the vaccine was observed among those with a kidney transplant. Additional study is needed to determine if vaccination before kidney transplantation or an alternative vaccination regimen would benefit transplant recipients.

Từ khóa


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Thông tin
Thông tin xuất bản

Clinical journal of the American Society of Nephrology : CJASN

Tập 11 Số 5

776-784

Thông tin tác giả