State-of-the-Science of human papillomavirus vaccination in women with human immunodeficiency Virus: Summary of a scientific workshop

Anne E Schuind; Helen Rees; John Schiller; Nelly Mugo; Peter Dull; Ruanne Barnabas; Gary M Clifford; Gui Liu; Shabir A Madhi; Rebecca B Morse; Anna-Barbara Moscicki; Joel M Palefsky; Stanley Plotkin; Mónica S Sierra; Mark K Slifka; Alex Vorsters; Aimée R Kreimer; Arnaud M Didierlaurent

doi:10.1016/j.pmedr.2023.102331

State-of-the-Science of human papillomavirus vaccination in women with human immunodeficiency Virus: Summary of a scientific workshop

Prev Med Rep. 2023 Jul 19:35:102331. doi: 10.1016/j.pmedr.2023.102331. eCollection 2023 Oct.

Authors

Anne E Schuind¹, Helen Rees², John Schiller³, Nelly Mugo⁴, Peter Dull⁵, Ruanne Barnabas⁶, Gary M Clifford⁷, Gui Liu⁸, Shabir A Madhi⁹, Rebecca B Morse¹⁰, Anna-Barbara Moscicki¹¹, Joel M Palefsky¹², Stanley Plotkin¹³, Mónica S Sierra³, Mark K Slifka¹⁴, Alex Vorsters¹⁵, Aimée R Kreimer³, Arnaud M Didierlaurent¹⁰

Affiliations

¹ PATH, Washington DC, United States.
² Wits Reproductive Health and HIV Institute (Wits RHI), University of the Witwatersrand, Johannesburg, South Africa.
³ National Cancer Institute, National Institutes of Health, Bethesda, United States.
⁴ Kenya Medical Research Institute, Nairobi, Kenya and Department of Global Health, University of Washington, Seattle, United States.
⁵ Vaccine Development, Bill & Melinda Gates Foundation, Seattle, United States.
⁶ Division of Infectious Diseases, Mass General Hospital, Harvard Medical School, Boston, United States.
⁷ Early Detection, Prevention, and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France.
⁸ Department of Global Health, University of Washington, Seattle, United States.
⁹ South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Johannesburg, South Africa.
¹⁰ Centre of Vaccinology, University of Geneva, Switzerland.
¹¹ Department of Pediatrics, University of California Los Angeles, Los Angeles, United States.
¹² University of California, San Francisco School of Medicine, San Francisco, United States.
¹³ Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States.
¹⁴ Oregon Health & Science University, Beaverton, United States.
¹⁵ Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium.

Abstract

The burden of cervical cancer is disproportionately distributed globally, with the vast majority of cases occurring in low- and middle-income countries. Women with human immunodeficiency virus (HIV) (WWH) are at increased risk of human papillomavirus (HPV) infection and cervical cancer as compared to HIV-negative individuals. HPV vaccination remains a priority in regions with a high burden of cervical cancer and high HIV prevalence. With HPV vaccines becoming more accessible, optimal use beyond the initial World Health Organization-recommended target population of 9 to 14-year-old girls is an important question. In March 2022, a group of experts in epidemiology, immunology, and vaccinology convened to discuss the state-of-the-science of HPV vaccination in WWH. This report summarizes the proceedings: review of HIV epidemiology and its intersection with cervical cancer burden, immunology, HPV vaccination including reduced-dose schedules and experience with other vaccines in people with HIV (PWH), HPV vaccination strategies and knowledge gaps, and outstanding research questions. Studies of HPV vaccine effectiveness among WWH, including duration of protection, are limited. Until data from ongoing research is available, the current recommendation for WWH remains for a multi-dose HPV vaccination regimen. A focus of the discussion included the potential impact of HIV acquisition following HPV vaccination. With no data currently existing for HPV vaccines and limited information from non-HPV vaccines, this question requires further research. Implementation research on optimal HPV vaccine delivery approaches for WWH and other priority populations is also urgently needed.

Keywords: Epidemiology; HPV vaccine; Human papillomavirus (HPV); Immunization; Immunology; Prevention; Vaccination strategies; human immunodeficiency virus (HIV); women with HIV (WWH).

Publication types

Review

Grants and funding

001/WHO_/World Health Organization/International