May 7, 2014
Gardasil, the most common vaccine against the human papillomavirus (HPV), is effective in HIV-positive women, according to a new study published in the journal Clinical Infectious Diseases. The vaccine even worked well in women with low CD4 counts, the researchers found.
HPV is a common virus that can cause genital warts and is the primary cause of cervical, anal and pharyngeal cancers. Gardasil protects against the four most common strains of HPV -- strains 6, 11, 16 and 18 -- that are responsible for most of these cancers. HPV vaccination is recommended in the U.S. for all females between the ages of 11 and 26, and for all males between the ages of 11 and 21 (26 if they have sex with men or are living with HIV).
However, there has been an ongoing debate as to Gardasil's effectiveness in HIV-positive women, who some health care professionals say have likely already been exposed to HPV and may not get as many benefits from the vaccine due to their HIV status. No published research exists on how well the HPV vaccine works in people with HIV, according to Erna Milunka Kojic, M.D., of Brown University, and an international team of colleagues.
The group conducted a study to measure the immune system's response to Gardasil in HIV-positive women aged 13 to 45 with a wide range of CD4 counts. In the vast majority of the 319 study participants -- who hailed from the U.S., Brazil and South Africa -- the vaccine built up antibodies against the four primary HPV strains and posed no unusual safety issue during the study's 28-week duration.
In the trial, the women were divided into groups based on CD4 count and then tested as to how much protection they had against each strain. At least 75% of all groups were protected against each strain of HPV. Most groups experienced 90% to 100% protection against each strain, with slightly lower rates of protection among women with a CD4 count of 200 or lower, especially for HPV-18.
"The vaccine works for HIV-infected women in terms of developing antibodies," Kojic said in a Brown University press release. In the same release, study co-author Susan Cu-Uvin, M.D., added that women with HIV are especially susceptible to cervical cancer from HPV because their weakened immune systems are less able to clear the virus. While vaccinating HIV-positive women is extremely important, so is doing so in a safe and effective manner, she suggested.
Kojic expressed hope in the press release that by confirming that women with HIV are responsive to the vaccine without unusual adverse effects, more health care providers will vaccinate their HIV-positive patients.
Mathew Rodriguez is the community editor for TheBody.com and TheBodyPRO.com.
Follow Mathew on Twitter: @mathewrodriguez.