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人乳头瘤病毒16/18 AS04佐剂宫颈癌疫苗在健康印度女性中的免疫原性和安全性

Immunogenicity and safety of human papillomavirus-16/18 AS04-adjuvanted cervical cancer vaccine in healthy Indian women.

作者信息

Bhatla Neerja, Suri Vanita, Basu Partha, Shastri Surendra, Datta Sanjoy K, Bi Dan, Descamps Dominique J, Bock Hans L

机构信息

All India Institute of Medical Sciences, New Delhi, India.

出版信息

J Obstet Gynaecol Res. 2010 Feb;36(1):123-32. doi: 10.1111/j.1447-0756.2009.01167.x.

Abstract

AIM

India has the highest number of annual incident cases and mortality rates for cervical cancer worldwide. This study was conducted to assess the immunogenicity and safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted cervical cancer vaccine in healthy Indian women aged 18-35 years old.

METHODS

This double-blind, randomized (1:1), controlled and multicenter trial with two parallel groups, the Vaccine and Placebo groups, included 354 subjects in four centers across India. Subjects were given GlaxoSmithKline's HPV-16/18 AS04-adjuvanted cervical cancer vaccine or aluminum hydroxide placebo according to a 0, 1 and 6 month schedule and followed up until month 7. Serum samples were drawn at pre-vaccination and at month 7. Safety data were collected throughout the study.

RESULTS

A total of 330 subjects completed the study. One month post-Dose 3, all initially seronegative subjects in the Vaccine group had seroconverted for HPV-16 and HPV-18 antibodies with anti-HPV-16 and anti-HPV-18 geometric mean titer levels of 10226.5 EL.U/ml (95% confidence interval: 8847.1-11821.0) and 3953.0 EL.U/ml (95% confidence interval: 3421.8-4566.8), respectively. Initially seropositive subjects also showed an increase to similar geometric mean titer levels. Six serious adverse events (two in the Vaccine group and four in the Placebo group), all unrelated to vaccination, were reported. Commonly reported solicited local (injection-site pain) and general (fatigue, headache and fever) symptoms were similar in both groups. Compliance to the three-dose vaccination course was >97%.

CONCLUSIONS

The AS04-adjuvanted HPV-16/18 cervical cancer vaccine was highly immunogenic and generally well-tolerated making it a potential tool for prevention and control of cervical cancer in India.

摘要

目的

在全球范围内,印度每年宫颈癌的发病例数和死亡率最高。本研究旨在评估人乳头瘤病毒(HPV)-16/18 AS04佐剂宫颈癌疫苗在18至35岁健康印度女性中的免疫原性和安全性。

方法

这项双盲、随机(1:1)、对照的多中心试验设有疫苗组和安慰剂组两个平行组,在印度四个中心纳入了354名受试者。受试者按照0、1和6个月的接种程序,接种葛兰素史克公司的HPV-16/18 AS04佐剂宫颈癌疫苗或氢氧化铝安慰剂,并随访至第7个月。在接种前和第7个月采集血清样本。在整个研究过程中收集安全性数据。

结果

共有330名受试者完成了研究。在第3剂接种后1个月,疫苗组所有最初血清学阴性的受试者均已产生HPV-16和HPV-18抗体血清转化,抗HPV-16和抗HPV-18几何平均滴度水平分别为10226.5 EL.U/ml(95%置信区间:8847.1 - 11821.0)和3953.0 EL.U/ml(95%置信区间:3421.8 - 4566.8)。最初血清学阳性的受试者也显示出几何平均滴度水平升高至相似水平。报告了6例严重不良事件(疫苗组2例,安慰剂组4例),均与疫苗接种无关。两组中常见的主动报告的局部(注射部位疼痛)和全身(疲劳、头痛和发热)症状相似。三剂疫苗接种疗程的依从率>97%。

结论

AS04佐剂的HPV-16/18宫颈癌疫苗具有高度免疫原性且总体耐受性良好,使其成为印度预防和控制宫颈癌的潜在工具。

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