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10-14 岁少女接种 HPV-16/18 AS04 佐剂疫苗的免疫原性和安全性 4 年随访结果。

Four-year follow-up of the immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine when administered to adolescent girls aged 10-14 years.

机构信息

Central Laboratory and Vaccination Centre, Stiftung Juliusspital Wuerzburg, Wuerzburg, Germany.

出版信息

J Adolesc Health. 2012 Feb;50(2):187-94. doi: 10.1016/j.jadohealth.2011.11.004.

Abstract

PURPOSE

Long-term immunogenicity and safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine when administered to adolescent girls was evaluated.

METHODS

This open-label, follow-up study (NCT00316706) was conducted in 31 centers in Taiwan, Germany, Honduras, Panama, and Colombia. In the initial study (NCT00196924), 1,035 girls aged 10-14 years received the HPV-16/18 AS04-adjuvanted vaccine at 0, 1, and 6 months. Here, geometric mean titers (GMTs) of antibodies against HPV-16, HPV-18, and monophosphoryl lipid A (MPL), a component of the AS04 Adjuvant System, were reported up to month 48.

RESULTS

In the according-to-protocol immunogenicity cohort (N = 563), GMTs at month 48 in initially seronegative participants were 2,374.9 (95% confidence interval: 2,205.7-2,557.0) EL.U/mL for anti-HPV-16 and 864.8 (796.9-938.4) EL.U/mL for anti-HPV-18, that is, six- and threefold higher than the plateau level in a reference study demonstrating vaccine efficacy in young women (age, 15-25 years). All participants remained seropositive for anti-HPV-16 and anti-HPV-18 at month 48. Most participants (81.8%) were seropositive for anti-MPL antibodies before vaccination. Anti-MPL antibody titers in initially seropositive participants increased initially, and then declined. Most initially seronegative participants for anti-MPL seroconverted; 69.6% remained seropositive at month 48, with anti-MPL antibody titers similar to the natural background level. The vaccine was generally well tolerated. No serious adverse events were considered related to vaccination.

CONCLUSIONS

In adolescent girls, the HPV-16/18 AS04-adjuvanted vaccine produces anti-HPV-16 and anti-HPV-18 antibody titers that are maintained for up to 4 years at higher levels than those in young women in whom vaccine efficacy against cervical lesions was demonstrated.

摘要

目的

评估 HPV-16/18 AS04 佐剂疫苗在少女中的长期免疫原性和安全性。

方法

这是一项在台湾、德国、洪都拉斯、巴拿马和哥伦比亚的 31 个中心进行的开放性、随访研究(NCT00316706)。在初始研究(NCT00196924)中,1035 名 10-14 岁女孩在 0、1 和 6 个月时接受 HPV-16/18 AS04 佐剂疫苗接种。在此,报道了截至 48 个月时针对 HPV-16、HPV-18 和单磷酰脂质 A(MPL)的抗体几何平均滴度(GMT),MPL 是 AS04 佐剂系统的一个成分。

结果

在符合方案免疫原性队列(N=563)中,最初血清阴性参与者在第 48 个月时的 GMT 为 2374.9(95%置信区间:2205.7-2557.0)EL.U/mL 针对抗 HPV-16 和 864.8(796.9-938.4)EL.U/mL 针对抗 HPV-18,这分别是在一项证明年轻女性(年龄 15-25 岁)疫苗有效性的参考研究中 HPV 抗体水平的六倍和三倍。所有参与者在第 48 个月时仍保持针对 HPV-16 和 HPV-18 的血清阳性。所有参与者在接种疫苗前均针对 MPL 抗体呈血清阳性。最初血清阳性参与者的抗 MPL 抗体滴度最初增加,然后下降。大多数最初针对 MPL 抗体血清阴性的参与者发生血清转换;69.6%在第 48 个月时仍保持血清阳性,其抗 MPL 抗体滴度与自然背景水平相似。该疫苗通常具有良好的耐受性。没有严重不良事件被认为与疫苗接种有关。

结论

在少女中,HPV-16/18 AS04 佐剂疫苗可产生针对 HPV-16 和 HPV-18 的抗体滴度,在长达 4 年的时间内保持在高于在证明针对宫颈病变的疫苗有效性的年轻女性中的水平。

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