Human papillomavirus (HPV) vaccination produces a robust and sustained immune response in girls and young women with chronic kidney disease (CKD) and those on dialysis, but a suboptimal response in those who have undergone a kidney transplant, according to a study, “Immunogenicity of Human Papillomavirus Recombinant Vaccine in Children with CKD,” published in the Clinical Journal of the American Society of Nephrology.
Cervical cancer is mainly caused by the human papillomavirus infection, and girls and young women with CKD or who have progressed to kidney failure are at higher-than-average risk of the infection because their immune systems are compromised. Consequently, the HPV vaccine’s effect has important implications for this patient group.
To assess antibody response to the HPV vaccine in adolescent girls with CKD, Delphine Nelson, MD, MHS, from the Johns Hopkins University School of Medicine, and research colleagues studied 57 girls, ages 9–21, with CKD (n=25), on dialysis (n=9), or who had received a kidney transplantation (n=23). All participants were given a typical, three-dose series of the HPV vaccine.
Immune responses were evaluated through antibody levels produced to HPV genotypes 6, 11, 16, and 18 prior to first vaccine dose, at less than 12 months after third vaccine dose, and again at a later period.
Results indicated that only those adolescents with CKD or undergoing dialysis had antibody levels over the threshold established for protection from infection, while a significant proportion of those with a kidney transplant showed an inadequate antibody response.
“This is important information as it means that patients with a kidney transplant, whom we know are at increased risk of developing cervical cancer from HPV infection, may not be protected from HPV infections from the HPV genotypes included in the vaccine,” Dr. Nelson said in a news release. “The next step is to determine the best way to protect these young women. Some potential interventions include a higher dose of the vaccine, or an additional booster.”
HPV is a common sexually transmitted infection in the U.S., with estimates from 2003-06 showing that 42.5 percent of women, ages 14–59 , were infected with one or more strains of HPV (40 are known). HPV vaccines developed since that time have shown success in protecting healthy women from infection, and from developing either cervical cancer or genital warts.