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Determining the HPV vaccine schedule for a HIV-infected population in sub Saharan Africa, a commentary

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Abstract
Background: Epidemiological studies have established human papillomavirus (HPV) infection as the central cause of invasive cervical cancer (ICC) and its precursor lesions. HIV is associated with a higher prevalence and persistence of a broader range of high-risk HPV genotypes, which in turn results in a higher risk of cervical disease. Recent WHO HPV vaccination schedule recommendations, along with the roll out of HAART at an earlier CD4 count within the female HIV-infected population, may have programmatic implications for sub Saharan Africa. This communication identifies research areas, which will need to be addressed for determining a HPV vaccine schedule for this population in sub Saharan Africa. A review of WHO latest recommendations and the evidence concerning one-dose HPV vaccine schedules was undertaken. Conclusion: For females >= 15 years at the time of first dose and immunocompromised and/or HIV-infected, a 3-dose schedule (0, 1-2, 6 months) is recommended for all three vaccines. There is some evidence that there is similar protection against HPV 16 and 18 infection from a single vaccination than from two or three doses, however there is no cross protection conferred to other genotypes. There is a need for periodic prevalence studies to determine the vaccination coverage of bivalent, quadrivalent and nonavalent vaccine targeted oncogenic HPV genotypes in women with CIN 3 or ICC at national level. In light of the increasing number of sub Saharan HIV-infected girls initiating HAART at a CD4 count above 350 mm(3), there are a number of clinical, virological and public health research gaps to address before a tailored vaccine schedule can be established for this population.
Keywords
Vaccine schedule, Sub Saharan Africa, HIV, HUMAN-PAPILLOMAVIRUS INFECTION, COSTA-RICA VACCINE, WOMEN, PREVALENCE, NEOPLASIA, RESPONSES, VIRUS, TRIAL, RISK

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Citation

Please use this url to cite or link to this publication:

Chicago
Menon, Sonia, Rodolfo Rossi, Mbabazi Kariisa, and Steven Callens. 2018. “Determining the HPV Vaccine Schedule for a HIV-infected Population in Sub Saharan Africa, a Commentary.” Virology Journal.
APA
Menon, S., Rossi, R., Kariisa, M., & Callens, S. (2018). Determining the HPV vaccine schedule for a HIV-infected population in sub Saharan Africa, a commentary. VIROLOGY JOURNAL.
Vancouver
1.
Menon S, Rossi R, Kariisa M, Callens S. Determining the HPV vaccine schedule for a HIV-infected population in sub Saharan Africa, a commentary. VIROLOGY JOURNAL. 2018.
MLA
Menon, Sonia, Rodolfo Rossi, Mbabazi Kariisa, et al. “Determining the HPV Vaccine Schedule for a HIV-infected Population in Sub Saharan Africa, a Commentary.” VIROLOGY JOURNAL 2018 : n. pag. Print.
@misc{8572551,
  abstract     = {Background: Epidemiological studies have established human papillomavirus (HPV) infection as the central cause of invasive cervical cancer (ICC) and its precursor lesions. HIV is associated with a higher prevalence and persistence of a broader range of high-risk HPV genotypes, which in turn results in a higher risk of cervical disease. Recent WHO HPV vaccination schedule recommendations, along with the roll out of HAART at an earlier CD4 count within the female HIV-infected population, may have programmatic implications for sub Saharan Africa. This communication identifies research areas, which will need to be addressed for determining a HPV vaccine schedule for this population in sub Saharan Africa. A review of WHO latest recommendations and the evidence concerning one-dose HPV vaccine schedules was undertaken. 
Conclusion: For females >= 15 years at the time of first dose and immunocompromised and/or HIV-infected, a 3-dose schedule (0, 1-2, 6 months) is recommended for all three vaccines. There is some evidence that there is similar protection against HPV 16 and 18 infection from a single vaccination than from two or three doses, however there is no cross protection conferred to other genotypes. There is a need for periodic prevalence studies to determine the vaccination coverage of bivalent, quadrivalent and nonavalent vaccine targeted oncogenic HPV genotypes in women with CIN 3 or ICC at national level. In light of the increasing number of sub Saharan HIV-infected girls initiating HAART at a CD4 count above 350 mm(3), there are a number of clinical, virological and public health research gaps to address before a tailored vaccine schedule can be established for this population.},
  articleno    = {129},
  author       = {Menon, Sonia and Rossi, Rodolfo and Kariisa, Mbabazi and Callens, Steven},
  issn         = {1743-422X},
  keywords     = {Vaccine schedule,Sub Saharan Africa,HIV,HUMAN-PAPILLOMAVIRUS INFECTION,COSTA-RICA VACCINE,WOMEN,PREVALENCE,NEOPLASIA,RESPONSES,VIRUS,TRIAL,RISK},
  language     = {eng},
  pages        = {4},
  series       = {VIROLOGY JOURNAL},
  title        = {Determining the HPV vaccine schedule for a HIV-infected population in sub Saharan Africa, a commentary},
  url          = {http://dx.doi.org/10.1186/s12985-018-1039-y},
  volume       = {15},
  year         = {2018},
}

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