Immunogenicity and safety of the bivalent HPV vaccine in female patients with juvenile idiopathic arthritis: a prospective controlled observational cohort study

M.W. Heijstek, M. Scherpenisse, N. Groot, C.E. Tacke, R.M. Schepp, A.M. Buisman, G.A. Berbers, F.M van der Klis, N.M. Wulffraat

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: To compare the immunogenicity and safety of the bivalent human papillomavirus (HPV)16/18 vaccine between female patients with juvenile idiopathic arthritis (JIA) and healthy female adolescents.

METHODS: 68 patients and 55 healthy girls aged 12-18 years were included in a prospective controlled observational cohort and were vaccinated at 0, 1 and 6 months. Primary outcomes were immunogenicity expressed as seropositivity rate after three vaccine doses at 7 and 12 months and HPV-specific geometric mean antibody concentrations. Secondary outcomes were HPV16/18-specific memory B cell responses in a subset of participants and safety, defined as adverse events and the effect of vaccination on JIA disease activity.

RESULTS: All participants were seropositive for HPV16 and HPV18 at 7 months. One patient turned seronegative at 12 months for HPV16/18. No significant differences were found between patients and controls in HPV-specific antibody concentrations; however, antibody concentrations were consistently lower in patients. No effect of methotrexate on HPV16 antibodies (p=0.79) or HPV18 antibodies (p=0.37) was detected. All patients on anti-TNFα treatment were seropositive after vaccination. The kinetics of HPV16/18 memory B cell responses was comparable between patients and controls, but the magnitude of B cell responses at 7 and 12 months appeared lower in patients. No relevant differences in adverse events were found. HPV vaccination did not aggravate JIA disease.

CONCLUSIONS: The bivalent HPV16/18 vaccine is immunogenic and well tolerated in JIA patients. However, HPV-specific antibodies and B cell responses tended to be lower in patients compared with healthy controls.

CLINICAL TRIAL LISTING: NCT00815282.

Original languageEnglish
Pages (from-to)1500-1507
Number of pages8
JournalAnnals of the Rheumatic Diseases
Volume73
Issue number8
DOIs
Publication statusPublished - Aug 2014

Keywords

  • Adolescent
  • Antibodies, Viral/blood
  • Arthritis, Juvenile/immunology
  • Child
  • Female
  • Follow-Up Studies
  • Human papillomavirus 16/immunology
  • Human papillomavirus 18/immunology
  • Humans
  • Papillomavirus Infections/immunology
  • Papillomavirus Vaccines/administration & dosage
  • Prospective Studies
  • Uterine Cervical Neoplasms/immunology

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