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High-risk vaccine-specific HPV infection in HIV-infected and HIV-uninfected, vaccine-naïve Asian female adolescents (Abstract no. MOAB0206).

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  1. High-risk vaccine-specific HPV infection in HIV-infected and HIV-uninfected, vaccine-naïve Asian female adolescents(Abstract no. MOAB0206) Sricharoenchai S, Bunupuradah T, Hansudewechakul R, Le HD, Ngoc HD T, Kerr S, Chalermchockcharoenkit A, Teeratakulpisarn N, Achalapong J, Ngoc DY, Termrungruanglert W, Chaithongwongwatthana S, Singtoroj T,Pankam T, Phanuphak N, Sohn AH, Chokephaibulkit K  TREAT Asia/ amfAR - The Foundation for AIDS Research Thailand: Faculty of Medicine Siriraj Hospital, Mahidol University, HIV Netherlands-Australia-Thailand Research Collaboration (HIV-NAT), Chiangrai Prachanukroh Hospital, Thai Red Cross AIDS Research Centre, Faculty of Medicine, Chulalongkorn University Vietnam: Hung Vuong Hospital, Children’s Hospital 1

  2. Disclosures • None to report

  3. Background & Objectives Human papillomavirus (HPV) vaccine uptake has been inconsistent in resource-limited settings. It is unclear how well current vaccines would cover common HPV genotype infections among perinatally HIV-infected and HIV-uninfected adolescents and young adult (AYA) females in Southeast Asia. We studied high-risk vaccine-specific HPV types in the nonavalent vaccine, neutralizing antibody (NAb) to HPV-16 or 18, and factors associated with orogenital HPV infection in HPV vaccine-naïve AYA.

  4. Methods

  5. Study procedures

  6. Statistical analysis Participant characteristics • Descriptive statistics • Fisher’s exact test, Mann-Whitney U test • High-risk vaccine-specific genotypes (HRVS-9) • 7 of 9 included in the vaccine • Excluded: types associated with genital warts • Associations with orogenital HPV infection, HRVS-9 genotypes at any site, positive NAb to HPV-16 or -18 • Multiple logistic regression

  7. Participant characteristics STI: sexually transmitted infection; HSV: herpes simplex virus

  8. Prevalence of HPV infection by HRVS-9 & HPV-16,18 NAb 49 (53%) 49 (49%) 43 (46%) 39 (39%) 26 (28%) 19 (22%) P=0.34 P=0.66 P=0.30 HRVS-9 genotypes or Positive HPV-16,18 NAb HRVS-9 genotypes Positive HPV-16,18 NAb

  9. Prevalence of HPV infection by HRVS-9 & HPV-16,18 NAbstratified by AGE 20 (61%) 19 (58%) 28 (52%) 50 (48%) 42 (40%) 21 (39%) 17 (33%) 9 (27%) 19 (20%) P=0.16 P=0.18 P=0.42 Positive HPV-16,18 NAb HRVS-9 genotypes or Positive HPV-16,18 NAb HRVS-9 genotypes

  10. Prevalence of HPV infection by HRVS-9 stratified by anatomical site P=0.92 P=0.08 P=0.04 P=0.10 37 (41%) 34 (37%) 29 (30%) 26 (28%) 23 (23%) 17 (17%) 3 (3%) 3 (3%) Anus Cervix Vagina Oral rinse

  11. Factors associated with infection with HRVS-9 at any site or NAb to HPV 16,18 STI: sexually transmitted infection

  12. Limitations • Cross-sectional analysis, and age at HPV acquisition not known • Recently acquired vs. persistent infection undistinguishable • Neutralizing antibody was not measured against other vaccine types

  13. Conclusions Half of all HPV vaccine-naïve female AYA in our study had evidence of prior vaccine-preventable HPV orogenital infection While HIV-uninfected AYA were more likely to engage high-risk behaviors, perinatally HIV-infected AYA had similar prior HPV infection and more cervical infection with HRVS-9 types In perinatally HIV-infected AYA, HIV-RNA >40 copies/mL and any non-HPV STI independently predicted increased HPV risk Greater access to HPV vaccination is needed in early adolescence in the region to prevent future cancer risk

  14. Acknowledgements • All patients, study staff, and participating sites in Thailand and Vietnam • Eunice Kennedy Shriver National Institute of Child Heath and Human Development, National Institutes of Health, USA (R01HD073972) • Joel Palefsky, University of California, San Francisco

  15. Prevalence of HPV infection by each vaccine-specific genotype 23% 8% 22% 18% 10% 13% 10% 13% 11% 11% 5% 6 % 4% 0% 3% 2% 2% 1% HPV6 HPV11 HPV16 HPV18 HPV31 HPV33 HPV45 HPV52 HPV58

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