title: Immunogenicity of bivalent HPV vaccine among partially vaccinated young adolescent girls in Uganda.
abstract: BACKGROUND
  Investigations of vaccine efficacy and immunogenicity for adult females receiving fewer than three doses of human papillomavirus (HPV) vaccine have suggested protection against infection and precancerous lesions. We investigated the immunogenicity of bivalent HPV vaccines among adolescent girls from Uganda who received one, two, or three vaccine doses.
  
  
  METHODS
  Young girls vaccinated through a government program in Uganda were invited to participate. HPV16- and HPV18-specific antibodies were measured at ≥24 months after the last vaccine dose using an enzyme linked immunoassay in girls who received one (n=36), two (n=145), or three (n=195) doses.
  
  
  RESULTS
  Nearly all subjects (99%) were HPV16 and HPV18 seropositive at the time of blood-draw. Geometric mean antibody levels (GMTs) were: HPV16₁-dose=230 EU/mL, HPV16₂-dose=808 EU/mL, and HPV16₃-dose=1607 EU/mL; HPV18₁-dose=87 EU/mL, HPV18₂-dose=270 EU/mL, and HPV18₃-dose=296 EU/mL. The GMT ratio for 2:3 doses was 0.50 (HPV16) and 0.68 (HPV18) and did not meet the non-inferiority criteria (i.e., lower bound of 97.5% confidence interval of the GMT ratio greater than 0.50). The GMT ratio for 1:3 doses for HPV16 and HPV18 was inferior, but absolute GMTs for one dose were higher than adult women who received one dose (HPV16=124 EU/mL, HPV18=69 EU/mL) where efficacy has been demonstrated.
  
  
  CONCLUSIONS
  Even though immunogenicity with less than three doses did not meet a priori non-inferiority thresholds, antibody levels measured ≥24 months after last dose were similar to those of adult women who have been followed for more than eight years for efficacy.
authors.affiliation: PATH, Seattle, USA. Electronic address: slamontagne@path.org.
authors.forename: D Scott
authors.initials: DS
authors.lastname: LaMontagne
authors.affiliation: PATH, Kampala, Uganda.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mugisha
authors.affiliation: National Cancer Institute, Bethesda, MD, USA.
authors.forename: Yuanji
authors.initials: Y
authors.lastname: Pan
authors.affiliation: PATH, Kampala, Uganda.
authors.forename: Edward
authors.initials: E
authors.lastname: Kumakech
authors.affiliation: Uganda Virus Research Institute, UVRI-IAVI HIV Vaccine Program, Entebbe, Uganda.
authors.forename: Aloysius
authors.initials: A
authors.lastname: Ssemaganda
authors.affiliation: HPV Immunology Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA.
authors.forename: Troy J
authors.initials: TJ
authors.lastname: Kemp
authors.affiliation: PATH, Seattle, USA; PATH, Kampala, Uganda.
authors.forename: Jane
authors.initials: J
authors.lastname: Cover
authors.affiliation: HPV Immunology Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA.
authors.forename: Ligia A
authors.initials: LA
authors.lastname: Pinto
authors.affiliation: National Cancer Institute, Bethesda, MD, USA. Electronic address: safaeianm@mail.nih.gov.
authors.forename: Mahboobeh
authors.initials: M
authors.lastname: Safaeian
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood*; D000917:Antibody Formation; D002648:Child; D003430:Cross-Sectional Studies; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D052162:Human papillomavirus 16; D052161:Human papillomavirus 18; D006801:Humans; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology; D014454:Uganda; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control
chemical_list: D000914:Antibodies, Viral; D053918:Papillomavirus Vaccines
keywords: Adolescents; HPV vaccine; Immunogenicity; Partially vaccinated; Uganda