HPV Vaccine May Not Be as Effective in Kidney Transplant Patients
Administration of the human papillomavirus (HPV) vaccine led to sustained immune response in girls and young women with chronic kidney disease (CKD) and in those on dialysis but led to an inadequate response in those with a kidney transplant. Findings from the study are published in the Clinical Journal of the American Society of Nephrology.
Female adolescents with CKD and those who require dialysis or a kidney transplant are immunocompromised and have a significantly higher risk of developing cervical cancer and genital warts if they acquire HPV infection. Delphine Nelson, MD, MHS, and Jeffrey Fadrowski, MD, MHS from the Johns Hopkins University School of Medicine, conducted a study (n=57) in female patients aged 9–21 years to assess the immune response to HPV vaccination.
Of the total patients, 25 had CKD, 9 were on dialysis, and 23 had received a kidney transplant. Study patients received the 3-dose HPV vaccine series and their immune responses were determined by their antibody levels against each of the 4 HPV genotypes. Antibody levels were assessed prior to vaccine Dose 1, <12 months after Dose 3, and ≥12 months after Dose 3.
They found that antibody response to all 4 HPV genotypes was 100% in the CKD and dialysis arms with samples drawn at <12 and ≥12 months after Dose 3 of the HPV vaccine. For patients with transplants, the percentage of patients achieving seropositivity was lower at blood draw 2 for HPV genotypes 6 (63.6%;P=0.003), 11 (63.6%; P=0.003), and 18 (72.7%; P=0.02); and at blood draw 3 for HPV genotypes 6 (62.5%; P=0.02), 11 (50%; P=0.001), 16 (75%; P=0.04), and 18 (50%; P=0.001).
Overall, study findings suggest that HPV vaccination offers benefits for patients with kidney disease and those on dialysis but it may not be as beneficial for those with kidney transplants. More research is needed to assess whether vaccination prior to kidney transplantation or a different vaccination regimen would benefit transplant patients.
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