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HIV CareLink newsletter for HIV/AIDS Primary Care Providers (Florida/Caribbean AIDS Education and Training Center
  Human Papillomavirus (HPV) Vaccine Recommendations - pdf attached
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Jan 27, 2011
Though the ACIP recommendations for HPV vaccines do not specifically address HIV-infected individuals, they do state that the vaccines can be administered to females who are immunosuppressed from disease or medications. However, they add that the immune response and vaccine efficacy may be less than that in immunocompetent individuals. The latest data on the safety and immunogenicity of the HPV vaccine in HIV-1 infected males as well as in children are also discussed below.
Merck is attempting to obtain an indication for HPV4 vaccine for older women between the ages of 27 and 45.
HPV Vaccine and HIV-Infected Individuals
· HIV-infected individuals are at increased risk of genital and anal dysplasia and cancers.
· HPV vaccine can be administered to individuals who are immunocompromised as this is not a live vaccine.
· Until recently there was concern that the immune response might be less than that of immunocompetent individuals.
· A recent study demonstrated that the HPV4 was both safe and highly immunogenic in HIV-1 infected men with 95% or greater seroconversion for each of the HPV types contained in the vaccine.
· Another recent study demonstrated that the HPV4 was safe and immunogenic in HIV-infected children ages 7 to 12 years old.
· HPV4 vaccine is shown to prevent 93% of persistent anal infections with vaccine types in young (aged 16-26) HIV-1 uninfected MSM.
· The Infectious Diseases Society of America (IDSA) Primary Care Guidelines for the Management of Persons Infected with Human Immunodeficiency Virus 2009 also recommends HPV4 routine vaccination for females aged 9-26 years, but also state it may be considered for use in other groups.
· HIV-infected individuals are at increased risk of dysplasia and cancers.
· The HPV vaccine is safe and highly immunogenic when administered to HIV-infected individuals.
· HPV vaccine is indicated for the prevention of cervical cancers and precancers; vulvar and vaginal cancers, and precancers; genital warts; and (with FDA approval) anal cancers.
· HPV vaccine should be considered as a part of routine immunizations in HIV-infected men and women in certain age groups; however, it is not yet a recommendation of the CDC/ACIP.
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