Impact of smoking on the quantity and quality of antibodies induced by human papillomavirus type 16 and 18 AS04-adjuvanted virus-like-particle vaccine - a pilot study

• Published in: BMC research notes Vol. 7; no. 1; p. 445
• Main Authors: Namujju, Proscovia B, Pajunen, Emma, Simen-Kapeu, Aline, Hedman, Lea, Merikukka, Marko, Surcel, Helja-Marja, Kirnbauer, Reinhard, Apter, Dan, Paavonen, Jorma, Hedman, Klaus, Lehtinen, Matti
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.07.2014; BioMed Central
• Subjects: Adjuvants, Immunologic - administration & dosage; Adolescent; Analysis; Antibodies, Viral - blood; Antibody Affinity; Cervical cancer; Double-Blind Method; Female; Finland; Hepatitis A - immunology; Hepatitis A - prevention & control; Hepatitis A - virology; Hepatitis A virus; Hepatitis A virus - immunology; Human papillomavirus; Human papillomavirus 16; Human papillomavirus 16 - immunology; Human papillomavirus 18; Human papillomavirus 18 - immunology; Humans; Medical research; Papillomavirus Infections - immunology; Papillomavirus Infections - prevention & control; Papillomavirus Infections - virology; Papillomavirus Vaccines - administration & dosage; Papillomaviruses; Physiological aspects; Pilot Projects; Prevention; Risk Factors; Smoking; Studies; Uterine Cervical Neoplasms - immunology; Uterine Cervical Neoplasms - prevention & control; Uterine Cervical Neoplasms - virology; Vaccination; Vaccines; Viral Hepatitis Vaccines - administration & dosage; Finland
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/1756-0500-7-445

The AS04-adjuvanted bivalent L1 virus-like-particle (VLP) vaccine (Cervarix™) against infection with human papillomavirus (HPV) types 16/18 holds great promise to prevent HPV16/18 infections and associated neoplasias, but it is important to rule out significant co-factors of the neoplasias like smoking. We conducted a pilot study to compare the quantity and quality of HPV16/18 antibody response at baseline and 7 months post vaccination in 104 non-smoking and 112 smoking female participants vaccinated at 0, 1 and 6 months with Cervarix™ (55 and 48 study participants) or with Hepatitis A vaccine (HAVRIX™) (48 and 64 participants, respectively). These 216 women were a sub-sample of 4808 baseline 16- to 17-year old Finnish women initially enrolled in the double-blind, randomized controlled phase III PATRICIA trial. Following end-of-study unblinding in 2009 they were randomly chosen out of all the participants of the three major Finnish PATRICIA study sites in the Helsinki metropolitan area (University of Helsinki, N = 535, and Family Federation Finland, N = 432) and Tampere (University of Tampere, N = 428). Following enrolment, serum samples were collected at month 0 and month 7 post 1st vaccination shot, and were analysed for levels and avidity of IgG antibodies to HPV16 and HPV18 using standard and modified (4 M urea elution) VLP ELISAs. We found that at month 7 post vaccination women who smoked (cotinine level > 20 ng/ml) had levels of anti-HPV16/18 antibodies comparable to those of non-smoking women. Low-avidity HPV16/18 IgG antibodies were observed in 16% of the vaccinated women, and active smoking conferred a three-fold increased risk (95% CI 1.0-9.3) of having the low-avidity antibodies. Our data suggest that while smoking does not interfere with the quantity of vaccine-induced peak IgG levels, it may affect the avidity of IgG induced by HPV16/18 vaccination.