Human papillomavirus vaccination in girls and women living with HIV
Bibliographic record
Abstract
Background: Human papillomavirus (HPV) is the causal agent of virtually all cervical cancer and genital warts. Women living with HIV (WLWH) experience higher rates of HPV-associated infection and disease than women without HIV. HPV vaccination has proven safe and efficacious in young women without HIV, however, little was known about the vaccine in WLWH. The work represented in this thesis was designed to answer key questions around HPV infection and the impact of HPV vaccination in WLWH. Methods: WLWH across Canada were invited to participate in a CIHR-funded, multi-centre study of quadrivalent HPV vaccination starting in 2009. Participants were administered three doses of vaccine at 0/2/6 months. Demographic and clinical data, serology (cLIA), liquid-based cervical cytology, and HPV DNA genotyping (Linear array assay) were collected at baseline and post-vaccine series every 6-12 months up to 8 years. Participants were referred for clinical colposcopies as per the standard at their institutions. Results: Pre-vaccination rates of prevalent and persistent oncogenic HPV infection among participants were high. Extending the spacing of the three vaccine doses out to two years did not significantly impact the peak anti-HPV antibody titer achieved in this cohort. Two years post-vaccination, efficacy of the vaccine was good, demonstrating lower rates of clinical endpoints than in unvaccinated Canadian WLWH, but higher rates than those seen in vaccinated women without HIV. Post-vaccination rates of persistent non-vaccine oncogenic HPV types were relatively high with a higher proportion of non-vaccine HPV types than of HPV types contained in the nonavalent vaccine. Conclusions: These findings support the value of HPV vaccination and the need for ongoing cervical cancer screening post-vaccination in WLWH. They also do not indicate concern with extending the spacing interval between the first and third doses up to two years. Collectively, these findings have provided great value to the clinical care of WLWH by informing best vaccination and screening practices for this particularly vulnerable population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".