University of California, Los Angeles
Pediatrics
Dr. Moscicki is a Professor of Pediatrics at University of California, Los Angeles, Chief, Division of Adolescent and Young Adult Medicine, Interim Chief, Division of General Pediatrics, Associate Executive Chair for Clinical Research, and Chair, Clinical Trials Committee for Pediatrics. She has 35+ years of experience working in the field of molecular epidemiology, behavioral studies of adolescents, mucosal immunology, and phase I and II clinical trials. Much of her work has focused on detailing the natural history of HPV in adolescents and young adults, primarily from a 25-year study “Natural History of HPV in Teens”. Her work has also involved children and adolescents living with HIV working with several national networks including Adolescent HIV and AIDS Research Network (AMHARN), Adolescent Therapeutic Trials Network, IMPAACT and Pediatric HIV/AIDS Cohort study. Much of her work has influenced public health policies involving cervical and anal cancer screening in general and vulnerable populations. She is past president of ASCCP, and has served on multiple national and international committees including NIH, PATH, WHO and SAGE. She is a current Board Member of IPVS and Chair of the Membership Committee.

Moderator of 4 Sessions

Session Type
Interdisciplinary Workshop
Date
Mon, Apr 17, 2023
Session Time
10:00 AM - 11:30 AM
Room
Ballroom C
Session Type
Special Satellite Symposium
Date
Wed, Apr 19, 2023
Session Time
02:00 PM - 03:30 PM
Room
207B
Session Description
There is both biologic, clinical and epidemiologic evidence that HPV can exist in a latent phase in the cervix. Other anogenital sites are less studied. Whether there is a truly latent phase (that is, dormant state within a cell in which the virus production ceases but the viral genome continues to exist) that can be reactivated to restart its life cycle remains highly controversial. From an epidemiology point of view, reactivation would be defined as redetection of an identical specific genotype after a period of no detection. Since sexual exposure can result in reinfection, supporting evidence would require redetection during periods of abstinence. Unfortunately, redetection during this time period doesn’t necessarily assure the existence of latency since negative tests can occur for several reasons including sampling error or low copy numbers. There is certainly evidence that HPV can exist in a state of low copy persistence which may reflect one mechanism for immune evasion. In addition, autoinoculation from other sites such as the anus remains another source of reinfection. Whether detection is reactivation or newly acquired, its clinical implication is questionable since data suggest a positive test preceded by a negative test is associated with low risk for CIN 3+. An IPVC working group has been created to examine the basic science, epidemiologic, clinical and modeling evidence for latency. Each of the 4 groups will review observable events, possible explanation, uncertainties, best inference with explicit assumptions and practical implications. This will be followed by panel discussion with the audience.
Session Type
Plenary Session
Date
Fri, Apr 21, 2023
Session Time
11:45 AM - 01:15 PM
Room
Ballroom C

Presenter of 2 Presentations

MANAGEMENT OF HPV-RELATED DISEASE IN TRANSPLANT RECIPIENTS AND OTHER IMMUNOSUPPRESSED HOSTS

Session Type
Clinical Science
Date
Tue, Apr 18, 2023
Session Time
02:30 PM - 04:00 PM
Room
207A
Presentation Type
ONSITE
Lecture Time
03:00 PM - 03:15 PM

SINGLE DOSE OF NONAVALENT PROPHYLACTIC HPV VACCINE INDUCES STABLE HPV16 AND HPV18 ANTIBODY RESPONSES UP TO 24 MONTHS AMONG 9-11 YEAR-OLD GIRLS AND BOYS

Session Type
Clinical Science
Date
Fri, Apr 21, 2023
Session Time
10:00 AM - 11:30 AM
Room
207A
Presentation Type
ONSITE
Lecture Time
11:00 AM - 11:10 AM

Abstract

Introduction

Emerging data suggest that a single dose of the bivalent or quadrivalent HPV vaccine generates antibody responses and efficacies similar to 2-dose schedules in children. No similar data are yet available for the nonavalent vaccine (9vHPV). Such data may inform policy considerations around usage of a single dose of 9vHPV to reduce costs of vaccination worldwide.

Methods

This is a prospective, single-arm, open-label, non-randomized, Phase IIa trial to determine the stability of HPV type-specific antibody responses up to 24 months after a single dose of 9vHPV in 201 healthy 9–11-year-old girls and boys. Subjects received a single dose of the 9vHPV at baseline, a delayed 2nd dose at month 24, and an optional 3rd dose at month 30. Blood samples were collected at baseline and at 6, 12, 18, 24, and 30 months after the prime dose. Primary outcomes were serum geometric mean concentrations (GMC) of HPV-16 and HPV-18 IgG antibodies.

Results

Demographics are shown in Table 1. GMCs of HPV16 and HPV18 antibodies are shown in Table 2. Table 3 shows high GMC at 6 months that declined between months 6 to 12, and stabilized between months 12, 18, and 24 (meeting the pre-specified hypotheses of non-inferior responses). The GMC were stable (or slightly higher) among 87.7% participants between months 12 and 24; among the remaining participants none showed consistent declines declines between both 18- vs. 12- and 24- vs. 18-months timepoint comparisons. Almost all participants (97%/96%) had significantly boosted responses for HPV16/HPV18 after the 3rd dose. One participant (0.5%) did not seroconvert after the single dose.

table1.jpg

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Conclusions

A single dose of 9vHPV induced persistent and stable antibody responses up to 24 months in the majority of participants, and a delayed dose at 24-months induces robust anamnestic responses. Declines and irregularities in antibody levels merit further study.

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