Scientists have created a test using novel research to measure antibodies in girls who have received a vaccine for human papilloma virus (HPV), the leading cause of cervical cancer in women. The research was presented at the 2021 AACC Annual Scientific Meeting & Clinical Lab Expo in Atlanta, this new test and a second study establishing accurate reference intervals for pregnant patients could help resolve persistent challenges in healthcare and lab testing for women.
Monitoring HPV Immunity After Vaccination
HPV is one of the most common sexually transmitted viruses, and research has clearly linked HPV infections to reproductive cancers in both women and men. Most cases of cervical cancer are caused by HPV infection, which means that vaccinating girls against HPV is key to preventing and eliminating this cancer.
Determining how long protection from HPV lasts after vaccination could help to bolster public confidence in the vaccine and increase uptake. Using novel research, a team led by Emmanuel Donkoh, PhD, of the University of Energy and Natural Resources in Sunyani, Ghana, created a rapid, high-throughput test to detect and quantify antibodies against HPV in Ghanaian girls. The scientists validated their test with blood samples from 49 preadolescent girls who received a quadrivalent HPV vaccine and 40 age-matched, unvaccinated girls. The test showed that immunoglobulin G antibodies for HPV-16 and -18 (common types of HPV) were much more prevalent among vaccinated girls three years after the third dose of the vaccine compared with unvaccinated girls (63.3 percent vs. 12.5 percent for HPV-16).
“Our results provide empirical evidence that the initial antibody response is sustained even at 36 months post-vaccination and around the average age of sexual debut for African girls,” Donkoh says. “The higher HPV-16 and -18 antibodies among vaccinated girls emphasize the need to scale-up HPV vaccination among girls in the country.”
Novel Research Creating Better Reference Intervals
Another obstacle in women’s health is the lack of standardized reference intervals for patients who are pregnant or have just given birth. To correctly interpret laboratory test results, providers must evaluate results within the context of reference intervals, which are the range of normal test values that indicate a person is healthy. However, pregnancy affects proteins and other biomarkers measured by common lab tests. This means that using existing reference intervals for pregnant patients can lead to incorrect interpretation of their lab results, which in turn can lead to subpar maternity care.
Vilte Barakauskas, PhD, Ann Tran, MD, and colleagues from the BC Children’s and Women’s Hospital in Vancouver, Canada, have now established accurate reference intervals for coagulation tests commonly ordered for peripartum patients (i.e., patients who are about to or have just given birth). The research team collected and analyzed blood samples from an ethnically diverse group of more than 400 healthy patients with singleton pregnancies before and after delivery. Barakauskas’ team then calculated reference intervals using eligible test results from 196 of the participants. The new intervals revealed that peripartum patients have different levels of fibrinogen, von Willebrand factor, and other proteins involved in bleeding and clotting compared with nonpregnant adults.
“Lab testing in pregnant women should be compared to reference intervals specific for pregnancy,” Tran says. “If a lab does not have pregnancy-specific reference intervals, then any out-of-range lab values should be interpreted cautiously and with knowledge of how pregnancy itself can change lab values.”