SUSCEPTIBILITY TO MEASLES AMONG PERINATALLY HIV-POSITIVE ADOLESCENTS AND YOUNG ADULTS

Wednesday, 25th of July 2012

• SUSCEPTIBILITY TO MEASLES AMONG PERINATALLY HIV-POSITIVE ADOLESCENTS AND YOUNG ADULTS 

L. Morris¹, R. Posada¹, C. Hickman², D. Latner², T. Singh³, A. Rautenberg³, J. Jao⁴, W. Bellini², R. Sperling<sup>3

1</sup>Mount Sinai School of Medicine, Division of Pediatric Infectious Disease, New York, United States, ²Centers for Disease Control & Prevention, Division of Viral Diseases, Atlanta, United States, ³Mount Sinai School of Medicine, Department of OB/Gyn, New York, United States, ⁴Mount Sinai School of Medicine, Division of Infectious Disease, New York, United StatesAlso accessible at http://pag.aids2012.org/abstracts.aspx?aid=14088

 

Background: Many youth with perinatally acquired HIV (PAH) exhibit poor immune responses to vaccinations, including measles, mumps and rubella (MMR). This has worldwide public health implications, particularly in areas with high prevalence of HIV and measles. The objective of this pilot study was to determine the prevalence of measles immunity among individuals with PAH and prior MMR vaccination.

Methods: Individuals with PAH >13 years old, receiving care at Mount Sinai Hospital (MSH), New York with prior MMR vaccination were enrolled. Measles IgG titers were determined at MSH via commercially available ELISA and at the Centers for Disease Control and Prevention, Atlanta by plaque reduction neutralization (PRN) assay. Measles immunity was defined as IgG titers >120mIU by PRN assay. Medical records were reviewed for demographics and pertinent clinical data. P-values were calculated using Wilcoxon test, Chi-square or Fisher's exact test as appropriate.

Results: Based on PRN assay, only 6/34 (17.6%) subjects were measles immune. Measles immune subjects were younger [median age 14.5 vs. 19 years (p=0.01)]. Differences in gender and race/ethnicity were not statistically significant between immune and non-immune groups [65% vs. 50% female (p=0.648) and 79% vs. 67% Black or Hispanic (p=0.802) respectively].

	Measles Non-Immune (n = 28)	Measles Immune (n = 6)	p-value
Age, years (Median) (IQR)	19 (17-20)	14.5 (13-18)	0.01
Female, No. (%)	19 (65%)	3 (50%)	0.648
Race/Ethnicity, No. (%)			0.802
White	1 (4%)	0 (0%)
African American	7 (24%)	1 (17%)
Hispanic	16 (55%)	3 (50%)
Other	5 (17%)	2 (33%)

• [Table 1: Baseline Demographics]
  
  
  One (17%) measles immune subject had a history of opportunistic infections compared to 18 (62%) non-immune subjects (p=0.07). Median CD4 count at enrollment and nadir CD4 count were 682 cells/mm³ and 299 cells/mm³ in measles immune subjects vs. 263 cells/mm³ (p=0.054) and 143 cells/mm³ (p=0.175) in non-immune subjects, respectively. Additionally, 83% immune subjects received antiretroviral therapy at vaccination compared to 30% non-immune subjects (p=0.025).

Measles Non-Immune (n = 28)	Measles Immune (n = 6)	p-value
18 (62%)	1 (17%)	0.07
143 (23-231)	299 (34-442)	0.175
14 (3-25)	25 (7-41)	0.227
3.74 (3.18-4.3)	2.79 (1.22-4.36)	0.159
2 (1-4)	2 (2-3)	0.618
12 (11-18)	13.5 (11-15)	0.873