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‘Measles revaccination induced high rates of seroprotection and memory in children receiving HAART.’
J Infect Dis. (2012) 206 (4): 512-522. doi: 10.1093/infdis/jis386 First published online: June 12, 2012
Immunogenicity, Immunologic Memory, and Safety Following Measles Revaccination in HIV-Infected Children Receiving Highly Active Antiretroviral Therapy
Abstract below; full text available to JID subscribers
Mark J. Abzug1, Min Qin2, Myron J. Levin1, Terence Fenton2, Judy A. Beeler3, William J. Bellini4,
Susette Audet3, Sun Bae Sowers4, William Borkowsky5, Sharon A. Nachman6, Stephen I. Pelton7,
and for the International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1024 and P1061s Protocol Teams
+ Author Affiliations
1University of Colorado School of Medicine and Children's Hospital Colorado, Aurora
2Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts
3Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland
4Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
5New York University School of Medicine and Bellevue Hospital Center, New York
6State University of New York at Stony Brook, Stony Brook, New York
7Boston University School of Medicine and Boston Medical Center, Massachusetts
8Baylor College of Medicine and Texas Children's Hospital, Houston
Correspondence: Mark J. Abzug, MD, Pediatric Infectious Diseases, Box B055, Children's Hospital Colorado, 13123 East 16th Ave, Aurora, CO 80045 (mark.abzug@childrenscolorado.org).
Abstract
Background. Response rates and immunologic memory following measles vaccination are reduced in human immunodeficiency virus (HIV)–infected children in the absence of highly active antiretroviral therapy (HAART).
Methods. HIV-infected children 2 to <19 years old receiving HAART and with HIV loads <30 000 copies/mL, CD4% ≥15, and ≥1 prior measles-mumps-rubella vaccination (MMR) were given another MMR. Measles antibody concentrations before and 8, 32, and 80 weeks postvaccination were determined by plaque reduction neutralization (PRN). A subset was given another MMR 4–5 years later, and PRN antibody was measured before and 7 and 28 days later.
Results. At entry, 52% of 193 subjects were seroprotected (PRN ≥120 mIU/mL). Seroprotection increased to 89% 8 weeks postvaccination, and remained at 80% 80 weeks postvaccination. Of 65 subjects revaccinated 4–5 years later, 85% demonstrated memory based on seroprotection before or 7 days after vaccination. HIV load ≤400 copies/mL at initial study vaccination was associated with higher seroprotection rates, greater antibody concentrations, and memory. Grade 3 fever or fatigue occurred in 2% of subjects.
Conclusions. Measles revaccination induced high rates of seroprotection and memory in children receiving HAART. Both endpoints were associated with HIV viral load suppression.