IMMUNOGENICITY, IMMUNOLOGIC MEMORY, AND SAFETY FOLLOWING MEASLES REVACCINATION IN HIV-INFECTED CHILDREN RECEIVING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY

Monday, 1st of September 2014

[source]Journal of Infectious Diseases[|source]

Prior to highly active antiretroviral therapy (HAART), HIV-infected children had reduced response rates, lower antibody titers, and more rapid antibody decline following measles vaccination; lack of recall responses; and vaccine failures. Endemic measles and measles outbreaks pose a risk to HIV-infected children, and the HIV epidemic may complicate efforts for global measles control. Therefore, it is important to assess vaccine-induced immunity against measles in HIV-infected children in the context of HAART

In this study, the authors conducted a multicenter study of the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) designed to evaluate immunogenicity of vaccines in HIV-infected children on HAART. The report documents varying immune responsiveness to different vaccines in the same population of HIV-infected children. Detailed findings and recommendations are accessible at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491735/

 

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.