Immunogenicity of standard-titer measles vaccine in HIV-1-infected and uninfected Zambian children: an observational study.
BACKGROUND
Achieving the level of population immunity required for measles elimination may be difficult in regions of high human immunodeficiency virus type 1 (HIV-1) prevalence, because HIV-1-infected children may be less likely to respond to or maintain protective antibody levels after vaccination.


METHODS
We conducted a prospective study of the immunogenicity of standard-titer measles vaccine administered at 9 months of age to HIV-1-infected and uninfected children in Lusaka, Zambia.


RESULTS
From May 2000 to November 2002, 696 children aged 2-8 months were enrolled. Within 6 months of vaccination, 88% of 50 HIV-1-infected children developed antibody levels of >or=120 mIU/mL, compared with 94% of 98 HIV-seronegative children and 94% of 211 HIV-seropositive but uninfected children (P=.3). By 27 months after vaccination, however, only half of the 18 HIV-1-infected children who survived and returned for follow-up maintained measles antibody levels >or=120 mIU/mL, compared with 89% of 71 uninfected children (P=.001) and in contrast with 92% of 12 HIV-1-infected children revaccinated during a supplemental measles immunization activity.


CONCLUSIONS
Although HIV-1-infected children showed good primary antibody responses to measles vaccine, their rapid waning of antibody suggests that measles vaccination campaigns may need to be repeated more frequently in areas of high HIV-1 prevalence.
Moss
William J
WJ
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. wmoss@jhsph.edu
Scott
Susana
S
Mugala
Nanthalile
N
Ndhlovu
Zaza
Z
Beeler
Judy A
JA
Audet
Susette A
SA
Ngala
Mirriam
M
Mwangala
Sheila
S
Nkonga-Mwangilwa
Chansa
C
Ryon
Judith J
JJ
Monze
Mwaka
M
Kasolo
Francis
F
Quinn
Thomas C
TC
Cousens
Simon
S
Griffin
Diane E
DE
Cutts
Felicity T
FT
D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology*; D006801:Humans; D007117:Immunization, Secondary; D007223:Infant; D008297:Male; D008457:Measles / Q000150:complications / Q000276:immunology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage / Q000276:immunology*; D015024:Zambia / Q000453:epidemiology
D000914:Antibodies, Viral; D008458:Measles Vaccine