title: Immunogenicity of standard-titer measles vaccine in HIV-1-infected and uninfected Zambian children: an observational study.
abstract: 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.
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. wmoss@jhsph.edu
authors.forename: William J
authors.initials: WJ
authors.lastname: Moss
authors.forename: Susana
authors.initials: S
authors.lastname: Scott
authors.forename: Nanthalile
authors.initials: N
authors.lastname: Mugala
authors.forename: Zaza
authors.initials: Z
authors.lastname: Ndhlovu
authors.forename: Judy A
authors.initials: JA
authors.lastname: Beeler
authors.forename: Susette A
authors.initials: SA
authors.lastname: Audet
authors.forename: Mirriam
authors.initials: M
authors.lastname: Ngala
authors.forename: Sheila
authors.initials: S
authors.lastname: Mwangala
authors.forename: Chansa
authors.initials: C
authors.lastname: Nkonga-Mwangilwa
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Ryon
authors.forename: Mwaka
authors.initials: M
authors.lastname: Monze
authors.forename: Francis
authors.initials: F
authors.lastname: Kasolo
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.forename: Simon
authors.initials: S
authors.lastname: Cousens
authors.forename: Diane E
authors.initials: DE
authors.lastname: Griffin
authors.forename: Felicity T
authors.initials: FT
authors.lastname: Cutts
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral; D008458:Measles Vaccine