Immunogenicity, immunologic memory, and safety following measles revaccination in HIV-infected children receiving highly active antiretroviral therapy.
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.


BACKGROUND
NCT00013871 (www.clinicaltrials.gov).
Pediatric Infectious Diseases, Box B055, Children’s Hospital Colorado, 13123 East 16th Ave, Aurora, CO 80045, USA. mark.abzug@childrenscolorado.org
Mark J
MJ
Abzug
Min
M
Qin
Myron J
MJ
Levin
Terence
T
Fenton
Judy A
JA
Beeler
William J
WJ
Bellini
Susette
S
Audet
Sun Bae
SB
Sowers
William
W
Borkowsky
Sharon A
SA
Nachman
Stephen I
SI
Pelton
Howard M
HM
Rosenblatt
D000293:Adolescent; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D007117:Immunization, Secondary / Q000379:methods*; D007156:Immunologic Memory; D007223:Infant; D008297:Male; D008458:Measles Vaccine / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D009500:Neutralization Tests; D019562:Viral Load; D010948:Viral Plaque Assay
D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D008458:Measles Vaccine