title: Changes in measles serostatus among HIV-infected Zambian children initiating antiretroviral therapy before and after the 2010 measles outbreak and supplemental immunization activities.
abstract: BACKGROUND
  In 2010, Zambia had a large measles outbreak, providing an opportunity to measure changes in measles serostatus following highly active antiretroviral therapy (HAART), exposure to measles virus, and revaccination among children infected with human immunodeficiency virus (HIV).
  
  
  METHODS
  A prospective cohort study of 169 HIV-infected Zambian children aged 9-60 months with a history of measles vaccination was conducted to characterize the effects of HAART and revaccination on measles immunoglobulin G (IgG) serostatus by enzyme immunoassay.
  
  
  RESULTS
  Prior to the measles outbreak, only 23% of HIV-infected children were measles IgG seropositive at HAART initiation. After adjusting for 6-month changes in baseline age and 5% changes in nadir CD4(+) T-cell percentage, HAART was not associated with measles IgG seroconversion. However, 18 of 19 children seroconverted after revaccination. Eight children seroconverted during the outbreak without revaccination and were likely exposed to wild-type measles virus, but none were reported to have had clinical measles.
  
  
  CONCLUSIONS
  Immune reconstitution after HAART initiation did not restore protective levels of measles IgG antibodies, but almost all children developed protective antibody levels after revaccination. Some previously vaccinated HIV-infected children had serological evidence of exposure to wild-type measles virus without a reported history of measles.
authors.affiliation: Department of Epidemiology.
authors.forename: Kaitlin
authors.initials: K
authors.lastname: Rainwater-Lovett
authors.forename: Hope C
authors.initials: HC
authors.lastname: Nkamba
authors.forename: Mwangelwa
authors.initials: M
authors.lastname: Mubiana-Mbewe
authors.forename: Carolyn
authors.initials: C
authors.lastname: Bolton-Moore
authors.forename: William J
authors.initials: WJ
authors.lastname: Moss
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007117:Immunization, Secondary; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D008458:Measles Vaccine / Q000008:administration & dosage / Q000276:immunology; D008459:Measles virus / Q000276:immunology*; D011446:Prospective Studies; D016036:Seroepidemiologic Studies; D014611:Vaccination; D019562:Viral Load; D015024:Zambia / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D008458:Measles Vaccine
keywords: HIV; antibody; antiretroviral therapy; immune reconstitution; measles; outbreak
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