title: Measles and Rubella Seroprevalence Among HIV-infected and Uninfected Zambian Youth.
abstract: Measles and congenital rubella syndrome remain significant causes of morbidity and mortality despite available vaccines. HIV-infected youth may be at increased risk of measles because of greater waning immunity after vaccination. At a population level, they constitute a potentially large pool of susceptibles to measles and rubella. More data among HIV-infected youth in sub-Saharan Africa are needed to guide vaccination policy and control strategies.
  
  
  
  This cross-sectional study was nested within 2 ongoing studies of malaria and HIV in Zambia. Dried blood spot cards from youth (5-15 years) in these studies from 2009 to 2013 were tested for IgG antibodies to measles and rubella viruses. HIV-uninfected youth, HIV-infected treatment-naive youth and HIV-infected youth receiving antiretroviral therapy (ART) were compared.
  
  
  
  A total of 617 HIV-uninfected, 144 HIV-infected treatment-naive and 128 HIV-infected youth receiving ART were included in this study. The proportion seropositive for measles virus was significantly higher among HIV-uninfected youth (92.5%) compared with HIV-infected treatment-naive youth (74.1%) and HIV-infected youth receiving ART (71.9%). No differences by age were observed. The proportion seropositive for rubella virus was significantly higher among HIV-uninfected youth (54.7%) compared with HIV-infected treatment-naive youth (41.7%) and HIV-infected youth receiving ART (49.6%), with increases observed by age for all groups.
  
  
  
  Measles seroprevalence was lower among HIV-infected than uninfected youth, consistent with waning immunity after measles vaccination. HIV-infected youth would benefit from revaccination. Half of all youth in rural Zambia were susceptible to rubella and may need targeting for catch-up rubella campaigns when measles-rubella vaccine is introduced.
authors.affiliation: From the *Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; †Macha Research Trust, Macha Hospital, Choma, Zambia; and ‡Department of Pediatrics-Infectious Diseases, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Catherine G
authors.initials: CG
authors.lastname: Sutcliffe
authors.forename: Kelly
authors.initials: K
authors.lastname: Searle
authors.forename: Hellen K
authors.initials: HK
authors.lastname: Matakala
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Greenman
authors.forename: Kaitlin
authors.initials: K
authors.lastname: Rainwater-Lovett
authors.forename: Philip E
authors.initials: PE
authors.lastname: Thuma
authors.forename: William J
authors.initials: WJ
authors.lastname: Moss
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008457:Measles / Q000453:epidemiology*; D012307:Risk Factors; D012409:Rubella / Q000453:epidemiology*; D016036:Seroepidemiologic Studies; D015024:Zambia / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral