Seroprevalence of measles IgG among HIV-1-infected and uninfected Kenyan adults

Abstract

Summary Despite global efforts to reduce measles incidence, outbreaks continue to occur in developing countries where HIV-1-infected adults represent a vulnerable population. Immunization campaigns have targeted children, although little is known about the levels of measles protection in adult populations in Kenya. The objective of this study was to determine seroprevalence and titers of measles IgG among HIV-1-infected and uninfected adults in Nairobi, Kenya. The presence of anti-measles IgG was measured in cryopreserved serum of 257 HIV-1-infected and 367 uninfected adults using a commercial ELISA (Enzygnost, Germany). The measles IgG concentration was calculated for those samples that were positive. Overall, 96% of adults were measles seropositive and the mean measles IgG concentration among those who were seropositive was 4134 mIU/ml, which is well above previously reported protective levels. There was no statistical difference in seroprevalence or antibody concentration between the HIV-infected and HIV-uninfected groups. While local vaccination efforts and circulating measles infection likely contribute to this high measles seroprevalence rate, these data are unique to an urban population and may not reflect a country-wide distribution. Our results suggest that reduced immunity among HIV-1-infected adults is not a major contributor to measles resurgence in Kenya.

Soil transmitted helminth infections are not associated with compromised antibody responses to previously administered measles and tetanus vaccines among HIV-1 infected, ART naïve Kenyan adults

“…In this study, most (> 70%) of the HIV-1 and helminth co-infected individuals appear to have adequate immune protection against measles as confirmed by measles seropositivity. The seroprevalence we observed was lower than that seen in a recent study among a similar population of HIV-1 infected adults in Kenya (96%), as well as a study among HIV-1 infected adults in the UK (93%), and comparable to a study in Mexico (76%) ( Belaunzaran-Zamudio et al, 2009 , Molton et al, 2010 , Merkel et al, 2014 ).…”

Exploring HIV infection and susceptibility to measles among older children and adults in Malawi: a facility-based study

“…22 Further, the antibody response to measles vaccine was not associated with CD4 count in HIV-infected Zambian children. 37 However, a low CD4 count was associated with both a lower measles antibody concentration and a worse response to revaccination with measles vaccine among HIVinfected children in Central Africa.…”

“…[15][16][17][18] Other reports have shown that HIV infection is associated with greater severity of measles disease, 19 higher mortality from measles, 20 and prolonged measles virus shedding. 21 Few studies have addressed the role of HIV infection in measles infection risk among adults and children after infancy: 18,22 one study concluded that measles vaccine-derived antibodies decline more rapidly in HIV-infected adults (n = 48); 23 a further three studies reported finding no difference in measles seropositivity between HIV-infected adults at different stages of disease progression (as measured by CD4 count). [24][25][26] A study among Kenyan adults in Nairobi found no statistical difference in measles IgG seroprevalence and concentration between HIV-infected and HIV-uninfected adults, and concluded that reduced immunity among HIV-infected adults was not a major contributor to measles resurgence in that country.…”

“…[24][25][26] A study among Kenyan adults in Nairobi found no statistical difference in measles IgG seroprevalence and concentration between HIV-infected and HIV-uninfected adults, and concluded that reduced immunity among HIV-infected adults was not a major contributor to measles resurgence in that country. 22 An association between HIV infection and measles susceptibility in individuals over 18 months of age could have wide-ranging implications throughout areas of high HIV prevalence in Africa and Asia that remain at risk for measles outbreaks, 10 where achieving measles control goals may need to include specific guidance for HIV-infected individuals. To investigate this possible association, we assessed measles antibody levels according to HIV status and CD4 count among individuals presenting at a hospital-based outpatient clinic in a rural district of southern Malawi.…”

Seroprevalence of Antibodies to Measles, Mumps and Rubella (MMR) Vaccines in Previously Vaccinated Human Immunodeficiency Virus-Infected Children and their Control Counterparts

“…Infections caused by these three illnesses can be severe in individuals with impaired cell-mediated immunity, including HIV infections [4][5][6]. Little data is available regarding anti-measles, mumps, and rubella antibody levels in vaccinated HIV-infected individuals [7][8][9][10]; and no published data are available in the United States which evaluate the seroprevalence of measles, mumps, and rubella IgG antibodies in HIV-infected children compared with control children. Recent US outbreaks of measles, mumps, and rubella in vaccinated immune-competent children [11][12][13] have raised concerns regarding the risk of immunocompromised HIV-infected children, adolescents, and adults contracting these infections and suffering the complications, which include death.…”