Susceptibility to Measles Among Perinatally HIV-Infected Adolescents and Young Adults

Morris, L; Posada, Roberto; Hickman, Carole J.; Latner, Donald R.; Singh, Tricia; Rautenberg, Alyssa; Jao, Jennifer; Bellini, William J.; Sperling, Rhoda

doi:10.1093/jpids/pit054

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Seventy-one studies fulfilled the eligibility criteria (Supplementary data 4). Twenty-eight studies reported on safety [24], [25], [29], [33], [34], [35], [36], [37], [38], [39], [40], [41], [42], [43], [44], [45], [46], [47], [48], [49], [50], [51], [52], [53], [54], [55], [56], [57], [58], [59], [60], [61] and 62 reported on immunogenicity [23], [24], [25], [29], [30], [33], [34], [35], [36], [37], [39], [40], [41], [43], [44], [45], [47], [48], [50], [51], [53], [55], [56], [57], [59], [60], [61], [62], [63], [64], [65], [66], [67], [68], [69], [70], [71], [72], [73], [74], [75], [76], [77], [78], [79], [80], [81], [82], [83], [84], [85], [86], [87], …”

Section: Resultsmentioning

confidence: 99%

Safety and Immunogenicity of Measles Vaccination in HIV-Infected and HIV-Exposed Uninfected Children: A Systematic Review and Meta-Analysis

et al. 2018

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Background HIV-infected and HIV-exposed uninfected (HEU) children have an increased risk of measles that may be due to altered immune responses or suboptimal timing of measles vaccination. We aimed to evaluate the safety and immunogenicity of measles vaccination in HIV-infected and HEU children. Methods For this systematic review and meta-analysis, we searched PubMed, Embase, Cochrane Library, CINAHL, Global Health Library and IndMED on May 9, 2018. Studies were included if they reported on safety or seroresponse (either seroprotection/seropositivity/seroconversion) after measles vaccination in HIV-infected or HEU children. We calculated pooled estimates to compare immunogenicity outcomes between HIV-infected, HEU and HIV-unexposed children, using risk ratios [RRs] (with 95%CIs). PROSPERO registration number: CRD42017057411. Findings Seventy-one studies met the inclusion criteria (15,363 children). Twenty-eight studies reported on safety; vaccine-associated adverse events and deaths were uncommon. Sixty-two studies reported on immunogenicity, 27 were included in the meta-analysis. HIV-infected children had lower seroresponse rates after primary vaccination compared with HIV-unexposed (RR 0.74; 95%CI: 0.61–0.90, I 2 = 85.9%) and HEU children (0.78; 0.69–0.88, I 2 = 77.1%), which was mitigated by antiretroviral therapy and time interval between vaccination and serology. HEU and HIV-unexposed children had similar seroresponses. Vaccination at 6-months resulted in similar proportions of HIV-infected children having seroresponse compared with HIV-unexposed (0.96; 0.77–1.19) and HEU children (1.00; 0.73–1.37, I 2 = 63.7%). Interpretation Primary measles vaccination at 6-months of age may provide protection against measles during early infancy in settings with high prevalence of maternal HIV-infection, however, further studies are needed to evaluate this strategy in HEU children and HIV-infected children receiving antiretroviral therapy. Funding South African Research Chairs Initiative of the Department of Science and Technology and National Research Foundation in Vaccine Preventable Diseases; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit.

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Section: Resultsmentioning

confidence: 99%

Safety and Immunogenicity of Measles Vaccination in HIV-Infected and HIV-Exposed Uninfected Children: A Systematic Review and Meta-Analysis

et al. 2018

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“…A lower response rate to early childhood immunisations, and waning immunity after early vaccination, are likely causes; in outbreak situations, HIV-infected adolescents can be especially vulnerable. 30–33 Of 195 HIV-infected children identified with measles in an outbreak in Botswana in 2009–10, the median age was 13 years (IQR 10–15). 34 The most severely affected patients were HIV-infected adolescents, most of whom had been immunised against measles during early childhood.…”

Section: Infections and Malignant Diseasementioning

confidence: 99%

Perinatally acquired HIV infection in adolescents from sub-Saharan Africa: a review of emerging challenges

Lowenthal

Bakeera-Kitaka

Marukutira

et al. 2014

The Lancet Infectious Diseases

376

397

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Worldwide, more than three million children are infected with HIV, 90% of whom live in sub-Saharan Africa. As the HIV epidemic matures and antiretroviral treatment is scaled up, children with HIV are reaching adolescence in large numbers. The growing population of adolescents with perinatally acquired HIV infection living within this region presents not only unprecedented challenges but also opportunities to learn about the pathogenesis of HIV infection. In this Review, we discuss the changing epidemiology of paediatric HIV and the particular features of HIV infection in adolescents in sub-Saharan Africa. Longstanding HIV infection acquired when the immune system is not developed results in distinctive chronic clinical complications that cause severe morbidity. As well as dealing with chronic illness, HIV-infected adolescents have to confront psychosocial issues, maintain adherence to drugs, and learn to negotiate sexual relationships, while undergoing rapid physical and psychological development. Context-specific strategies for early identification of HIV infection in children and prompt linkage to care need to be developed. Clinical HIV care should integrate age-appropriate sexual and reproductive health and psychological, educational, and social services. Health-care workers will need to be trained to recognise and manage the needs of these young people so that the increasing numbers of children surviving to adolescence can access quality care beyond specialist services at low-level health-care facilities.

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“…Limited data are available on immunity to vaccine-preventable diseases among older HIV-infected children and adolescents with and without ART, 26–29 particularly in sub-Saharan Africa. 30 These data will be needed to guide vaccine policy on revaccination against measles and catch-up rubella vaccination.…”

Section: Introductionmentioning

confidence: 99%

Measles and Rubella Seroprevalence Among HIV–infected and Uninfected Zambian Youth

Sutcliffe

Searle

Matakala

et al. 2017

Pediatric Infectious Disease Journal

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Background 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 following 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. Methods This cross-sectional study was nested within two ongoing studies of malaria and HIV in Zambia. Dried blood spot cards from youth (5–15 years) in these studies from 2009–2013 were tested for IgG antibodies to measles and rubella viruses. HIV-uninfected youth, HIV-infected treatment-naïve youth, and HIV-infected youth receiving antiretroviral therapy (ART) were compared. Results 617 HIV-uninfected, 144 HIV-infected treatment-naïve, and 128 HIV-infected youth receiving ART were included in the study. The proportion seropositive for measles virus was significantly higher among HIV-uninfected youth (92.5%) compared to HIV-infected treatment-naïve 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-naïve youth (41.7%) and HIV-infected youth receiving ART (49.6%), with increases observed by age for all groups. Conclusions Measles seroprevalence was lower among HIV-infected than uninfected youth, consistent with waning immunity following measles vaccination. HIV-infected youth would likely 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.

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Susceptibility to Measles Among Perinatally HIV-Infected Adolescents and Young Adults

Cited by 4 publications

References 13 publications

Safety and Immunogenicity of Measles Vaccination in HIV-Infected and HIV-Exposed Uninfected Children: A Systematic Review and Meta-Analysis

Safety and Immunogenicity of Measles Vaccination in HIV-Infected and HIV-Exposed Uninfected Children: A Systematic Review and Meta-Analysis

Perinatally acquired HIV infection in adolescents from sub-Saharan Africa: a review of emerging challenges

Measles and Rubella Seroprevalence Among HIV–infected and Uninfected Zambian Youth

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