Immunogenicity, immunologic memory, and safety following measles revaccination in HIV-infected children receiving highly active antiretroviral therapy
Mark J Abzug, Min Qin, Myron J Levin, Terence Fenton, Judy A Beeler, William J Bellini, Susette Audet, Sun Bae Sowers, William Borkowsky, Sharon A Nachman, Stephen I Pelton, Howard M Rosenblatt, International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1024 and P1061s Protocol Teams, Shirley Jankelevich, Patrick Jean-Philippe, Jennifer Read, Victoria Hadhazy, Alison Robbins, Beth Sheeran, Jane C Lindsey, Lin-Ye Song, Janice Hodge, Mary Caporale, Nancy Webb, Courtney Ashton, Dorothy Smith, Lourdes Angeli, John Pella, Paul Tran, Grace Aldrovandi, Rachel Barrett, William Kabat, Alan Shaw, Daniel Isaacman, Velma Keeley, Paul Willems, Carol Gore, Ram Yogev, Barry Dashefsky, Linda Bettica, Paul Palumbo, Elaine Abrams, Maxine Frere, Lisa Gaye Robinson, Mahrukh Bamji, Audra Deveikis, Susan Marks, Karen Elkins, Lisa Melton, Eleanor Jimenez, James Homans, Ana Melendez, Andrea Kovacs, Mobeen H Rathore, Ana Alvarez, Ayesha Mirza, Thomas Chiu, Stephen A Spector, Rolando Viani, Mary Caffery, Lisa Stangl, Denise Ferraro, Silvia Muniz, Michell Davi, Jody Maes, Carol Salbenblatt, Suzanne Paul, Emily Barr, Vincent R Bonagura, Susan J Schuval, Connie Colter, Ann Petru, Teresa Courville, Karen Gold, Lauren Poole, Janet S Chen, Jill A Foster, Daniel H Conway, Gary Koutsoubis, Ann Marie Regan, H Jack Moallem, Edward Handelsman, Denise Swindell, Jean Kaye, Wanda Figueroa, Mavis Dummitt, Anantha Kallury, Murli Purswani, Saroj Bakshi, Emma Stuard, Steven Arpadi, Katherine Luzuriaga, Dottie Smith, Sandra Burchett, Lynne Lewis, Catherine Kneut, Amy Inman, Linh Tran, Guillermo Talero, Ann Puga, John Farley, Mary MacFadden, Diane Wara, Siham Akleh, Aditya Kaul, Sulachni Chandwani, Thomas Hastings, Geoffrey A Weinberg, Susan Laverty, Barbra Murante, Francis Gigliotti, Warren A Andiman, Leslie Hurst, Sostena Romano, Irma Rodriguez, Juan C Salazar, Gail Karas, Lorraine Wells, William Shearer, Jaime Martinez, Joseph Stavola, Hans Spiegel, Robert Lawrence, Russell Van Dyke, Cheryl Borne, Margaret Cowie, Robert Pass, Marilyn Crain, Newana Beatty, Mark J Abzug, Min Qin, Myron J Levin, Terence Fenton, Judy A Beeler, William J Bellini, Susette Audet, Sun Bae Sowers, William Borkowsky, Sharon A Nachman, Stephen I Pelton, Howard M Rosenblatt, International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1024 and P1061s Protocol Teams, Shirley Jankelevich, Patrick Jean-Philippe, Jennifer Read, Victoria Hadhazy, Alison Robbins, Beth Sheeran, Jane C Lindsey, Lin-Ye Song, Janice Hodge, Mary Caporale, Nancy Webb, Courtney Ashton, Dorothy Smith, Lourdes Angeli, John Pella, Paul Tran, Grace Aldrovandi, Rachel Barrett, William Kabat, Alan Shaw, Daniel Isaacman, Velma Keeley, Paul Willems, Carol Gore, Ram Yogev, Barry Dashefsky, Linda Bettica, Paul Palumbo, Elaine Abrams, Maxine Frere, Lisa Gaye Robinson, Mahrukh Bamji, Audra Deveikis, Susan Marks, Karen Elkins, Lisa Melton, Eleanor Jimenez, James Homans, Ana Melendez, Andrea Kovacs, Mobeen H Rathore, Ana Alvarez, Ayesha Mirza, Thomas Chiu, Stephen A Spector, Rolando Viani, Mary Caffery, Lisa Stangl, Denise Ferraro, Silvia Muniz, Michell Davi, Jody Maes, Carol Salbenblatt, Suzanne Paul, Emily Barr, Vincent R Bonagura, Susan J Schuval, Connie Colter, Ann Petru, Teresa Courville, Karen Gold, Lauren Poole, Janet S Chen, Jill A Foster, Daniel H Conway, Gary Koutsoubis, Ann Marie Regan, H Jack Moallem, Edward Handelsman, Denise Swindell, Jean Kaye, Wanda Figueroa, Mavis Dummitt, Anantha Kallury, Murli Purswani, Saroj Bakshi, Emma Stuard, Steven Arpadi, Katherine Luzuriaga, Dottie Smith, Sandra Burchett, Lynne Lewis, Catherine Kneut, Amy Inman, Linh Tran, Guillermo Talero, Ann Puga, John Farley, Mary MacFadden, Diane Wara, Siham Akleh, Aditya Kaul, Sulachni Chandwani, Thomas Hastings, Geoffrey A Weinberg, Susan Laverty, Barbra Murante, Francis Gigliotti, Warren A Andiman, Leslie Hurst, Sostena Romano, Irma Rodriguez, Juan C Salazar, Gail Karas, Lorraine Wells, William Shearer, Jaime Martinez, Joseph Stavola, Hans Spiegel, Robert Lawrence, Russell Van Dyke, Cheryl Borne, Margaret Cowie, Robert Pass, Marilyn Crain, Newana Beatty
Abstract
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.
Clinical trials registration: NCT00013871 (www.clinicaltrials.gov).
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Source: PubMed