Low HIV load tied to good MMR vaccine response in children
An HIV load below 400 copies/mL is associated with good antibody response and memory to MMR vaccination in HIV-positive children and adolescents.
An HIV load below 400 copies/mL was associated with good antibody response and memory to measles-mumps-rubella (MMR) vaccination in HIV-positive children and adolescents. Eighty percent of study participants had evidence of seroprotection 80 days after vaccination.
Children not taking combination antiretroviral therapy (ART) have reduced response rates and immunologic memory after MMR vaccination. This study by the International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1024 and P1061s Protocol Teams aimed to study responses to revaccination in 2- to under-19-year-old youngsters taking ART.
All study participants had 1 or more previous MMR vaccinations. All had a CD4 percent at or above 15%. Researchers measured antibody concentrations before and 8, 32, and 80 weeks after vaccination by plaque reduction assay. A subset of children received another MMR vaccination 4 to 5 years later.
When 193 children entered the study, 100 (52%) had seroprotection, defined as a plaque reduction assay level at or above 120 mIU/mL. Seroprotection rates were 89% at 8 weeks after vaccination and 80% at 80 weeks after vaccination.
Among 65 children revaccinated 4 to 5 years later, 55 (85%) had memory based on seroprotection before or 7 days after revaccination.
A viral load at or below 400 copies/mL at the time of the initial study vaccination was associated with higher seroprotection rates, greater antibody concentrations, and memory.
Grade 3 fever or fatigue affected only 2% of study participants.
By Mark Mascolini
Source: 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, for the International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1024 and P1061s Protocol Teams. Immunogenicity, immunologic memory, and safety following measles revaccination in HIV-infected children receiving highly active antiretroviral therapy. Journal of Infectious Diseases. 2012; 206: 512-522.
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