INTRODUCTION: The high burden of maternal HIV-infection in sub-Saharan Africa may affect measles control. We evaluated the effect of in-utero HIV-exposure and antiretroviral treatment (ART) strategies on measles antibody kinetics prior and following measles vaccination. METHODS:Infants aged 6-12 weeks were enrolled. This included HIV-uninfected infants born to HIV-uninfected (HUU) and HIV-infected mothers (HEU). Additionally, we enrolled perinatal HIV-infected infants with CD4% equal or greater than 25% randomized todeferred-ART until clinically or immunologically indicated (Group-3) or immediate-ART initiation (Group-4). Group-4 was further randomized to interrupt ART at 1 year (Group-4a) or 2 years of age (Group-4b). Additionally, a convenience sample of HIV-infected infants with CD4⁺ less than 25% initiated on immediate-ART was enrolled (Group-5). Measles immunoglobulin-G antibodies were quantified by an indirect enzyme immunoassay with titers 330 mIU/ml or more considered 'sero-protective'. The referent group was HUU-children. RESULTS: The proportion with sero-protective titers at 7.3 weeks of age was higher in HUU (65.2%) compared with any HIV-infected group (range: 16.7-41.8%), but dropped to less than 17% in all groups at age 19.6 weeks. Twenty-eight weeks following the first measles vaccine, Group-4a was less likely to have sero-protective titers (79.3%) as compared to HUU (91.1%; P<0.0001), Group-3 (95.7%; P=0.003) or Group-4b (92.1%; P=0.018). Although the proportion with sero-protective levels were similar between groups immediately postbooster dose, this was lower in HEU (79.6%; P=0.002) and Group-4a (80.3%; P=0.010) compared with HUU (94.3%) 41-weeks later. CONCLUSION: Greater waning of immunity among HIV-infected children in whom ART was interrupted and in HEU following a booster-dose, indicate the possible need for further measles-booster doses after 2 years of age in these children.
RCT Entities:
INTRODUCTION: The high burden of maternal HIV-infection in sub-Saharan Africa may affect measles control. We evaluated the effect of in-utero HIV-exposure and antiretroviral treatment (ART) strategies on measles antibody kinetics prior and following measles vaccination. METHODS:Infants aged 6-12 weeks were enrolled. This included HIV-uninfected infants born to HIV-uninfected (HUU) and HIV-infected mothers (HEU). Additionally, we enrolled perinatal HIV-infectedinfants with CD4% equal or greater than 25% randomized to deferred-ART until clinically or immunologically indicated (Group-3) or immediate-ART initiation (Group-4). Group-4 was further randomized to interrupt ART at 1 year (Group-4a) or 2 years of age (Group-4b). Additionally, a convenience sample of HIV-infectedinfants with CD4⁺ less than 25% initiated on immediate-ART was enrolled (Group-5). Measles immunoglobulin-G antibodies were quantified by an indirect enzyme immunoassay with titers 330 mIU/ml or more considered 'sero-protective'. The referent group was HUU-children. RESULTS: The proportion with sero-protective titers at 7.3 weeks of age was higher in HUU (65.2%) compared with any HIV-infected group (range: 16.7-41.8%), but dropped to less than 17% in all groups at age 19.6 weeks. Twenty-eight weeks following the first measles vaccine, Group-4a was less likely to have sero-protective titers (79.3%) as compared to HUU (91.1%; P<0.0001), Group-3 (95.7%; P=0.003) or Group-4b (92.1%; P=0.018). Although the proportion with sero-protective levels were similar between groups immediately postbooster dose, this was lower in HEU (79.6%; P=0.002) and Group-4a (80.3%; P=0.010) compared with HUU (94.3%) 41-weeks later. CONCLUSION: Greater waning of immunity among HIV-infectedchildren in whom ART was interrupted and in HEU following a booster-dose, indicate the possible need for further measles-booster doses after 2 years of age in these children.
Authors: Adriana Weinberg; Marisa M Mussi-Pinhata; Qilu Yu; Rachel A Cohen; Volia C Almeida; Fabiana R Amaral; Laura Freimanis; Donald Robert Harris; Christiana Smith; George Siberry Journal: AIDS Res Hum Retroviruses Date: 2018-04-23 Impact factor: 2.205
Authors: Eleonora A M L Mutsaerts; Marta C Nunes; Martijn N van Rijswijk; Kerstin Klipstein-Grobusch; Kennedy Otwombe; Mark F Cotton; Avy Violari; Shabir A Madhi Journal: Clin Infect Dis Date: 2019-08-01 Impact factor: 9.079
Authors: Omphile E Simani; Alane Izu; Marta C Nunes; Avy Violari; Mark F Cotton; Nadia Van Niekerk; Peter V Adrian; Shabir A Madhi Journal: Expert Rev Vaccines Date: 2018-11-19 Impact factor: 5.217
Authors: Myron J Levin; Jane C Lindsey; Susan S Kaplan; Werner Schimana; Jody Lawrence; Monica M McNeal; Mutsa Bwakura-Dangarembizi; Anthony Ogwu; Evans M Mpabalwani; Paul Sato; George Siberry; Margaret Nelson; Darcy Hille; Geoffrey A Weinberg; Adriana Weinberg Journal: AIDS Date: 2017-01-02 Impact factor: 4.177
Authors: Kirsty Le Doare; Lauren Allen; Beate Kampmann; Paul Trafford Heath; Stephen Taylor; Anneke C Hesseling; Andrew Gorringe; Christine Elizabeth Jones Journal: Vaccine Date: 2014-12-24 Impact factor: 3.641
Authors: Shabir A Madhi; Anthonet Koen; Lisa Jose; Nadia van Niekerk; Peter V Adrian; Clare Cutland; Nancy François; Javier Ruiz-Guiñazú; Juan-Pablo Yarzabal; Marta Moreira; Dorota Borys; Lode Schuerman Journal: Medicine (Baltimore) Date: 2017-01 Impact factor: 1.889
Authors: Christiana Smith; Emilie Jalbert; Volia de Almeida; Jennifer Canniff; Laurel L Lenz; Marisa M Mussi-Pinhata; Rachel A Cohen; Qilu Yu; Fabiana R Amaral; Jorge Pinto; Jorge O Alarcon; George Siberry; Adriana Weinberg Journal: Front Immunol Date: 2017-04-24 Impact factor: 7.561
Authors: Chloe I Jones; Suzanne L Rose; Ashley Shutt; Cristiana Cairo; Natasha M Bourgeois; Manhattan Charurat; Donald L Sodora; Matthew P Wood Journal: AIDS Date: 2021-01-01 Impact factor: 4.632