Implications of the Human Immunodeficiency Virus Epidemic for Control and Eradication of Measles

Abstract

Human immunodeficiency virus (HIV)-infected persons may be important, unrecognized transmitters of measles virus, thwarting eradication efforts. We reviewed the published English-language literature on measles and measles immunization in HIV-infected persons to investigate the clinical features of measles, the responses to measles immunization, and the safety of measles vaccine in HIV-infected persons and, conversely, the effect of measles and measles immunization on HIV infection. HIV-infected persons with measles are likely to have uncharacteristic clinical findings and severe illness, with high rates of pneumonitis and death. Primary and secondary failure of measles vaccine in HIV-infected children may permit transmission of measles virus in spite of high rates of immunization coverage. A factor that complicates measles-control efforts in areas of high prevalence of HIV is the potential for fatal infection with measles vaccine virus. Further research on the impact of the HIV epidemic on measles and measles immunization is necessary to guide strategies for the eradication of measles.

Selectively Receptor-Blind Measles Viruses: Identification of Residues Necessary for SLAM- or CD46-Induced Fusion and Their Localization on a New Hemagglutinin Structural Model

“…Receptor-blind viruses may be developed as more attenuated live vaccines for the protection of immunocompromized individuals (2,17,42) and derivatives thereof may find applications in cytoreductive therapy protocols based on the efficient replication of MV in cancer cells (21,(55)(56)(57). Moreover, recombinant MVs entering cells through targeted receptors have been produced (23,71), and their efficacy in eliminating human cancer cell xenografts has been proven (5,54).…”

A Chimeric Human-Bovine Parainfluenza Virus Type 3 Expressing Measles Virus Hemagglutinin Is Attenuated for Replication but Is Still Immunogenic in Rhesus Monkeys

“…Additional chimeric recombinant PIVs expressing the measles virus F glycoprotein with or without HA will also be generated, and their immunogenicity and efficacy will be examined in animal models. The need for a measles virus vaccine to protect children less than 15 months of age is greatest in the regions of the world where there also is a high prevalence of infection with human immunodeficiency virus (30,33). The candidate measles vaccine described here should be phenotypically stable in vivo following prolonged replication in an immunocompromised host because the attenuation phenotype is likely specified by many of the 79 amino acid differences that differentiate the bovine and human N proteins, but this assumption requires experimental verification.…”

Identifying high-risk areas for sporadic measles outbreaks: lessons from South Africa

“…In addition, achieving a high level of population immunity may be difficult in areas such as sub-Saharan Africa where the prevalence of human immunodeficiency virus (HIV) infection is high because infected children are less likely to respond to vaccination or maintain a protective antibody level or may acquire lower antibody levels from an HIV-positive (HIV+) mother. [14][15][16] Vaccination may need to be repeated more frequently in these areas. 16 Since 1995, several African countries have launched initiatives to eliminate measles, as recommended by the World Health Organization (WHO).…”