Measles Seropositivity in HIV-infected Kenyan Children on Antiretroviral Therapy

Newman, Laura P.; Njoroge, Anne; Ben-Youssef, Leïla; Merkel, Michele; Gatuguta, Ann; Ton, Quy; Obimbo, Elizabeth; Wamalwa, Dalton; Lohman-Payne, Barbara; Richardson, Barbra A.; Nduati, Ruth; Farquhar, Carey

doi:10.1097/inf.0000000000000332

Cited by 11 publications

(10 citation statements)

References 8 publications

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“…Cohort and caregiver characteristics, as well as measles serostatus before revaccination were previously described 13 . Of the enrolled children, 220 (95%) attended their one month post revaccination visit, 224 (97%) attended their 12 month visit, and 220 (95%) attended their 24 months visit.…”

Section: Resultsmentioning

confidence: 99%

“…HIV-infected children and their caregivers were recruited from the HIV Comprehensive Care Centre at Kenyatta National Hospital in Nairobi, Kenya, during routine HIV care visits between May 2011 and January 2013, as previously described 13 . Caregivers willing to be screened were asked to read and sign an informed consent document, approved by Kenyatta National Hospital and the University of Washington.…”

Section: Methodsmentioning

confidence: 99%

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Sustained Responses to Measles Revaccination at 24 Months in HIV-infected Children on Antiretroviral Therapy in Kenya

Newman

Njoroge

Magaret³

et al. 2017

Pediatric Infectious Disease Journal

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Background There are limited data on whether HIV-infected children in resource-limited countries who are receiving antiretroviral therapy (ART) are able to produce sustained, protective levels of measles antibody after multiple measles vaccinations. Methods We administered an additional measles vaccine to HIV-infected children 15 months to 12 years of age receiving ART in Nairobi, Kenya. Measles antibody concentrations were determined by enzyme-linked immunosorbent assay (ELISA) at enrollment, one month, 12 months, and 24 months post revaccination. Results At enrollment, 125 (54%) of 232 study participants had protective concentrations of measles antibody. Measles seropositivity increased to 98% of all children at one month post revaccination, but decreased to 71% at 12 months, and 60% at 24 months post revaccination. Measles seroconversion and sustained measles seropositivity among those who were measles seronegative at enrollment was 25% at 24 months post revaccination. In this group, 39% of children with <50 copies/mL plasma HIV RNA measles seroconverted compared with 4% of children with plasma HIV RNA ≥1,000 copies/mL (p=0.018). Conclusions Measles revaccination can result in a sustained antibody response in a subset of HIV-infected children receiving ART, especially among those with HIV suppression.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Sustained Responses to Measles Revaccination at 24 Months in HIV-infected Children on Antiretroviral Therapy in Kenya

Newman

Njoroge

Magaret³

et al. 2017

Pediatric Infectious Disease Journal

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“…We support the recent Paediatric European Network for Treatment of AIDS/ Children's HIV Association guidelines, 2 W e were interested to read the paper by Newman et al 1 They conclude that most HIV-infected children were not immune to measles and "might benefit from revaccination." We agree that many HIVinfected children are not immune to measles, but revaccination may only benefit a proportion of these children.…”

Section: Discussionmentioning

confidence: 83%

Measles Reimmunization May Not Be Effective in Protecting HIV-Infected Children

Rowson

Tan²,

Donaghy³

et al. 2015

Pediatric Infectious Disease Journal

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“…The demographic characteristics of the overall cohort have been described previously [9]. Briefly, 232 children attending routine clinic visits at the Comprehensive HIV Care Centre at Kenyatta National Hospital in Nairobi, Kenya were enrolled.…”

Section: Demographic and Clinical Characteristics Of Study Participantsmentioning

confidence: 99%

“…HIV-infected children are less capable of mounting and maintaining responses to vaccination against measles than uninfected, otherwise healthy children [4][5][6][7]. Studies in Kenya have demonstrated that administration of anti-retroviral therapy (ART) to HIV-infected individuals alone is not sufficient to restore measles antibody titres [8,9].…”

Section: Introductionmentioning

confidence: 99%

T cell anergy and activation are associated with suboptimal humoral responses to measles revaccination in HIV-infected children on anti-retroviral therapy in Nairobi, Kenya

Buechler

Newman²,

Chohan

et al. 2015

Clinical and Experimental Immunology

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SummaryHIV-infected children are less capable of mounting and maintaining protective humoral responses to vaccination against measles compared to HIV-uninfected children. This poses a public health challenge in countries with high HIV burdens. Administration of anti-retroviral therapy (ART) and revaccinating children against measles is one approach to increase measles immunity in HIV-infected children, yet it is not effective in all cases. Immune anergy and activation during HIV infection are factors that could influence responses to measles revaccination. We utilized a flow cytometry-based approach to examine whether T cell anergy and activation were associated with the maintenance of measles-specific immunoglobulin (Ig)G antibodies generated in response to measles revaccination in a cohort of HIV-infected children on ART in Nairobi, Kenya. Children who sustained measles-specific IgG for at least 1 year after revaccination displayed significantly lower programmed cell death 1 (PD-1) surface expression on CD81 T cells on a per-cell basis and exhibited less activated CD4 1 T cells compared to those unable to maintain detectable measles-specific antibodies. Children in both groups were similar in age and sex, CD4 1 T cell frequency, duration of ART treatment and HIV viral load at enrolment. These data suggest that aberrant T cell anergy and activation are associated with the impaired ability to sustain an antibody response to measles revaccination in HIVinfected children on ART.

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Measles Seropositivity in HIV-infected Kenyan Children on Antiretroviral Therapy

Cited by 11 publications

References 8 publications

Sustained Responses to Measles Revaccination at 24 Months in HIV-infected Children on Antiretroviral Therapy in Kenya

Sustained Responses to Measles Revaccination at 24 Months in HIV-infected Children on Antiretroviral Therapy in Kenya

Measles Reimmunization May Not Be Effective in Protecting HIV-Infected Children

T cell anergy and activation are associated with suboptimal humoral responses to measles revaccination in HIV-infected children on anti-retroviral therapy in Nairobi, Kenya

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