Impact of HIV on Measles and Measles Immunisation

This study has been completed.
Sponsor:
Collaborators:
Burroughs Wellcome
London School of Hygiene and Tropical Medicine
University of Zambia
Information provided by:
Johns Hopkins Bloomberg School of Public Health
ClinicalTrials.gov Identifier:
NCT00247091
First received: October 28, 2005
Last updated: NA
Last verified: October 2005
History: No changes posted
  Purpose

We conducted a longitudinal study to assess the immunogenicity of standard-titer measles vaccine in HIV-infected and uninfected Zambian children. The study hypothesis was that HIV-infected children would have higher rates of primary and secondary measles vaccine failure compared to uninfected children, contributing to decreased levels of population immunity to measles and facilitating measles virus transmission in regions of high HIV prevalence.


Condition Intervention
HIV Infection
Measles
Children
Biological: standard-titer measles vaccine

Study Type: Observational
Study Design: Observational Model: Defined Population
Time Perspective: Longitudinal
Official Title: Impact of HIV on Measles and Measles Immunisation

Resource links provided by NLM:


Further study details as provided by Johns Hopkins Bloomberg School of Public Health:

Estimated Enrollment: 700
Study Start Date: May 2000
Estimated Study Completion Date: September 2004
Detailed Description:

Despite great progress in measles control in sub-Saharan Africa, measles remains a significant cause of morbidity and mortality in young children. In regions of high HIV prevalence, measles virus transmission may be sustained despite high immunization coverage rates if HIV-infected children are important transmitters of measles virus. Factors potentially contributing to enhanced measles virus transmission by HIV-infected children include an early decline in protective maternal antibody titers resulting in susceptibility to measles at a younger age, and high rates of primary and secondary measles vaccine failure. To evaluate the potential impact of the HIV-1 epidemic on immunity following measles vaccination, we conducted a longitudinal study to compare the primary vaccine failure rate and rate of antibody decline following administration of standard-titer measles vaccine at nine months of age to HIV-infected and HIV-uninfected Zambian children. Our results show that children born to HIV-infected women have lower levels of passively-acquired maternal antibodies to measles virus prior to the age of routine vaccination at 9 months, and HIV-infected children are particularly susceptible to measles in infancy. This finding supports the WHO recommendation to provide the first dose of measles vaccine to HIV-infected children at 6 months. Furthermore, HIV-infected children develop adequate primary antibody responses to measles vaccine in the months following vaccination but lose protective antibody titers by two to three years of age. Mitigating the potential impact of this decreased immunogenicity on the level of population immunity to measles virus was the high mortality rate observed among HIV-infected children. Improved access to antiretroviral therapy will likely improve the survival of HIV-infected children without enhancing protective immunity to measles virus, although this has yet to be investigated. We are working to incorporate our findings into a mathematical model to better understand the impact of the HIV-1 epidemic on measles control strategies and to investigate the immunologic mechanisms for impaired memory B cell responses in HIV-infected children.

  Eligibility

Ages Eligible for Study:   2 Months to 15 Months
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • children aged 2 to 8 months presenting for well-child care
  • reside within 10 miles of the study clinic
  • parents or caretakers provide signed informed consent

Exclusion Criteria:

-children with severe illness

  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00247091

Locations
Zambia
Chawama Clinic
Lusaka, Zambia
Sponsors and Collaborators
Johns Hopkins Bloomberg School of Public Health
Burroughs Wellcome
London School of Hygiene and Tropical Medicine
University of Zambia
Investigators
Principal Investigator: William J. Moss, MD Johns Hopkins University Bloomberg School of Public Health
Principal Investigator: Felicity Cutts, MD London School of Hygiene and Tropical Medicine
Principal Investigator: Francis Kasolo, MD, PhD University of Zambia
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00247091     History of Changes
Other Study ID Numbers: GR059114MA
Study First Received: October 28, 2005
Last Updated: October 28, 2005
Health Authority: United States: Institutional Review Board

Keywords provided by Johns Hopkins Bloomberg School of Public Health:
HIV
measles
measles vaccine
children
Zambia

Additional relevant MeSH terms:
Measles
HIV Infections
Acquired Immunodeficiency Syndrome
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Slow Virus Diseases
Morbillivirus Infections
Paramyxoviridae Infections
Mononegavirales Infections

ClinicalTrials.gov processed this record on September 22, 2014