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Impact of HIV on Measles and Measles Immunisation

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ClinicalTrials.gov Identifier: NCT00247091
Recruitment Status : Completed
First Posted : November 1, 2005
Last Update Posted : November 1, 2005
Sponsor:
Collaborators:
Burroughs Wellcome
London School of Hygiene and Tropical Medicine
University of Zambia
Information provided by:
Johns Hopkins Bloomberg School of Public Health

Brief Summary:
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 or disease Intervention/treatment
HIV Infection Measles Children Biological: standard-titer measles vaccine

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.

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Study Type : Observational
Enrollment : 700 participants
Observational Model: Defined Population
Observational Model: Natural History
Time Perspective: Longitudinal
Time Perspective: Prospective
Official Title: Impact of HIV on Measles and Measles Immunisation
Study Start Date : May 2000
Study Completion Date : September 2004

Resource links provided by the National Library of Medicine

MedlinePlus related topics: HIV/AIDS Measles





Information from the National Library of Medicine

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Ages Eligible for Study:   2 Months to 15 Months   (Child)
Sexes Eligible for Study:   All
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


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00247091


Locations
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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
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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

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ClinicalTrials.gov Identifier: NCT00247091    
Other Study ID Numbers: GR059114MA
First Posted: November 1, 2005    Key Record Dates
Last Update Posted: November 1, 2005
Last Verified: October 2005
Keywords provided by Johns Hopkins Bloomberg School of Public Health:
HIV
measles
measles vaccine
children
Zambia
Additional relevant MeSH terms:
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Measles
RNA Virus Infections
Virus Diseases
Morbillivirus Infections
Paramyxoviridae Infections
Mononegavirales Infections
Vaccines
Immunologic Factors
Physiological Effects of Drugs