To reduce the risk of contracting measles in areas with high HIV-1 prevalence, WHO recommended that infants receive two doses of measles vaccine, at 6 and 9 months. This regimen was evaluated in Zambia and results published in 2008 showed that 59% of children with HIV-1 were measles antibody positive after the first vaccine dose; this number increased to 64% after the second dose. Among HIV-1-exposed non-infected children, 68% and 94% were seropositive after the first and second immunisation, respectively, and similar figures were shown for control children (62% and 92%). To further pinpoint the B cell impairments leading to low antibody levels after measles vaccination in children with HIV-1, Nair characterised early antibody responses to measles following vaccination at 9 months of age. Interestingly, HIV-1 infection impaired IgG responses after vaccination as well as the development of high avidity measles antibodies. In a study from Kenya, antibody titres to measles were evaluated 2 to 5 years after measles immunisation received during the first year of life. Several years after immunisation, only 33% of the children with HIV-1 maintained measles IgG antibodies, indicating impairment in the establishment and the maintenance of serological memory responses.
- Emerging disease
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