Clinical measles after measles virus challenge in simian immunodeficiency virus-infected measles virus-vaccinated rhesus monkeys

Understanding the impact of human immunodeficiency virus (HIV) infection on the clinical manifestations and kinetics of measles virus (MV) replication in MV-vaccinated and unvaccinated individuals is important for developing successful vaccine strategies for measles eradication. To model the pathogenesis of MV infection in MV-vaccinated and unvaccinated individuals infected with HIV, previously vaccinated and unvaccinated rhesus monkeys infected with simian immunodeficiency virus (SIV) were challenged with MV and monitored for clinical, virologic, and immunologic sequelae of infection. The magnitude and duration of MV viremia were unchanged by SIV infection. Nevertheless, clinical manifestations of MV infection were altered in animals with significant CD4 ⁺ T lymphocyte loss. Importantly, 2 of the 3 SIV-infected monkeys with high titers of vaccine-induced MV-neutralizing antibody developed clinical evidence of MV infection. Thus, in this experimental animal model, a high-titer vaccine-induced MV-neutralizing antibody response does not protect against clinical manifestations of measles in the setting of a chronic acquired immunodeficiency syndrome virus infection.