Measles Seroprevalence and Vaccine Responses in Human Immunodeficiency Virus-infected Adolescents and Adults: A Systematic Review

Gideon Loevinsohn, Lori Rosman, William J. Moss

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The World Health Organization (WHO) recommends an additional dose of measles-containing vaccine (MCV) for human immunodeficiency virus (HIV)-infected children receiving highly active antiretroviral therapy following immune reconstitution. We conducted a systematic review to synthesize available evidence regarding measles seroprevalence and measles vaccine immunogenicity, efficacy, and safety in HIV-infected adolescents and adults to provide the evidence base for recommendations on the need for measles vaccination. Methods: We conducted searches of 8 databases through 26 September 2017. Identified studies were screened independently by 2 reviewers. Results: The search identified 30 studies meeting inclusion criteria. Across studies, measles seroprevalence among HIV-infected adolescents and adults was high (median, 92%; 27 studies), with no significant difference compared to HIV-uninfected participants (10 studies). In 6 studies that evaluated the immunogenicity of MCVs among seronegative HIV-infected adults, measles seropositivity at end of follow-up ranged from 0% to 56% (median, 39%). No severe adverse events were reported following measles vaccination in HIV-infected patients. Conclusions: Based on similar measles seroprevalence between HIV-infected and HIV-uninfected adolescents and adults, and the low response to vaccination, these studies do not support the need for an additional dose of MCV in HIV-infected adolescents and adults. These findings support WHO guidelines that measles vaccine be administered to potentially susceptible, asymptomatic HIV-infected adults, and may be considered for those with symptomatic HIV infection if not severely immunosuppressed. Measles-susceptible adolescents and adults, regardless of HIV status, may require targeted vaccination efforts to reach critical vaccination thresholds and achieve regional elimination goals.

Original languageEnglish (US)
Article numberciy980
Pages (from-to)836-844
Number of pages9
JournalClinical Infectious Diseases
Volume69
Issue number5
DOIs
StatePublished - Aug 16 2019

Keywords

  • HIV infection
  • immunity
  • immunogenicity
  • measles vaccine
  • safety

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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