Measles seroprevalence and vaccine responses in HIV-infected adolescents and adults: A systematic review

Background: The World Health Organization recommends an additional dose of measles-containing vaccine (MCV) for HIV-infected children receiving highly active antiretroviral therapy (HAART) 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 Medline (Ovid), Embase, Cohrane Library, PubMed, LILACS, INDMED, AIM, and WHO Global Index Medicus databases. Identified studies were screened independently by two reviewers. Results: The search identified 30 studies meeting inclusion criteria. Across studies, measles seroprevalence was high (median: 92%, 27 studies), with no significant difference compared to HIV-uninfected participants (10 studies). In six studies that evaluated the immunogenicity of MCV 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

• Population(s)
  • Children or Youth (less than 18 years old)
  • General HIV+ population
• Co-infections
  • Other