Despite Vaccination, Children with HIV May Lack Immunity to Measles, Mumps, Rubella

Up to half of US children infected with HIV around the time of birth may not have sufficient immunity to protect against measles, mumps, and rubella despite having received the MMR (measles, mumps, and rubella) vaccine as recommended, according to a study in the online Clinical Infectious Diseases. The risk seems to be highest among children born before 1996, when treatment with combined antiretroviral therapy became widespread.

"Having a high level of immunity to measles, mumps, and rubella is important not only for an individual's health, but also for preventing disease outbreaks in the larger community," said researcher George K. Siberry, MD, medical officer, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health. "Individuals infected with HIV at birth who did not have the benefit of combined antiretroviral therapy before they were vaccinated should speak with their physician about whether they need a repeated course of the vaccine."

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The findings stem from an analysis of serum specimens from 428 children infected perinatally with HIV and 221 children without HIV who were born to HIV-positive mothers. Children were ages 7 to 15 between 2007 and 2009 when they were enrolled in the Pediatric HIV/AIDS Cohort Study. Looking at serum samples taken in 2011, researchers found that just 57% of children infected perinatally with HIV had the necessary antibodies to protect them from measles, compared with 99% of children exposed to HIV in the womb but born without HIV.

Along the same lines, researchers found that only 65% of children infected perinatally with HIV showed protection against rubella and 59% of them against mumps. Among children exposed to but without HIV, 98% showed protection against rubella and 97% against mumps.        

Children who started combined antiretroviral therapy and who had higher levels of CD4+ cells before receiving their MMR vaccine were more likely to have the necessary immunity to protect against the diseases, researchers reported.—Jolynn Tumolo

References

1. Skwarecki B. HIV-positive youth may lack immunity to MMR diseases. Medscape Medical News. August 18, 2015.
2. Siberry GK, Patel K, Bellini WJ, et al. Immunity to measles, mumps, and rubella in US children with perinatal HIV infection or perinatal HIV exposure without infection. Clinical Infectious Disease. 2015 June 9. [Epub ahead of print].
3. Large percentage of youth with HIV may lack immunity to measles, mumps, rubella [press release]. EurekAlert!: Washington, DC; August 13, 2015.