

@mastersthesis {6224,
	title = {The impact of {HIV} on measles and measles immunisation},
	year = {2006},
	note = {U489637},
	school = {University of London, London School of Hygiene and Tropical Medicine (United Kingdom)},
	type = {phdPh.{D}.},
	address = {Ann Arbor},
	abstract = {Methods: A prospective study of the immunogenicity of standard-titre measles vaccine administered at 9 months of age to HIV-1-infected and uninfected children in Lusaka, Zambia was performed. Measles antibody levels before, at and 1, 3, 15 and 27 months after vaccination were measured using the Plaque Reduction Neutralisation Assay. HIV-seropositive and negative paired maternal-cord sera from rural Kenya were tested for measles antibodies using ELISA. A simple mathematical model was used to explore the potential impact of HIV infection on the transmission dynamics of measles infection. Results: Maternal HIV infection was associated with a 35\% reduction in newborn measles antibody levels. By six months of age 91\% of HIV-infected children, had measles antibody levels that were unlikely to interfere vaccination (<=50 mlU/mL) compared to 58\% of HIV-seronegative children. HIV-infected children responded to measles vaccine, but by 27 months post-vaccination only half had protective antibody titres compared with 92\% of uninfected children (titres {\textless}120 mlU/mL) (P = 0.001). The force of infection was estimated to be 20\% per year (95\% CI 16.5, 23.5). Mathematical modelling suggests that high mortality in the absence of anti-retroviral therapy (280.4 per 1,000 child years in HIV-infected children compared to 9.3 per 1,000 in HIV-uninfected children) limits the impact of HIV on measles transmission dynamics. Conclusions: Although protection against measles virus infection appears to be lower in HIV-infected children than HIV-uninfected children, in the absence of anti-retroviral therapy HIV-induced children die before they can play a major role in the transmission dynamics of measles infection. This may change with the scaling up of ART in sub-Saharan Africa, and improved survival of HIV-infected children.},
	keywords = {0766:Epidemiology, Bibliographies, DXN106921, epidemiology, Health and environmental sciences, Psychology{\textendash}Abstracting, Statistics},
	url = {http://search.proquest.com/docview/301722573?accountid=14270},
	author = {Scott, S}
}
