Measles vaccination of children born to HIV-infected mothers (clinical and immunological aspects)

Cover Page

Cite item

Abstract

Vaccination of children born to HIV-infected mothers in accordance with the national Calendar of preventive vaccinations represents an important issue. Upon that, measles incidence rate especially among unvaccinated children has been substantially elevated. Use of live measles vaccine in both HIV-infected children and mothers has some features primarily due to HIV-associated immunocompromised state that was poorly investigated. Here we monitored 212 children aged 12–36 months born to HIV-infected women, 184 HIV-negative children born to HIVinfected women who were included into the group with the diagnosis “Perinatal HIV contact” (R75) after verification. In addition, 28 children were included into the group” HIV infection “(B23), whereas 42 children — into the control group. Live measles vaccine was administered subcutaneously at a dose of 0.5 ml. All children were followed up for 36 weeks. HIV status, measles antibodies level by measured by ELISA and RPG methods, as well as total immunoglobulin A, M, G classes and CD3+, CD4+, CD8+, CD19+ lymphocyte counts were examined. No post-vaccination complications or severe vaccine-induced reactions were reported in HIV-infected patients group. A satisfactory course of the vaccine process in all children born to HIV-infected mothers was observed that did not significantly differ from that one in control group. Children with perinatal HIV contact are able to respond adequately to vaccination with live measles vaccine. The number of children with conditionally protective antibody levels, still remaining seronegative among children with perinatal HIV contact (R75) was comparable to that one in healthy control group. At the same time, children with perinatal HIV contact were shown to display protective antibody level after administering live measles vaccine only in 36.4% of cases, whereas the remainder (63.6%) demonstrated a conditionally protective antibody level or lack it (compared to 76% of children with perinatal HIV contact). Children with perinatal HIV infection who did not respond to the first administered live measles vaccine produced low amount of antibodies after re-vaccination. Seroconversion was observed in up to 68% of cases, whereas protective antibody level was found in up to 33.6% of child ren. On the contrary, children from the perinatal HIV contact group were shown to have protective antibody level in 69.6% of cases upon seroconversion rate reaching 91.3% that did not differ them from those in control group. In the post-vaccination period, suppressive modality of immune reaction tended to increase indirectly evidenced by increased percentage of CD8+ T cell subset. 

About the authors

N. F. Snegova

National Research Center — Institute of Immunology

Email: snegova@list.ru
PhD, MD (Medicine), Leading Researcher, Department of Children’s Immunopathology Russian Federation

M. P. Kostinov

Mechnikov Research Institute of Vaccines and Sera;
I.M. Sechenov First Moscow State Medical University

Email: monolit.96@mail.ru
ORCID iD: 0000-0002-1382-9403
Kostinov M.P., PhD, MD (Medicine), Professor, Head of the Laboratory of Vaccine Prophylaxis and Immunotherapy of Allergic Diseases, Mechnikov Research Institute of Vaccines and Sera; Professor, I.M. Sechenov First Moscow State Medical University Russian Federation

D. V. Pakhomov

Mechnikov Research Institute of Vaccines and Sera

Author for correspondence.
Email: dm_pachomov@mail.ru
ORCID iD: 0000-0002-4073-6085

PhD (Medicine), Senior Researcher, Laboratory of Vaccination and Immunotherapy

Contacts: Dmitry V. Pakhomov 105064, Russian Federation, Moscow, Malyi Kazennyi Lane, 5a, I.I. Mechnikov Research Institute of Vaccines and Sera. Phone: +7 (495) 917-41-49.

Russian Federation

N. I. Ilina

National Research Center — Institute of Immunology

Email: info@nrcii.ru
PhD, MD (Medicine), Professor, Deputy Director Russian Federation

References

  1. Вакцинация детей с нарушенным состоянием здоровья. Под ред. М.П. Костинова. 4-е изд., М.: 4Мпресс, 2013. 432 с.
  2. Вакцины и вакцинация: Национальное руководство. Под ред. В.В. Зверева, Р.М. Хаитова. М.: ГЭОТАР-Медиа, 2014. 640 с.
  3. ВИЧ-инфекция. Клинико-диагностические и лечебно-профилактические аспекты. Под ред. М.П. Костинова, М.Н. Папуашвили, М.В. Сухинина. М.: Боргес, 2004. 128 с. Серия «Социально значимые заболевания».
  4. Гланц С. Медико-биологическая статистика. М.: Практика, 1999. 460 c.
  5. Иммуномодуляторы и вакцинация. Под ред. М.П. Костинова, И.Л. Соловьёвой. М.: 4Мпресс, 2013. 272 с. [
  6. Ковальчук Л.В., Чередеев А.Н. Актуальные проблемы оценки иммунной системы человека на современном этапе //Иммунология. 1990. № 5. С. 4–5.
  7. Костинов М.П., Пахомов Д.В., Снегова Н.Ф., Никитина Т.И., Зинкина Т.Н., Хромова И.Е. Проблема вакцинации детей, рождённых от ВИЧ-инфицированных матерей //Детские инфекции. 2005. Т. 4, № 2. С. 31–33.
  8. Костинов М.П., Снегова Н.Ф. Вакцинация детей, рожденных от ВИЧ-инфицированных матерей //Аллергология и иммунология. 2013. № 2. С.58–68.
  9. Латышева И.Б., Додонов К.Н., Воронин Е.Е. Влияние клинико-социальных факторов ВИЧ-инфицированных женщин на риск перинатальной передачи ВИЧ //Русский медицинский журнал. 2014. Т. 22, № 14. С. 1034–1038.
  10. Мониторинг поствакцинальных осложнений и их профилактика: методические указания МУ 3.3.1.1123-02 от 26 мая 2002 года.
  11. Об эпидемиологической ситуации по кори в Российской Федерации в 2016 году: письмо Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека от 24 апреля 2017 года № 01/5110-17-32.
  12. Пахомов Д.В., Костинов М.П., Поддубиков А.В., Ванеева Н.П., Снегова Н.Ф., Никитина Т.Н., Зинкина Т.Н., Сулоева С.В. Безопасность и иммунологические эффекты вакцинации ВИЧ-инфицированных детей против пневмококковой инфекции //Педиатрия. 2009. Т. 88, № 5. С. 85–89.
  13. Пахомов Д.В., Костинов М.П., Поддубиков А.В., Ванеева Н.П., Снегова Н.Ф., Никитина Т.Н., Зинкина Т.Н., Сулоева С.В. Иммунологический эффект вакцинации против пневмококковой инфекции у ВИЧ-инфицированных детей //Журнал микробиологии, эпидемиологии и иммунобиологии. 2009. № 2. С. 48–52.
  14. Пахомов Д.В., Снегова Н.Ф., Костинов М.П. К проблеме эффективности вакцинации детей, рожденных ВИЧинфицированными матерями, и ВИЧ-инфицированных детей против пневмококковой инфекции. Риски и преимущества //Эпидемиология и вакцинопрофилактика. 2005. Т. 24, № 5. С. 53–54.
  15. Снегова Н.Ф., Костинов М.П., Пахомов Д.В. Опыт вакцинации против пневмококковой инфекции у ВИЧ-инфицированных детей и детей ВИЧ-инфицированных матерей //Вопросы современной педиатрии. 2006. Т. 5, № 1. С. 539–540.
  16. Соловьева И.Л., Костинов М.П., Кусельман А.И. Особенности вакцинации детей с измененным преморбидным фоном против гепатита B, кори, эпидемического паротита. Ульяновск: УлГУ, 2006. 296 с.
  17. Харит С.М., Рулева А.А., Голева О.В., Калиногорская О.С., Апрятина В.А. Результаты сочетанного введения вакцины против гриппа и вакцин национального календаря прививок у детей с соматической патологией и иммунодефицитными состояниями //Вопросы современной педиатрии. 2014. Т. 13, № 1. С. 148–154.
  18. Al-Attar I., Reisman J., Muehlmann M. Decline of measles antibody titers after immunzation in human immunodeficiency virusinfected children. Pediatr. Infect. Dis. J., 1995, vol. 14, pp. 149–151.
  19. Arpadi S.M., Markowitz L.E., Baughman A.L. Measles antibody in vaccinated human immunodeficiency virus type 1-infected children. Pediatrics, 1996, vol. 97, no. 5, pp. 653–657.
  20. Brena A.E., Cooper E.R., Cabral H.J. Antibody response to measles and rubella vaccine by children with HIV infection. J. Acquir. Immune. Defic. Syndr., 1993, vol. 6, no. 10, pp. 1125–1129.
  21. Centers for Disease Control and Prevention. Measles in HIV-infected children, United States. Morb. Mortal. Wkly Rep., 1988, vol. 37, pp. 183–186.
  22. Centres for Desease Control and Prevention. Measles pneumonitis following measles-mumps-rubella vactination of patient with HIV infection: 1993. Morb. Mortal. Wkly Rep., 1996, vol. 45, pp. 603–606.
  23. Current Trends Measles United States, 1990. Morb. Mortal. Wkly Rep., 1991, vol. 40, no. 22, pp. 369–372.
  24. Epidemiologic notes and reports measles in HIV-infected children, United States. Morb. Mortal. Wkly Rep., 1988, vol. 37, no. 12, pp. 183–186.
  25. Friedman S. Measles in New York City. JAMA, 1991, vol. 266, no. 9, p. 1220. doi: 10.1001/jama.1991.03470090054029
  26. Haas E.J., Wendt V.E Atypical measles 14 years after immunization. JAMA, 1976, vol. 236, no. 9, p. 1050. doi: 10.1001/jama.1976.03270100050031
  27. Kaplan L.J., Daum R.S., Smaron M. Severe measles in immunocompromised patients. JAMA, 1992, vol. 267, no. 9, pp. 1237– 1241. doi: 10.1001/jama.1992.03480090085032
  28. Markowitz L.E., Chandler F.W., Roldan E.O. Fatal measles pneumonia without rash in a child with AIDS. J. Infect. Dis, 1988, vol. 158, no. 2, pp. 480–483. doi: 10.1093/infdis/158.2.480
  29. Measles immunization in HIV-infected children. Pediatrics, 1999, vol. 103, no. 5, pp. 1057–1060. doi: 10.1542/peds.103.5.1057
  30. Nadel S., McGann K., Hodinka R.L. Measles giant cell pneumonia in a child with human immunodeficiency virus infection. Pediatr. Infect. Dis. J., 1991, vol. 10, no. 7, pp. 542–544.

Copyright (c) 2019 Snegova N.F., Kostinov M.P., Pakhomov D.V., Ilina N.I.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies