Breña A E, Cooper E R, Cabral H J, Pelton S I
Department of Pediatrics, Maxwell Finland Laboratory for Infectious Diseases, Boston City Hospital/Boston University School of Medicine, Massachusetts.
J Acquir Immune Defic Syndr (1988). 1993 Oct;6(10):1125-9.
To determine the immunogenicity of the measles and rubella components of the measles, mumps, and rubella virus (MMR) vaccine in human immunodeficiency virus (HIV)-infected children, we compared their response to that of uninfected controls. Sera were collected from HIV-infected patients and HIV seroreverters followed in our clinic and tested as close to 2 months post-MMR vaccination as possible. Specific IgG to both rubella and measles were measured by enzyme-linked immunosorbent assay. Of 20 children with HIV, 11 responded with adequate levels of antibody to measles. In the seroreverters, 12 of 13 responded. Of the measles responders, the median antibody level was significantly lower in the HIV-infected group than in the seroreverter group. In addition, HIV-infected responders tested at 9-15 months after vaccination demonstrated a significant decline in measles antibody levels. Although there was not a difference between the two cohorts in the proportion of patients who responded to the rubella component of the vaccine, there was a significant difference in the median antibody level of the responders of the two groups. We did not find a statistical difference in CD4 counts between responders and nonresponders. Alternate strategies will need to be established to prevent measles in HIV-infected children.
为了确定麻疹、腮腺炎和风疹病毒（MMR）疫苗中的麻疹和风疹成分对人类免疫缺陷病毒（HIV）感染儿童的免疫原性，我们将他们的反应与未感染的对照组进行了比较。从在我们诊所随访的HIV感染患者和HIV血清转化者中采集血清，并在尽可能接近MMR疫苗接种后2个月时进行检测。通过酶联免疫吸附测定法测量风疹和麻疹的特异性IgG。在20名HIV感染儿童中，11名对麻疹产生了足够水平的抗体反应。在血清转化者中，13名中有12名有反应。在麻疹有反应者中，HIV感染组的抗体水平中位数显著低于血清转化者组。此外，在接种疫苗后9 - 15个月进行检测的HIV感染有反应者显示麻疹抗体水平显著下降。虽然两组在对疫苗风疹成分有反应的患者比例上没有差异，但两组有反应者的抗体水平中位数存在显著差异。我们没有发现有反应者和无反应者之间的CD4细胞计数有统计学差异。需要制定替代策略来预防HIV感染儿童中的麻疹。
