Journal of Infectious Diseases
Volume 206 Issue 4 August 15, 2012
http://www.journals.uchicago.edu/toc/jid/current

Measles Vaccine, HIV Infection, and Antiretroviral Therapy—A Window of Opportunity
J Infect Dis. (2012) 206(4): 466-468 doi:10.1093/infdis/jis392
Yvonne Maldonado

Extract
Measles virus infection, a systemic rash illness commonly acquired in infancy and early childhood, is one of the most contagious infectious diseases in humans [1]. Measles is also an important cause of global morbidity and mortality, primarily among infants and children living in resource-limited settings [2]. Since the development of measles vaccines in the 1960s, intensive vaccination efforts, especially in the 21st century, have led to substantial reductions in measles-related deaths on a global scale, resulting in a reduction in mortality from almost 750 000 childhood deaths worldwide in 2000 to 164 000 in 2008 [3]. Eradication of measles infection on a global scale can, in theory, be accomplished because measles virus has no nonhuman reservoirs, and vaccination strategies to prevent transmission are available and feasible [4]. However, because of the highly contagious nature of measles virus, at least 95% vaccination coverage with at least 1 dose (and preferably 2 doses) of measles vaccine must be achieved to suppress and eventually eradicate continued global measles transmission [5].

One important characteristic of measles infection is that it produces more serious illness and increased mortality among immunocompromised individuals, primarily those with defects in T-cell immunity [6]. Because >90% of human immunodeficiency virus (HIV)–infected children live in regions where measles is still endemic [7, 8], achieving high rates of measles vaccine coverage is especially important among these populations to suppress excess measles-associated morbidity and mortality. However, live virus vaccines may also result in disease and, in general, are not recommended for administration to severely immunocompromised individuals. Measles vaccines are also known to induce short-term immunosuppressive effects and, therefore, the risk of further adverse events among HIV-infected infants and children is of concern. Moreover, it is well known that …