Measles seroprevalence and vaccine response in HIV-infected adults

Measles in HIV-infected patients can be a severe, even fatal, illness. The prevalence of measles seropositivity in HIV-infected adults and the durability of these antibody levels are uncertain. A prospective survey of 210 HIV-infected adults found that 95% of the adults had demonstrable antibodies using a standard ELISA technique. Seropositivity was no different in patients with CD4 counts over 400, from those with more advanced disease and CD4 counts under 200 (p = 0.8). Six seronegative patients were vaccinated and had serial antibody determinations; two of six (33%) patients had a durable positive antibody response at 1 year, and none had any observed toxicity. Vaccination of the identified measles-seronegative HIV-infected adults who are at high risk for measles is recommended, but a measurable antibody response may be expected in only a minority of cases.