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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Measles immunity gaps among children and adolescents with HIV in Zambia despite high measles vaccination and antiretroviral therapy coverage
AIDS, Volume 37, No. 13, Year 2023
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Description
Objective:The study objective was to identify measles and rubella immunity gaps among people with HIV (PWH) in Zambia despite high measles vaccine coverage and widespread access to antiretroviral therapy.Design:Nationally representative cross-sectional serosurvey using biorepository specimens.Methods:Blood specimens collected in the Zambia Population HIV Impact Assessment survey (ZAMPHIA) of 2016 were tested for measles and rubella immunoglobulin G (IgG) antibodies by enzyme immunoassay. Hierarchical generalized additive models were fit to characterize age-specific measles and rubella seroprevalence profiles by HIV infection status. Log-binomial regression was performed to identify factors associated with seronegativity.Results:Of the 25 383 specimens, a subsample of 11 500 were selected and 9852 (85%) were successfully tested. Measles seroprevalence was lower among PWH compared with HIV-uninfected individuals until approximately 30 years of age. Among children younger than the age of 10 years, measles seroprevalence was 47.2% [95% confidence interval (CI): 32.7, 61.7] in PWH and 76.4% (95% CI: 74.9, 78.0) in HIV-uninfected children in same age category. In contrast, rubella seroprevalence was higher among PWH than HIV-uninfected individuals, particularly for children younger than 10 years (68.6% vs. 44.3%, P < 0.001). Having a detectable viral load was associated with being measles seronegative (adjusted prevalence ratio 0.15, 95% CI: 0.06, 0.38).Conclusions:These results from a nationally representative serosurvey demonstrate persistence of measles immunity gaps among PWH younger than 30 years of age. There is need to implement the World Health Organization's recommendation to revaccinate children living with HIV against measles following immune reconstitution with antiretroviral therapy to protect these children and prevent measles outbreaks. © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Authors & Co-Authors
Mutembo, Simon
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Zambia, Lusaka
Zambian Ministry of Health
Yang, Yangyupei
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Carcelen, Andrea C.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Winter, Amy Kaye
United States, Athens
University of Georgia
Mwansa, Francis Dien
Zambia, Lusaka
Zambian Ministry of Health
Chilumba, Innocent
Zambia, Ndola
Tropical Diseases Research Centre Ndola
Mutale, Irene
Zambia, Ndola
Tropical Diseases Research Centre Ndola
Chongwe, Gershom
Zambia, Ndola
Tropical Diseases Research Centre Ndola
Monze, Mwaka
Zambia, Zambia
University Teaching Hospital
Mulundu, Gina
Zambia, Zambia
University Teaching Hospital
Nkamba, Hope C.
Zambia, Zambia
University Teaching Hospital
Mulenga, Lloyd Berdad
Zambia, Lusaka
Zambian Ministry of Health
Hayford, Kyla T.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Moss, William John
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Statistics
Citations: 1
Authors: 14
Affiliations: 5
Identifiers
Doi:
10.1097/QAD.0000000000003634
ISSN:
02699370
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Zambia