by Jeffrey T. Kirchner, DO, AAHIVS, AAHIVM Chief Medical Officer
November 17, 2020
Rearigh L et al. Surprisingly Low Levels of Measles Immunity in Persons With HIV: A Seroprevalence Survey in a United States HIV Clinic. Open Forum Infectious Diseases, October 2020. Volume 7, Issue 10. https://doi.org/10.1093/ofid/ofaa428
The finding that only 70% of this HIV patient population was immune to measles is cause for concern. There is little data on measles antibody seroprevalence in PWH and a Pubmed search revealed only 3 other studies, including the one cited above from 1992 which showed a 95% seropositivity. A two-dose series of MMR is currently recommended for PWH (without evidence of immunity) provided they have a CD4 count ≥200 cells/mm3. If further seroprevalence studies of measles in PWH show low levels of immunity, it may be appropriate to provide routine MMR. I believe this study supports antibody screening for PWH who are at risk of measles exposure. This includes: healthcare workers, students at post-high school educational institutions, international travelers, and others at increased risk during a measles outbreak. A report released jointly by the CDC and WHO on November 12 noted that cases increased to 869,770 and 207,500 people died worldwide from measles in 2019.
The author has no conflicts of interest to disclose.
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