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An In Vitro Model for Measuring Immune Responses to Malaria in the Context of HIV Co-infection
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An In Vitro Model for Measuring Immune Responses to Malaria in the Context of HIV Co-infection

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HIV type 1 infection is a risk factor for mortality in hospitalized Zambian children with measles

William J Moss1, Cynthia Fisher, Susana Scott

  • 1W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205-2179, USA. wmoss@jhsph.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 16, 2008
PubMed
Abstract

Insights

Human immunodeficiency virus type 1 (HIV-1) infection more than doubled the risk of death in children with measles in Zambia. This highlights the need for enhanced measles prevention in areas with high HIV-1 prevalence.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Measles causes significant preventable deaths in sub-Saharan Africa.
  • Limited research exists on measles mortality risk factors in high HIV-1 prevalence areas.

Purpose of the Study:

  • To investigate risk factors for measles mortality in children in Lusaka, Zambia, a region with high HIV-1 prevalence.

Main Methods:

  • An observational study enrolled 1474 children with clinically diagnosed measles between January 1998 and July 2003.
  • Data on demographics, clinical information, measles, and HIV-1 infection status were collected.
  • Measles and HIV-1 were confirmed via antibody and RNA detection, respectively.

Main Results:

  • Of 1227 children with confirmed measles and known HIV-1 status, 12.2% of HIV-1 infected children died compared to 4.3% of uninfected children (p < .001).
  • HIV-1 infection (OR, 2.5), maternal education ≤8 years (OR, 2.4), and desquamating rash (OR, 2.2) were significant predictors of measles mortality.
  • HIV-1 infected children were often younger than the routine measles vaccination age.

Conclusions:

  • HIV-1 coinfection more than doubled the odds of death in hospitalized children with measles in this high HIV-1 prevalence region.
  • Increased measles mortality in HIV-1 infected children underscores the need for intensified measles control efforts in areas with high HIV-1 prevalence.

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