麻疹和麻疹免疫在感染人类免疫缺陷病毒的儿童
1Deparment of Pediatrics, New York University Medical Center, NY 10016.
JAMA
|May 5, 1989
概括
感染人类免疫缺陷病毒 (HIV) 的儿童接种麻疹疫苗的有效性较低,但安全. 由于疫苗失败的风险,建议使用暴露后的免疫球蛋白.
科学领域:
- 儿科 儿科 儿科
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 麻疹对免疫缺陷儿童,包括患有人类免疫缺陷病毒 (HIV) 的儿童构成严重风险.
- 以前的麻疹免疫接种不能保证HIV感染儿童的保护,严重病例和死亡事件证明了这一点,尽管先前接种了疫苗.
研究的目的:
- 评估在艾滋病毒感染儿童中接种麻疹疫苗的风险和益处.
- 评估麻疹疫苗在这个脆弱人群中的免疫性和安全性.
主要方法:
- 对艾滋病毒感染儿童的麻疹疫苗接种的回顾性和前性研究.
- 通过酶相关免疫吸收试验 (ELISA) 和血液凝结抑制 (HAI) 测量抗体水平.
主要成果:
- 在4名艾滋病毒感染儿童中,麻疹感染导致了3例严重的肺炎和1例死亡,即使先前接种了免疫.
- 疫苗接种后 (25%在预期组中) 和疫苗接种前 (12.5%追溯) 检测到低的麻疹抗体水平.
- 疫苗失效发生在ELISA阴性但HAI阳性结果的儿童中,这表明免疫力不可靠.
结论:
- 感染艾滋病毒的儿童接种麻疹疫苗显示免疫性较低,疫苗失败.
- 尽管有效性较低,但疫苗似乎是安全的,支持其在潜在的致命麻疹疾病的背景下使用.
- 由于仅接种疫苗的免疫力是不可靠的,因此建议对所有感染艾滋病毒的儿童进行被动性暴露后免疫球蛋白预防.
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