Measles Seroprevalence and Vaccine Responses in Human Immunodeficiency Virus-infected Adolescents and Adults: A Systematic Review

Clin Infect Dis. 2019 Aug 16;69(5):836-844. doi: 10.1093/cid/ciy980.


Background: The World Health Organization (WHO) recommends an additional dose of measles-containing vaccine (MCV) for human immunodeficiency virus (HIV)-infected children receiving highly active antiretroviral therapy following immune reconstitution. We conducted a systematic review to synthesize available evidence regarding measles seroprevalence and measles vaccine immunogenicity, efficacy, and safety in HIV-infected adolescents and adults to provide the evidence base for recommendations on the need for measles vaccination.

Methods: We conducted searches of 8 databases through 26 September 2017. Identified studies were screened independently by 2 reviewers.

Results: The search identified 30 studies meeting inclusion criteria. Across studies, measles seroprevalence among HIV-infected adolescents and adults was high (median, 92%; 27 studies), with no significant difference compared to HIV-uninfected participants (10 studies). In 6 studies that evaluated the immunogenicity of MCVs among seronegative HIV-infected adults, measles seropositivity at end of follow-up ranged from 0% to 56% (median, 39%). No severe adverse events were reported following measles vaccination in HIV-infected patients.

Conclusions: Based on similar measles seroprevalence between HIV-infected and HIV-uninfected adolescents and adults, and the low response to vaccination, these studies do not support the need for an additional dose of MCV in HIV-infected adolescents and adults. These findings support WHO guidelines that measles vaccine be administered to potentially susceptible, asymptomatic HIV-infected adults, and may be considered for those with symptomatic HIV infection if not severely immunosuppressed. Measles-susceptible adolescents and adults, regardless of HIV status, may require targeted vaccination efforts to reach critical vaccination thresholds and achieve regional elimination goals.

Keywords: HIV infection; immunity; immunogenicity; measles vaccine; safety.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / blood*
  • Antiretroviral Therapy, Highly Active
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • Humans
  • Immunogenicity, Vaccine
  • Measles / epidemiology*
  • Measles / prevention & control
  • Measles Vaccine / administration & dosage
  • Measles Vaccine / adverse effects
  • Measles Vaccine / immunology*
  • Seroepidemiologic Studies


  • Antibodies, Viral
  • Measles Vaccine