# The impact of early antiretroviral treatment initiation on measles immunity among children living with HIV

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2021 · $210,372

## Abstract

PROJECT SUMMARY/ABSTRACT
There are an estimated 1.7 million children living with HIV globally, with approximately 90% in sub-Saharan
Africa. Despite antiretroviral treatment, many of these children remain susceptible to vaccine-preventable
diseases, including measles. Consequently, the World Health Organization’s Strategic Advisory Group of
Experts (SAGE) on immunization recommended in 2015 that children living with HIV and receiving treatment
be revaccinated against measles. With earlier diagnosis in infancy in recent years, children living with HIV may
now be initiating treatment prior to measles vaccination at 9 months of age. The impact of this change in the
relative timing of measles vaccination and treatment on short and long-term immunity to measles is not fully
known. SAGE found that there was insufficient evidence to make recommendations for children who start
treatment before measles vaccination and identified this as a research priority. This proposal will bring together
a team of institutions and investigators to address this gap and evaluate the short and long-term impact of
early treatment initiation on antibodies to measles among children living with HIV in Zambia. The proposed
research aligns with the priorities of the National Institute of Allergy and Infectious Diseases to better
understand immune responses to infectious diseases and to foster international scientific collaborations. The
studies will be conducted at an established research site in rural southern Zambia and will be nested within two
ongoing studies: 1) a long-standing cohort study of children living with HIV and receiving care at an HIV clinic;
and 2) a community-based study of malaria. The proposed studies will test stored samples collected from
these studies for measles antibodies to address the research questions. For Aim 1, samples collected 6-12
months after treatment initiation will be tested from children younger than 5 years of age and enrolled in the
pediatric HIV cohort. The level of measles antibodies will be compared across participants initiating treatment
at different ages (<9 months of age and prior to measles vaccination, 9 months to 1.9 years of age, and 2.0 to
4.9 years of age). For Aim 2, samples collected from children enrolled in the community-based malaria study
will be tested to serve as an age-matched HIV-uninfected control group for children tested in Aim 1. The level
of measles antibodies will be compared between HIV-infected and uninfected children. For Aim 3, samples
collected from participants in Aim 1 will be tested up to 4 years after treatment initiation. Long-term changes
and trajectories of antibody levels over time will be compared across participants initiating treatment at different
ages. The proposed studies will fill key gaps in our understanding of short and long-term immunity to measles
virus among children living with HIV and initiating treatment before and after measles vaccination. The findings
from the proposed studies...

## Key facts

- **NIH application ID:** 10158923
- **Project number:** 1R21AI152847-01A1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Catherine Gayle Sutcliffe
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $210,372
- **Award type:** 1
- **Project period:** 2020-12-01 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10158923

## Citation

> US National Institutes of Health, RePORTER application 10158923, The impact of early antiretroviral treatment initiation on measles immunity among children living with HIV (1R21AI152847-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10158923. Licensed CC0.

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