Even with vaccination, children with HIV may not have sufficient immunity against measles, mumps, and rubella, reports a new study in the journal Clinical Infectious Diseases. However, initiation of antiretroviral therapy before the first MMR vaccine dose was also associated with having adequate levels of immunity against these diseases.

Children aged 7–15 in the United States and Puerto Rico were enrolled in the National Institutes of Health’s (NIH) Pediatric HIV/AIDS Cohort Study (PHACS) from 2007–2009 to assess individuals who were exposed to HIV in the womb. 

Serum specimens from 428 children who were perinatally infected with HIV (PHIV) and 221 children who were HIV-exposed and uninfected (HEU) were analyzed for antibodies against measles, mumps, and rubella; about 93% of both groups had received at least the recommended two doses of the MMR vaccine.

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Overall the PHIV group was significantly less likely to have protective levels of antibodies against measles, mumps, and rubella compared to the HEU arm. 

Children who were PHIV who started combined antiretroviral therapy prior to receiving their MMR vaccine doses were more likely to have protective levels of antibodies against all three diseases, particularly if they had higher levels of CD4+ cells at the time of vaccination.

The authors noted that because the older children in the study were representative of the PHIV population in the U.S., other PHIV youth may also lack adequate immunity to measles, mumps, and rubella. 

They recommend that individuals who received their MMR vaccinations before the introduction of combined antiretroviral therapy should consult with their clinician on additional doses of the vaccine.


1. Siberry G, et al. Clin Infect Dis. (2015) 61 (6): 996-1003 doi:10.1093/cid/civ437

This article originally appeared on Infectious Disease Advisor