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Immune Reconstitution Of HIV-1 Infected Zambian Children Initiating Antiretroviral Therapy


We propose to build upon our studies of measles and measles vaccination in HIV-1-infected children in Lusaka, Zambia to characterize measles virus-specific immune reconstitution and immunologic memory in Zambian children initiating ART. Zambia has one of the highest HIV-1 prevalence rates in the world and is scaling-up the use of antiretroviral therapy for HIV-1-infected children. We will conduct a prospective, observational cohort study of HIV-1-infected children initiating ART at public clinics in Lusaka, Zambia to measure the magnitude and quality of immune reconstitution and, in particular, pathogen-specific immune reconstitution to measles virus. The five-year study will be conducted in collaboration with investigators from the Center for Infectious Disease Research Zambia (CIDRZ) and the Virology Laboratory, University of Zambia. Children receiving ART who lack protective antibody levels against measles virus will be revaccinated, and the magnitude, quality and duration of their immune responses to revaccination will be assessed. Estimates derived from these studies of the proportion of HIV-1-infected children receiving ART who are protected against measles virus both before and after revaccination will be used in a mathematical model to assess the impact of ART on population immunity to measles virus, with and without a policy of revaccination.


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