[sci.med.aids] Safty of Measles vaccine

hempling@quorum.com (David B. Hempling) (03/29/91)

A friend of mine is HIV+ and on AZT. His t-cell count 
hovers between 300 and 400. His doctor is suggesting that he
be vaccinated for Measles. The vaccine the docter wishes to use
contains live Measles virus. 

Could someone please present the risks involved in giving such a
vaccine to an HIV+ person? Are there other, less risky Measles
vaccines available?

Thank you,
dave
hempling@quorum.com

marco@ozdaltx.UUCP (Steve Giammarco) (03/30/91)

In article <1991Mar28.192813.5998@cs.ucla.edu>, hempling@quorum.com (David B. Hempling) writes:
> A friend of mine is HIV+ and on AZT. His t-cell count 
> hovers between 300 and 400. His doctor is suggesting that he
> be vaccinated for Measles. The vaccine the docter wishes to use
> contains live Measles virus. 
> 
> Could someone please present the risks involved in giving such a
> vaccine to an HIV+ person? Are there other, less risky Measles
> vaccines available?
> 

Hoo-boy. I hope this makes sense:  After HIV-infection occurs, the
virus probably exists in two states, (1) inside a cell (T cell, 
macrophage, etc), and (2) unattached and roaming the peripheral
bloodstream.  When the immune system is activated ("a cold", 
allergy, another virus (HIV, hepatitis, measles)), certain activities
take place that *sometimes* signal unattached HIV to find cells to
infect, and, infected cells begin manufacturing more virus which
normally "buds" out from the infected cell, ready to infect other
cells.  All this activity may avalanche into a permanent reduction
in the number of T-cells (not a good idea). 

If your friend hasn't had Measles yet, his body isn't real good at
fighting it off *if* he should become exposed (easier than you might
think).  It has to mount a considerable attack against the virus
which may produce this undesirable dip in T-cells.  Vaccination
will *also* stimulate the immune system, but in a milder, and more
controlled way. The premise is: vaccine lets the body figure out
how to manufacture sufficient antibody without being under "real"
viral attack. If one should become exposed to measles thereafter,
the body "remembers" the blueprint for creating more antibody very
quickly. It is the associated stimulation of the immune system that
may trigger the slippery-slope toward lowered T-cells.  
 
The vaccine's effects on T-cells will *probably* be temporary in 
nature, and your friend will regain most, if not all of them. A
hit with the REAL measles virus also causes general constitutional
problems which weakens other body defenses temporarily.  The 
overall effect of a REAL infection may be much more devastating.
  
This may appear as damned if you do, damned if you don't in your
friends eyes.  If I were under the same set of conditions,    
generally healthy, and in good spirits, I'd get the vaccine.
Hope your friend doesn't smoke, drink, do recreational drugs.
These weaken the immune system too. If he decides to get the 
vaccine, he might try to eliminate at least the alcohol and
drugs until the effect of the vaccine takes hold.

Hope this helps.  Sorry it was so long :)

-- 
Steve Giammarco        5330 Peterson Ln #1211 Dallas TX 75240      214.788.0976
AIDS Resource Center   4012 Cedar Springs Rd  Dallas TX 75219      214.521.5124
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