BACKGROUND: Worldwide, most infants born to mothers infected with human immunodeficiency virus (HIV) receive bacille Calmette-Guérin (BCG) vaccine. Tuberculosis is a major cause of death among infants infected with HIV in sub-Saharan Africa, and it should be prevented. However, BCG may itself cause disease (known as "BCGosis") in these infants. Information regarding the immunogenicity of BCG is imperative for the risk/benefit assessment of BCG vaccination in HIV-infected infants; however, no such data exist. METHODS: We compared BCG-induced CD4 and CD8 T cell responses, as assessed by flow cytometry, in HIV-infected (n=20), HIV-exposed but uninfected (n=25), and HIV-unexposed (n=23) infants, during their first year of life. RESULTS: BCG vaccination of the 2 HIV-uninfected groups induced a robust response, which was characterized by CD4 T cells expressing interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, and/or interleukin (IL)-2. In contrast, HIV-infected infants demonstrated a markedly lower response throughout the first year of life. These infants also had significantly reduced numbers of polyfunctional CD4 T cells coexpressing IFN-gamma, TNF-alpha, and IL-2, a finding that is thought to indicate T cell quality. CONCLUSIONS: Infection with HIV severely impairs the BCG-specific T cell response during the first year of life. BCG may therefore provide little, if any, vaccine-induced benefit in HIV-infected infants. Considering the significant risk of BCGosis, these data strongly support not giving BCG to HIV-infected infants.
BACKGROUND: Worldwide, most infants born to mothers infected with human immunodeficiency virus (HIV) receive bacille Calmette-Guérin (BCG) vaccine. Tuberculosis is a major cause of death among infants infected with HIV in sub-Saharan Africa, and it should be prevented. However, BCG may itself cause disease (known as "BCGosis") in these infants. Information regarding the immunogenicity of BCG is imperative for the risk/benefit assessment of BCG vaccination in HIV-infectedinfants; however, no such data exist. METHODS: We compared BCG-induced CD4 and CD8 T cell responses, as assessed by flow cytometry, in HIV-infected (n=20), HIV-exposed but uninfected (n=25), and HIV-unexposed (n=23) infants, during their first year of life. RESULTS: BCG vaccination of the 2 HIV-uninfected groups induced a robust response, which was characterized by CD4 T cells expressing interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, and/or interleukin (IL)-2. In contrast, HIV-infectedinfants demonstrated a markedly lower response throughout the first year of life. These infants also had significantly reduced numbers of polyfunctional CD4 T cells coexpressing IFN-gamma, TNF-alpha, and IL-2, a finding that is thought to indicate T cell quality. CONCLUSIONS:Infection with HIV severely impairs the BCG-specific T cell response during the first year of life. BCG may therefore provide little, if any, vaccine-induced benefit in HIV-infectedinfants. Considering the significant risk of BCGosis, these data strongly support not giving BCG to HIV-infectedinfants.
Authors: A C Hesseling; H Rabie; B J Marais; M Manders; M Lips; H S Schaaf; R P Gie; M F Cotton; P D van Helden; R M Warren; N Beyers Journal: Clin Infect Dis Date: 2006-01-11 Impact factor: 9.079
Authors: Andreia P Soares; Thomas J Scriba; Sarah Joseph; Ryhor Harbacheuski; Rose Ann Murray; Sebastian J Gelderbloem; Anthony Hawkridge; Gregory D Hussey; Holden Maecker; Gilla Kaplan; Willem A Hanekom Journal: J Immunol Date: 2008-03-01 Impact factor: 5.422
Authors: Willem A Hanekom; Jane Hughes; Maushumi Mavinkurve; Megan Mendillo; Marcia Watkins; Hoyam Gamieldien; Sebastian J Gelderbloem; Mzwandile Sidibana; Nazma Mansoor; Virginia Davids; Rose Ann Murray; Anthony Hawkridge; Patrick A J Haslett; Stanley Ress; Gregory D Hussey; Gilla Kaplan Journal: J Immunol Methods Date: 2004-08 Impact factor: 2.303
Authors: Annelies Van Rie; Shabir A Madhi; Jayvant R Heera; Stephen Meddows-Taylor; Aaron M Wendelboe; Fiona Anthony; Avy Violari; Caroline T Tiemessen Journal: Clin Vaccine Immunol Date: 2006-02
Authors: Timothy Lahey; Robert D Arbeit; Muhammad Bakari; C Robert Horsburgh; Mecky Matee; Richard Waddell; Lillian Mtei; Jenni M Vuola; Kisali Pallangyo; C Fordham von Reyn Journal: Vaccine Date: 2010-09-25 Impact factor: 3.641
Authors: H Rabie; A Violari; T Duong; S A Madhi; D Josipovic; S Innes; E Dobbels; E Lazarus; R Panchia; A G Babiker; D M Gibb; M F Cotton Journal: Int J Tuberc Lung Dis Date: 2011-09 Impact factor: 2.373
Authors: Alana T Brennan; Rachael Bonawitz; Christopher J Gill; Donald M Thea; Mary Kleinman; Lawrence Long; Caitryn McCallum; Matthew P Fox Journal: J Acquir Immune Defic Syndr Date: 2019-09-01 Impact factor: 3.731
Authors: Shabir A Madhi; Peter Adrian; Mark F Cotton; James A McIntyre; Patrick Jean-Philippe; Shawn Meadows; Sharon Nachman; Helena Käyhty; Keith P Klugman; Avye Violari Journal: J Infect Dis Date: 2010-08-15 Impact factor: 5.226