期刊
JOURNAL OF INFECTIOUS DISEASES
卷 199, 期 7, 页码 982-990出版社
OXFORD UNIV PRESS INC
DOI: 10.1086/597304
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资金
- Wellcome Trust [080929/Z/06/Z] Funding Source: Wellcome Trust
- NIAID NIH HHS [R01 AI054361, N01-AI70022, R01-AI054361, N01AI70022, R01-AI065653, R01 AI065653] Funding Source: Medline
- Wellcome Trust [080929, 080929/Z/06/Z] Funding Source: Medline
Background. Worldwide, most infants born to mothers infected with human immunodeficiency virus (HIV) receive bacille Calmette-Guerin (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.
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