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J Infect Dis. 2015 Feb 1;211(3):338-46. doi: 10.1093/infdis/jiu434. Epub 2014 Aug 8.

Delaying BCG vaccination until 8 weeks of age results in robust BCG-specific T-cell responses in HIV-exposed infants.

Author information

  • 1Division of Immunology.
  • 2Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
  • 3Division of Immunology Division of Medical Virology.
  • 4Division of Medical Virology National Health Laboratory Services, South Africa.
  • 5Institute of Infectious Disease and Molecular Medicine, Department of Clinical Laboratory Sciences, University of Cape Town Paediatric Infectious Diseases Research Group, St George's, University of London, United Kingdom.
  • 6Division of Immunology National Health Laboratory Services, South Africa.
  • 7Seattle Biomedical Research Institute, Washington.
  • 8Division of Immunology Seattle Biomedical Research Institute, Washington.

Abstract

BACKGROUND:

BCG vaccination prevents disseminated tuberculosis in children, but it is contraindicated for persons with human immunodeficiency virus (HIV) infection because it can result in severe disease in this population. In tuberculosis-endemic regions, BCG vaccine is administered soon after birth, before in utero and peripartum HIV infection is excluded. We therefore assessed the immunogenicity of BCG vaccine in HIV-exposed infants who received BCG at birth or at 8 weeks of age.

METHODS:

HIV-exposed, uninfected infants were randomly assigned to receive BCG vaccination at birth (the early vaccination arm) or 8 weeks of age (the delayed vaccination arm). BCG-specific proliferative and intracellular cytokine responses were assessed in 28 infants per arm at 6, 8, and 14 weeks of life.

RESULTS:

There was no difference in BCG-specific T-cell proliferation between the study arms 6 weeks after vaccination. However, at 14 weeks of age, the frequency of interferon γ-expressing CD4(+) T cells and multifunctional BCG-specific responses in the delayed vaccinated arm were significantly higher than those in the early vaccination arm (P = .021 and P = .011, respectively).

CONCLUSIONS:

The immunogenicity of BCG vaccination in HIV-exposed, uninfected infants is not compromised when delayed until 8 weeks of age and results in robust BCG-specific T-cell responses at 14 weeks of age. These findings support further evaluation of this modified BCG vaccination strategy for HIV-exposed infants.

CLINICAL TRIALS REGISTRATION:

NCT02062580.

© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

KEYWORDS:

BCG vaccination; T-cell proliferation; infants; intracellular cytokines; maternal HIV

PMID:
25108027
[PubMed - indexed for MEDLINE]
PMCID:
PMC4318913
Free PMC Article
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