Bacille Calmette-Guérin vaccine-related disease in HIV-infected children: a systematic review

Azzopardi, P., Bennett, C.M., Graham, S.M. and Duke, T. 2009, Bacille Calmette-Guérin vaccine-related disease in HIV-infected children: a systematic review, International journal of tuberculosis and lung disease, vol. 13, no. 11, pp. 1331-1344.

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Title Bacille Calmette-Guérin vaccine-related disease in HIV-infected children: a systematic review
Author(s) Azzopardi, P.
Bennett, C.M.
Graham, S.M.
Duke, T.
Journal name International journal of tuberculosis and lung disease
Volume number 13
Issue number 11
Start page 1331
End page 1344
Total pages 14
Publisher International Union Against Tuberculosis and Lung Disease
Place of publication Paris, France
Publication date 2009-11
ISSN 1027-3719
Keyword(s) BCG
Summary Objective: To describe the characteristics and risk of bacille Calmette-Guérin (BCG) vaccine related disease in human immunodeficiency virus (HIV) infected infants.
Methods: Systematic literature review of articles published from 1950 to April 2009 in the English language. We identified all microbiologically confirmed cases of disseminated BCG disease in vertically HIV-infected children reported in the literature.
Results: Sixteen observational studies and 11 case reports/series were included. Observational studies suffered from high rates of loss to follow-up and death. Loco-regional BCG disease was reported in both HIV-infected and non-infected children. Disseminated BCG disease was reported only in children with immunodeficiency and only in studies employing sophisticated laboratory techniques. Sixty-nine cases of disseminated BCG were identified in the literature: 47 cases were reported in six observational studies, the majority (41/47) from the Western Cape of South Africa. A Brazilian cohort study reported no cases of disseminated BCG amongst 66 HIV-infected children observed over a 7-year period. A recent South African surveillance study reported 32 cases of disseminated BCG over a 3-year period, estimating the risk of disseminated BCG to be 992 per 100 000 vaccinations in HIV-infected children. Few cases of severe disseminated TB were reported in the cohort studies among HIV-infected children vaccinated with BCG.
Conclusion: Data on the risk of BCG vaccination in HIV-infected children are limited. Targeted surveillance for BCG complications employing sophisticated diagnostic techniques is required to inform vaccination policy.
Notes (in press May 15th 2009)
Language eng
Field of Research 110399 Clinical Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
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