Vaccinia scars associated with improved survival among adults in rural Guinea-Bissau.
BACKGROUND
In urban Guinea-Bissau, adults with a vaccinia scar had better survival but also a higher prevalence of HIV-2 infection. We therefore investigated the association between vaccinia scar and survival and HIV infection in a rural area of Guinea-Bissau.


RESULTS
In connection with a study of HIV in rural Guinea-Bissau, we assessed vaccinia and BCG scars in 193 HIV-1 or HIV-2 infected and 174 uninfected participants. Mortality was assessed after 2(1/2)-3 years of follow-up. The analyses were adjusted for age, sex, village, and HIV status. The prevalence of vaccinia scar was associated with age, village, and HIV-2 status but not with sex and schooling. Compared with individuals without any scar, individuals with a vaccinia scar had better survival (mortality rate ratio (MR) = 0.22 (95% CI 0.08-0.61)), the MR being 0.19 (95% CI 0.06-0.57) for women and 0.40 (95% CI 0.04-3.74) for men. Estimates were similar for HIV-2 infected and HIV-1 and HIV-2 uninfected individuals. The HIV-2 prevalence was higher among individuals with a vaccinia scar compared to individuals without a vaccinia scar (RR = 1.57 (95% CI 1.02-2.36)).


CONCLUSIONS
The present study supports the hypothesis that vaccinia vaccination may have a non-specific beneficial effect on adult survival.
Jensen
Mette Lundsby
ML
Projecto de Saúde de Bandim, Statens Serum Institut, Bissau, Guinea-Bissau.
Dave
Sangeeta
S
Schim van der Loeff
Maarten
M
da Costa
Carlos
C
Vincent
Tim
T
Leligdowicz
Aleksandra
A
Benn
Christine Stabell
CS
Roth
Adam
A
Ravn
Henrik
H
Lisse
Ida Maria
IM
Whittle
Hilton
H
Aaby
Peter
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000008:administration & dosage / Q000276:immunology; D002921:Cicatrix / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality* / Q000821:virology; D015497:HIV-1; D015498:HIV-2; D006801:Humans; D008297:Male; D008875:Middle Aged; D012900:Smallpox Vaccine / Q000008:administration & dosage* / Q000276:immunology*
D001500:BCG Vaccine; D012900:Smallpox Vaccine