title: Vaccinia scars associated with improved survival among adults in rural Guinea-Bissau.
abstract: 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.
authors.affiliation: Projecto de Saúde de Bandim, Statens Serum Institut, Bissau, Guinea-Bissau.
authors.forename: Mette Lundsby
authors.initials: ML
authors.lastname: Jensen
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Dave
authors.forename: Maarten
authors.initials: M
authors.lastname: Schim van der Loeff
authors.forename: Carlos
authors.initials: C
authors.lastname: da Costa
authors.forename: Tim
authors.initials: T
authors.lastname: Vincent
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Leligdowicz
authors.forename: Christine Stabell
authors.initials: CS
authors.lastname: Benn
authors.forename: Adam
authors.initials: A
authors.lastname: Roth
authors.forename: Henrik
authors.initials: H
authors.lastname: Ravn
authors.forename: Ida Maria
authors.initials: IM
authors.lastname: Lisse
authors.forename: Hilton
authors.initials: H
authors.lastname: Whittle
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
mesh_terms: 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*
chemical_list: D001500:BCG Vaccine; D012900:Smallpox Vaccine