title: Effectiveness of the First Dose of BCG against Tuberculosis among HIV-Infected, Predominantly Immunodeficient Children.
abstract: The objective of this study was to estimate the protective effect of Bacille Calmette-Guérin (BCG) vaccine against tuberculosis among (predominantly immunodeficient) HIV-infected children in Angola. A hospital-based case-control study was conducted with 230 cases, children coinfected with tuberculosis, and 672 controls, HIV-infected children from the same hospital, aged 18 months to 13 years. The presence of a vaccination scar was taken as a proxy marker for BCG vaccination. The crude effectiveness was 8% (95% CI: -26 to 32) and the adjusted effectiveness was 30% (95% CI: -75 to 72). The present study suggests that BCG does not have a protective effect against tuberculosis among immunodeficient HIV-infected children. Since BCG is no longer given to HIV-infected children, the study may not be replicated. Accepting that these findings should be considered with caution, they are nonetheless likely to be the last estimate of BCG efficacy in a sufficiently powered study.
authors.affiliation: Departamento de Pediatria, Universidade Agostinho Neto, Avenida Amilcar Cabral, s/n, Maianga, Luanda, Angola.
authors.forename: Joaquim C V D
authors.initials: JC
authors.lastname: Van-Dunem
authors.affiliation: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Rodrigues
authors.affiliation: Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Avenida Professor Moraes Rêgo, s/n, Bloco A do Hospital das Clínicas, Cidade Universitária, 50670-420 Recife, PE, Brazil.
authors.forename: Luiz Claudio Arraes
authors.initials: LC
authors.lastname: Alencar
authors.affiliation: Pós-Graduação em Medicina Tropical, Universidade Federal de Pernambuco, Avenida Professor Moraes Rêgo, s/n, Bloco A do Hospital das Clínicas, Cidade Universitária, 50670-420 Recife, PE, Brazil ; Departamento de Saúde Coletiva, CPqAM, FIOCRUZ, Avenida Professor Moraes Rêgo, s/n, Campus da UFPE, Cidade Universitária, 50670-420 Recife, PE, Brazil.
authors.forename: Maria de Fátima Pessoa
authors.initials: Mde F
authors.lastname: Militão-Albuquerque
authors.affiliation: Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Avenida Professor Moraes Rêgo, s/n, Bloco A do Hospital das Clínicas, Cidade Universitária, 50670-420 Recife, PE, Brazil ; Programa de Mestrado e Doutorado em Ciências da Saúde, UPE, Rua Arnóbio Marques, No. 310, Santo Amaro, 50100-130 Recife, PE, Brazil.
authors.forename: Ricardo Arraes de Alencar
authors.initials: RA
authors.lastname: Ximenes
mesh_terms: D000293:Adolescent; D001500:BCG Vaccine / Q000008:administration & dosage*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D009163:Mycobacterium bovis / Q000276:immunology / Q000472:pathogenicity; D014376:Tuberculosis / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D014611:Vaccination
chemical_list: D001500:BCG Vaccine