title: Delayed BCG immunization does not alter antibody responses to EPI vaccines in HIV-exposed and -unexposed South African infants.
abstract: Bacille Calmette-Guérin (BCG) is routinely given at birth in tuberculosis-endemic settings due to its protective effect against disseminated tuberculosis in infants. BCG is however contraindicated in HIV-infected infants. We investigated whether delaying BCG vaccination to 14 weeks of age affected vaccine-induced antibody responses to Haemophilus influenzae type b (Hib)-conjugate, pertussis, tetanus and Hepatitis B (HBV) vaccines, in HIV-exposed uninfected (HEU) and -unexposed uninfected (HUU) infants.
  
  
  
  Infants were randomized to receive BCG at birth or at 14 weeks of age. Blood was taken at 14, 24, and 52 weeks of age and analyzed for Hib, pertussis, tetanus and HBV specific antibodies.
  
  
  
  BCG was given either at birth (106 infants, 51 HEU) or at 14 weeks of age (74 infants, 50 HEU). The timing of BCG vaccination did not influence the antibody response to any antigen studied. However, in a non-randomized comparison, HEU infants had higher Hib antibody concentrations at weeks 14 and 24 (p=0.001 and <0.001, respectively) and pertussis at week 24 (p=0.003). Conversely, HEU infants had lower antibody concentrations to HBV at 14 and 52 weeks (p=0.032 and p=0.031) with no differences in tetanus titres.
  
  
  
  HIV exposure, but not the timing of BCG vaccination, was associated with antibody concentrations to Hib, pertussis, HBV and tetanus primary immunization.
  
  
  
  DOH-27-1106-1520.
authors.affiliation: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. Electronic address: annekeh@sun.ac.za.
authors.forename: Anneke C
authors.initials: AC
authors.lastname: Hesseling
authors.affiliation: Division of Immunology, Institute of Infectious Disease and Molecular Medicine and Clinical Laboratory Sciences, University of Cape Town, South Africa; Department of Bioengineering, University of Washington, Seattle, WA, USA.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Blakney
authors.affiliation: Division of Immunology, Institute of Infectious Disease and Molecular Medicine and Clinical Laboratory Sciences, University of Cape Town, South Africa; Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK; Department of Academic Paediatrics, Imperial College London, Norfolk Place, London W2 1NY, UK.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Jones
authors.affiliation: Immunology Unit, Division of Medical Microbiology, Department of Pathology, National Health Laboratory Service, University of Stellenbosch, Cape Town, South Africa.
authors.forename: Monika M
authors.initials: MM
authors.lastname: Esser
authors.affiliation: Division of Medical Virology, Department of Pathology, National Health Laboratory Service, Stellenbosch University, South Africa.
authors.forename: Corena
authors.initials: C
authors.lastname: de Beer
authors.affiliation: Gertrude H. Sergievsky Center, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.
authors.forename: Louise
authors.initials: L
authors.lastname: Kuhn
authors.affiliation: Children's Infectious Diseases Clinical Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Cotton
authors.affiliation: Division of Immunology, Institute of Infectious Disease and Molecular Medicine and Clinical Laboratory Sciences, University of Cape Town, South Africa; Seattle Children's Research Institute and Departments of Pediatrics and Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Heather B
authors.initials: HB
authors.lastname: Jaspan
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D000917:Antibody Formation; D001500:BCG Vaccine / Q000008:administration & dosage* / Q000627:therapeutic use; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections; D018073:Haemophilus Vaccines / Q000627:therapeutic use*; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011055:Poliovirus Vaccine, Oral / Q000627:therapeutic use*; D011247:Pregnancy; D016037:Single-Blind Method; D013019:South Africa; D013745:Tetanus Toxoid / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D001500:BCG Vaccine; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D018073:Haemophilus Vaccines; C055753:Haemophilus influenza type b polysaccharide vaccine-tetanus toxin conjugate; D011055:Poliovirus Vaccine, Oral; D013745:Tetanus Toxoid; C080881:diphtheria-tetanus-pertussis-haemophilus b conjugate vaccine
keywords: BCG; HIV-exposed; Humoral immunity; Infants; South Africa