OBJECTIVE: To describe the characteristics and risk of bacille Calmette-Guérin (BCG) vaccine related disease in human immunodefi ciency virus (HIV) infected infants. METHODS: Systematic literature review of articles published from 1950 to April 2009 in the English language. We identifi ed all microbiologically confi rmed 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 HIVinfected and non-infected children. Disseminated BCG disease was reported only in children with immunodefi-ciency and only in studies employing sophisticated laboratory techniques. Sixty-nine cases of disseminated BCG were identifi ed 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.
|Number of pages||14|
|Journal||International Journal of Tuberculosis and Lung Disease|
|Publication status||Published - 1 Nov 2009|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Infectious Diseases