World
Health Organization Says the BCG Tuberculosis Vaccine Is Too Dangerous for HIV
Positive Infants
 | The
World Health Organization (WHO) now recommends that use of the Bacille Calmette-Guérin
(BCG) vaccine against tuberculosis (TB) be delayed until infants can be tested
for HIV. A new WHO study finds BCG, which is routinely given to 75 percent of
babies worldwide, is too risky for those born infected with HIV. |
 In
use since 1921, the BCG vaccine is effective against deadly TB meningitis, though
it is less so against the TB lung disease. Because it is a live vaccine, it can
cause "disseminated BCG disease," a type of whole-body bacterial infection
that is fatal in more than 70 percent of cases.
In
countries with co-existing TB and HIV epidemics, giving BCG to HIV-infected newborns
offers them no protection against TB and may kill them due to BCG disease, according
to the WHO study, which was performed at three South African pediatric hospitals.
Since
BCG disease and TB can look identical, the researchers had to culture each infection
individually. Although the researchers recommended delaying BCG vaccination, they
said this will not be easy. In poor countries, babies are frequently not brought
back at six weeks for a test and 10 weeks for a shot. Thus the practice of vaccinating
every newborn may continue, since it protects the ones not infected with HIV.
In
conclusion, the study authors wrote, "Multicentre surveillance data showed
that the risk of disseminated BCG disease in HIV-infected infants is considerably
higher than previously estimated, although likely to be under-estimated." The
also stated, "There is an urgent need for data on the risk-benefit ratio
of BCG vaccination in HIV-infected infants to inform decision-making in settings
where HIV infection and tuberculosis burdens are high. Safe and effective tuberculosis
prevention strategies are needed for HIV-infected
infants." Source
DG.
McNeil Jr. Tuberculosis: TB Vaccine Too Dangerous for Babies with AIDS Virus,
Study Says. New York Times. July 2, 2009. Reference
AC Hesseling, LF Johnson, H Jaspan, and others. Disseminated Bacille Calmette-Guérin
Disease in HIV-Infected South African Infants [Full
article] Bulletin of the World Health Organization 87(7): 485-564.
2009.
| 
