3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

DELAYED COMPLICATIONS OF BACILLUS CALMETTE – GUERIN (BCG) VACCINATION IN HIV INFECTED CHILDREN

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. WeOa0104

Fallo A., Torrado L., Sanchez A., Cerqueiro C., Shadgrosky L., Lopez E.L.
Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina

INTRODUCTION: Local complications of BCG vaccine in normal hosts is an entity known from a long time ago, with 25 cases/million doses reported, being only 0.19/million for disseminated infection. Risk is increased for immunodeficient patients. The objective of this study is to communicate the risk of BCG complications in HIV infected children followed-up at the Hospital de Niños "R. Gutiérrez" of Buenos Aires.

METHODS: A retrospective study among 310 BCG vaccinated (at the first month of life) of 374 perinatally HIV infected children.

RESULTS: The study showed that 28/310 (9 %) of vaccinated patients presented BCG infection. Mean age at onset was 8.6 ± 7 mo. (r:3 – 31 mo). Male: 46%. At the time of BCG infection 71% was in C Category (CDC Classification), mean CD4 was: 11%, median viral load: 5.8 log. The 89 % had less than 3 mo of antiretroviral therapy. Local complications were detected in 24 patients (85.7%) and 4 (14%) had disseminated infection. Among local disease, 4 cases had abscesses only at the site of vaccination and 20 axillary adenitis ipsilateral to the vaccination site; 60% of them with chronic effusion. Disseminated cases were: 1) BCG osteitis of multiple bones and spleen; 2) Pneumonitis + persistent fever + axillary adenitis; 3) mediastine enlargement with a neck mass; 4) Pneumonitis + axillary adenitis. All 4 cases had positive BCG culture. TB drugs were used in 75% of cases. Four patients died no related to BCG infection. TB diagnosis was made in 44/310 (14%) of BCG vaccinated patients and in 7/64 (11%) of no vaccinated children (p=NS).

CONCLUSIONS: We report a high frequency of complications and an increased risk of severe disease, therefore we believe that BCG vaccination should be reconsidered in children at risk of HIV infection.

Download PDF of this abstract.

Download Power Point Presentation.

050724
Clinical | WeOa0104 | Aurelia Fallo
Mycobacterial diseases other than tuberculosis

Copyright © 2005 - International AIDS Society (IAS). All information and content relating to the abstracts from the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2005. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.