{"id":741,"date":"2008-06-12T19:33:42","date_gmt":"2008-06-12T18:33:42","guid":{"rendered":"http:\/\/localhost\/new\/htb\/?p=741"},"modified":"2013-08-28T08:05:24","modified_gmt":"2013-08-28T08:05:24","slug":"complications-with-bcg-vaccination-in-hiv-positive-and-negative-infants-cher-study","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/741","title":{"rendered":"Complications with BCG vaccination in HIV-positive and negative infants: CHER Study"},"content":{"rendered":"

Polly Clayden, HIV i-Base<\/strong><\/p>\n

A poster from the CHER study group looked at Bacille-Calmette-Guerin (BCG)-related complications in this cohort and in a comparator group of HIV-negative infants born to mothers participating in a vaccine trial.<\/strong><\/p>\n

In this study 292 HIV-positive infants 6 to12 weeks of age were randomised to immediate ART and 125 to deferred ART. The HIV-negative infants in the study were born to HIV-positive (n=125) and HIV-negative mothers (n=125).<\/p>\n

All children received BCG vaccination at birth as is standard in South Africa. Signs of local reaction to BCG and other clinical events were compared among the infants.<\/p>\n

This was data after a median follow up of 40 weeks.<\/p>\n

The investigators reported that the prevalence of regional BCG-adenitis among the HIV-positive infants was 33\/417, 7.9% (5.5 to 10.9), of which13 (10.4%), were in the deferred arm and 20 (6.9%) in the early ART arm (OR 1.6, 0.8 to 3.3; p =0.22). By comparison none of the HIV-negative infants had local BCG-adenitis.<\/p>\n

The majority, 31\/33 (93.9%) of cases of BCG-related regional adenitis occurred following initiation of HAART, which suggested IRIS. 2 infants in the deferred arm had pre-existing adenitis.<\/p>\n

There was no difference in the development of IRIS-related BCG-adenitis between the early-HAART 20\/292 (6.8%), p= 0.48 and the deferred HAART 11\/125 (8.8%) groups.<\/p>\n

Out of the 33 infants with BCG-adenitis, 3 died (2 in the deferred arm and 1 in the early ART group). One of the deaths (in the deferred arm) was considered to be associated with BCG disease.<\/p>\n

The investigators noted that the infants in the deferred arm received more concomitant therapy than in the early ART group (7\/13 infants vs 4 \/20 for TB treatment). Of 8 infants that received prednisone, 7 were in the deferred arm (53.9%) and 1 in the early ART group (0.5%).<\/p>\n

The percentage of local BCG reactogenicity to BCG was similar (>50%) regardless of HIV status.<\/p>\n

In the discussion section of this poster the investigators explained that in May 2007, the WHO revised its guidelines for BCG vaccination for children born to HIV-positive mothers. WHO recommended that it should not be given to children known to be HIV-positive. By that time, the CHER trial was fully recruited.<\/p>\n

The investigators concluded:<\/p>\n