Details

Autor(en) / Beteiligte

• Mak, Tippi K
• Hesseling, Anneke C
• Hussey, Gregory D
• Cotton, Mark F

Titel

Making BCG vaccination programmes safer in the HIV era

Ist Teil von

• The Lancet (British edition), 2008-09, Vol.372 (9641), p.786-787

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2008

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• The Expanded Programme on Immunization (EPI) schedule recommends infant BCG vaccination soon after birth in countries with a high burden of tuberculosis, on the basis of evidence that vaccination averts 40 cases of miliary tuberculosis or tuberculous meningitis, or both, per 100000 vaccinations in HIV-negative children.4 With 100 million BCG doses given every year worldwide, BCG is cost effective and prevents 40000 cases of childhood tuberculosis (table).4 In 2007, about 420000 new HIV infections occurred in children younger than 15 years of age.5 Most were caused by perinatal transmission in sub-Saharan Africa, which is also the region with the highest burden of tuberculosis. Concerns about the vaccine's safety coincide with the push for greater access to early HIV testing, and new guidance from WHO and UNAIDS7 that urges prompt initiation of antiretroviral therapy in HIV-infected infants, which is shown to reduce their mortality,sThe recommended test is HIV-DNA PCR between 4 and 6 weeks of age, but the cost of testing and turnaround time for results can be considerable.