Delayed BCG immunization does not alter antibody responses to EPI vaccines in HIV-exposed and -unexposed South African infants. Issue 32 (12th July 2016)

• Record Type: Journal Article
• Authors: Hesseling, Anneke C.; Blakney, Anna K.; Jones, Christine E.; Esser, Monika M.; de Beer, Corena; Kuhn, Louise; Cotton, Mark F.; Jaspan, Heather B.
• Is Part Of: Vaccine. Volume 34:Issue 32(2016)
• Page Start: 3702
• Page End: 3709
• Publication Date: 2016-07-12
• Subjects: BCG -- Humoral immunity -- Infants -- HIV-exposed -- South Africa; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2016.03.081
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Timing of BCG vaccination did not influence antibody levels to Hib, pertussis, tetanus or HBV. Effects of early vs. late BCG vaccination did not differ between HIV-exposed and -unexposed groups. HIV-exposure without infection was associated with increased Hib and pertussis antibody concentrations. Abstract: Background: Bacille Calmette-Guérin (BCG) is routinely given at birth in tuberculosis-endemic settings due to its protective effect against disseminated tuberculosis in infants. BCG is however contraindicated in HIV-infected infants. We investigated whether delaying BCG vaccination to 14 weeks of age affected vaccine-induced antibody responses to Haemophilus influenzae type b (Hib)-conjugate, pertussis, tetanus and Hepatitis B (HBV) vaccines, in HIV-exposed uninfected (HEU) and -unexposed uninfected (HUU) infants. Methods: Infants were randomized to receive BCG at birth or at 14 weeks of age. Blood was taken at 14, 24, and 52 weeks of age and analyzed for Hib, pertussis, tetanus and HBV specific antibodies. Results: BCG was given either at birth (106 infants, 51 HEU) or at 14 weeks of age (74 infants, 50 HEU). The timing of BCG vaccination did not influence the antibody response to any antigen studied. However, in a non-randomized comparison, HEU infants had higher Hib antibody concentrations at weeks 14 and 24 ( p = 0.001 and <0.001, respectively) and pertussis at week 24 ( p = 0.003). Conversely, HEU infants had lower antibody concentrations to HBV at 14 and 52 weeks ( p = 0.032 and p = 0.031) with no differences in tetanus titres. Conclusions: HIV exposure, but not the timing of BCG vaccination, was associated with antibody concentrations to Hib, pertussis, HBV and tetanus primary immunization. Clinical Trial Registration: DOH-27-1106-1520.