Thaithumyanon P, Thisyakorn U, Punnahitananda S, Praisuwanna P, Ruxrungtham K
Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 2000 Sep;31(3):482-6.
This prospective cohort study was conducted to determine the complication of Bacillus Calmette-Guerin (BCG) vaccination given to newborn infants born to HIV-1 seropositive mothers and to compare the tuberculin reaction 9 months after BCG vaccination between HIV-1 infected and non infected children. Two hundred and twenty-three infants with BCG immunization at birth were examined. No BCG complication was noted. Tuberculin skin tests were performed on 126 children (56.5%). Eleven of them were excluded because of failure to have skin tests read at 48 hours. Of the 115 infants enrolled to this study, 15 (13%) had no BCG scar and 50 (43.5%) had no tuberculin reaction. Twenty-six children were classified as group 1 or HIV-1 infected children and 89 children were group 2 or HIV-1 non infected. Group 1 children had a smaller tuberculin skin response (X+SD) than group 2 (1.15 +/- 2.82 vs 4.64 +/- 4.29 mm; p < 0.0001). Mean weight + SD of group 1 children was also significantly less than those in group 2 (8,013 +/- 741 vs 8,540 +/- 984 g; p < 0.05). The proportion of children with non reactivity to the tuberculin test, a negative tuberculin test and no BCG scar in group 1 was significantly higher than that in group 2 (76.9% vs 33.7%, 92.3% vs 52.8% and 36.4% vs 6.7% respectively; p < 0.0001 for all). But, the proportion of non reactivity to the tuberculin test in children with or without BCG scar of each group was not different (p > 0.05). Positive tuberculin tests were 7.7% and 47.2% in group 1 and 2 respectively. None of the children with positive tuberculin tests had clinical evidence of tuberculosis. The findings of this study indicate that BCG vaccine given to newborn infants of HIV-1 seropositive mothers is safe. Although tuberculin skin responses of HIV-1 infected children are less than those of HIV-1 non-infected children, it is possible that BCG vaccine might protect these children from developing severe tuberculosis.
本前瞻性队列研究旨在确定对感染人类免疫缺陷病毒1型（HIV-1）的母亲所生新生儿接种卡介苗（BCG）的并发症，并比较HIV-1感染儿童和未感染儿童在接种BCG疫苗9个月后的结核菌素反应。对223名出生时接种BCG的婴儿进行了检查。未发现BCG并发症。对126名儿童（56.5%）进行了结核菌素皮肤试验。其中11名儿童因48小时时未读取皮肤试验结果而被排除。在纳入本研究的115名婴儿中，15名（13%）没有BCG瘢痕，50名（43.5%）没有结核菌素反应。26名儿童被归为第1组即HIV-1感染儿童，89名儿童为第2组即HIV-1未感染儿童。第1组儿童的结核菌素皮肤反应（X+SD）小于第2组（1.15±2.82对4.64±4.29mm；p<0.0001）。第1组儿童的平均体重+SD也显著低于第2组（8013±741对8540±984g；p<0.05）。第1组中对结核菌素试验无反应、结核菌素试验阴性且无BCG瘢痕的儿童比例显著高于第2组（分别为76.9%对33.7%、92.3%对52.8%和36.4%对6.7%；所有p<0.0001）。但是，每组中有或无BCG瘢痕的儿童中对结核菌素试验无反应的比例没有差异（p>0.05）。第1组和第2组中结核菌素试验阳性的儿童分别为7.7%和47.2%。结核菌素试验阳性的儿童均无结核病的临床证据。本研究结果表明，对HIV-1血清阳性母亲的新生儿接种BCG疫苗是安全的。虽然HIV-1感染儿童的结核菌素皮肤反应小于HIV-1未感染儿童，但BCG疫苗有可能保护这些儿童不发生严重结核病。
