Araujo Zaida, de Waard Jacobus Henri, de Larrea Carlos Fernández, Borges Rafael, Convit Jacinto
Laboratorio de Inmunología de Enfermedades Infecciosas, Instituto de Biomedicina, Catedra de Inmunologia, Universidad Central de Venezuela, Apartado 4043, Caracas 1010A, Venezuela.
Vaccine. 2008 Oct 16;26(44):5575-81. doi: 10.1016/j.vaccine.2008.08.006. Epub 2008 Aug 22.
The Bacille Calmette-Guérin (BCG) vaccine is the most widely used vaccine in the world, however it may cause problems for the appropriate interpretation of the tuberculin skin test (TST). We assessed the diagnostic value of latent infection in vaccinated and unvaccinated indigenous children from communities that have a very high prevalence of adult tuberculosis (TB). A total of 997 children under 15 years old and classified in age groups (0-1.9, 2-5, 6-9 and 10-15 years old) were randomly selected and given TSTs using the Mantoux technique. TST induration values of vaccinated children (n=724) were compared with those of children unvaccinated (n=273). BCG vaccination was not an important cause of false-positive TST, except in communities with a low prevalence of active TB. In conclusion, the results suggested that a history of BCG vaccination on TST+ response after 10 years of vaccination was statistically insignificant but whether at earlier age TST+ reflects most probably the degree of exposure to TB cases than BCG vaccination should be clarified in the future.
卡介苗（BCG）是世界上使用最广泛的疫苗，然而它可能会给结核菌素皮肤试验（TST）的正确解读带来问题。我们评估了来自成人肺结核（TB）患病率极高的社区中接种疫苗和未接种疫苗的本地儿童潜伏感染的诊断价值。总共随机选取了997名15岁以下儿童，并按年龄组（0 - 1.9岁、2 - 5岁、6 - 9岁和10 - 15岁）进行分类，采用曼托试验技术进行结核菌素皮肤试验。将接种疫苗儿童（n = 724）的结核菌素皮肤试验硬结值与未接种疫苗儿童（n = 273）的硬结值进行比较。除了在活动性结核病患病率较低的社区外，卡介苗接种并非结核菌素皮肤试验假阳性的重要原因。总之，结果表明，接种疫苗10年后卡介苗接种史对结核菌素皮肤试验阳性反应无统计学意义，但在更早年龄时结核菌素皮肤试验阳性是否最能反映接触结核病病例的程度而非卡介苗接种情况尚有待未来阐明。
