Third Division, Centers for Disease Control, Taipei, Taiwan.
Thorax. 2013 Mar;68(3):263-8. doi: 10.1136/thoraxjnl-2012-202208. Epub 2012 Sep 27.
To address whether the effect of BCG vaccination against tuberculosis (TB) infection lasts to adulthood.
A cross-sectional study on the prevalence of latent TB infection (LTBI) among HIV-negative men, using QuantiFERON-TB Gold In-tube (QFT-IT), was conducted at a prison in northern Taiwan with >3000 inmates. A QFT-IT ≥0.35 IU/ml was defined as LTBI. A QFT-IT ≥0.7 IU/ml was defined as recent LTBI. The association between the number of BCG scars and LTBI stratified by age was analysed. The study procedure was approved by the institutional review board, and all participants gave written informed consent before receiving screening tests.
Among the 2385 participants, 25% had a QFT-IT ≥0.35 IU/ml. Increasing LTBI (14%, 32% and 50%) was observed with increased age (18-34 years, 35-54 years and ≥55 years) (p<0.001 by the Cochran-Armitage Trend Test). The number of BCG scars were found to be inversely correlated with QFT-IT results for both LTBI and recent LTBI in all three age groups (p<0.001 by Cochran-Mantel-Haenszel statistics).
Our results suggest that BCG vaccine seems to have a protective effect in adults decades after vaccination according to the number of recent infections (QFT-IT ≥0.7 IU/ml). This finding has important implications for national policy of BCG vaccination. Further prospective cohort studies on the protective effect of BCG vaccination against TB infection in adults are warranted.
探讨卡介苗（BCG）接种预防结核（TB）感染的效果是否持续至成年期。
在台湾北部的一所监狱中，对 3000 多名囚犯进行了一项关于 HIV 阴性男性潜伏性 TB 感染（LTBI）患病率的横断面研究，使用了 QuantiFERON-TB Gold In-tube（QFT-IT）。QFT-IT≥0.35IU/ml 定义为 LTBI。QFT-IT≥0.7IU/ml 定义为近期 LTBI。分析了年龄分层的 BCG 疤痕数量与 LTBI 的相关性。本研究程序经机构审查委员会批准，所有参与者在接受筛查检测前均签署了书面知情同意书。
在 2385 名参与者中，25%的人 QFT-IT≥0.35IU/ml。随着年龄的增加（18-34 岁、35-54 岁和≥55 岁），LTBI（14%、32%和 50%）逐渐增加（Cochran-Armitage 趋势检验，p<0.001）。在所有三个年龄组中，BCG 疤痕数量与 LTBI 和近期 LTBI 的 QFT-IT 结果均呈负相关（Cochran-Mantel-Haenszel 统计，p<0.001）。
根据近期感染（QFT-IT≥0.7IU/ml）的数量，我们的结果表明，BCG 疫苗在接种后几十年对成年人似乎具有保护作用。这一发现对国家 BCG 疫苗接种政策具有重要意义。需要进一步开展前瞻性队列研究，以评估 BCG 接种对成年人 TB 感染的保护作用。
