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BioMed Research International
Volume 2015 (2015), Article ID 275029, 10 pages
http://dx.doi.org/10.1155/2015/275029
Clinical Study

Effectiveness of the First Dose of BCG against Tuberculosis among HIV-Infected, Predominantly Immunodeficient Children

1Departamento de Pediatria, Universidade Agostinho Neto, Avenida Amilcar Cabral, s/n, Maianga, Luanda, Angola
2Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
3Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Avenida Professor Moraes Rêgo, s/n, Bloco A do Hospital das Clínicas, Cidade Universitária, 50670-420 Recife, PE, Brazil
4Pós-Graduação em Medicina Tropical, Universidade Federal de Pernambuco, Avenida Professor Moraes Rêgo, s/n, Bloco A do Hospital das Clínicas, Cidade Universitária, 50670-420 Recife, PE, Brazil
5Departamento de Saúde Coletiva, CPqAM, FIOCRUZ, Avenida Professor Moraes Rêgo, s/n, Campus da UFPE, Cidade Universitária, 50670-420 Recife, PE, Brazil
6Programa de Mestrado e Doutorado em Ciências da Saúde, UPE, Rua Arnóbio Marques, No. 310, Santo Amaro, 50100-130 Recife, PE, Brazil

Received 25 February 2015; Accepted 19 May 2015

Academic Editor: Pere Domingo

Copyright © 2015 Joaquim C. V. D. Van-Dunem et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The objective of this study was to estimate the protective effect of Bacille Calmette-Guérin (BCG) vaccine against tuberculosis among (predominantly immunodeficient) HIV-infected children in Angola. A hospital-based case-control study was conducted with 230 cases, children coinfected with tuberculosis, and 672 controls, HIV-infected children from the same hospital, aged 18 months to 13 years. The presence of a vaccination scar was taken as a proxy marker for BCG vaccination. The crude effectiveness was 8% (95% CI: −26 to 32) and the adjusted effectiveness was 30% (95% CI: −75 to 72). The present study suggests that BCG does not have a protective effect against tuberculosis among immunodeficient HIV-infected children. Since BCG is no longer given to HIV-infected children, the study may not be replicated. Accepting that these findings should be considered with caution, they are nonetheless likely to be the last estimate of BCG efficacy in a sufficiently powered study.