Consensus statement on the revised World Health Organization recommendations for BCG vaccination in HIV-infected infants: Submitted on behalf of the BCG Working Group, Child Lung Health Section, International Union Against Tuberculosis and Lung Disease, 38th Union World Conference on Lung Health, Cape Town, 8-12 November 2007 [Official statement]

Authors: Hesseling, A.C.¹; Cotton, M.F.²; Fordham von Reyn, C.³; Graham, S.M.⁴; Gie, R.P.⁵; Hussey, G.D.⁶

Source: The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 12, December 2008 , pp. 1376-1379(4)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

This document outlines the consensus agreement from the Union's BCG Working Group regarding BCG vaccination in HIV-infected infants, in response to recently revised World Health Organization (WHO) guidelines, which make HIV infection in infants a full contraindication to bacille Calmette-Guérin (BCG) vaccination. BCG is one of the most widely given vaccines globally and is safe in immunocompetent individuals. Recent evidence shows that HIV-infected infants who were routinely vaccinated with BCG at birth, when asymptomatic, and who later developed AIDS, are at high risk of developing disseminated BCG disease (estimated incidence 407-1300 per 100 000). The document outlines requirements to implement selective BCG vaccination strategies in infants born to HIV-infected women and strategies to reduce the risk of vertical HIV transmission and disseminated BCG disease in infants.

Keywords: BCG; HIV; disseminated disease; guidelines; PMTCT

Document Type: Invited paper

Affiliations: 1: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom 2: Children's Infectious Diseases Clinical Research Unit, Department of Pediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa 3: DarDar International Programs, Section of Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA 4: Centre for International Child Health, University of Melbourne Department of Paediatrics, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia 5: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa 6: Institute of Infectious Diseases and Molecular Medicine and the School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa