J 2014

BCG vaccination in patients with severe combined immunodeficiency: Complications, risks, and vaccination policies

MARCIANO, Beatriz E., Chiung Yu HUANG, Gyan JOSHI, Nima REZAEI, Beatriz Costa CARVALHO et. al.

Základní údaje

Originální název

BCG vaccination in patients with severe combined immunodeficiency: Complications, risks, and vaccination policies

Autoři

MARCIANO, Beatriz E. (840 Spojené státy), Chiung Yu HUANG (840 Spojené státy), Gyan JOSHI (840 Spojené státy), Nima REZAEI (364 Írán), Beatriz Costa CARVALHO (76 Brazílie), Zoe ALLWOOD (826 Velká Británie a Severní Irsko), Aydan IKINCIOGULLARI (792 Turecko), Shereen M. REDA (818 Egypt), Andrew GENNERY (826 Velká Británie a Severní Irsko), Vojtěch THON (203 Česká republika, garant, domácí), Francisco ESPINOSA-ROSALES (484 Mexiko), Walleed AL-HERZ (414 Kuvajt), Oscar PORRAS (188 Kostarika), Anna SHCHERBINA (643 Rusko), Anna SZAFLARSKA (616 Polsko), Sebnem KILIC (792 Turecko), Jose L. FRANCO (170 Kolumbie), Andrea C. GÓMEZ RACCIO (32 Argentina), Persio ROXO (76 Brazílie), Isabel ESTEVES (620 Portugalsko), Nermeen GALAL (76 Brazílie), Anete Sevciovic GRUMACH (76 Brazílie), Salem AL-TAMEMI (512 Omán), Alisan YILDIRAN (792 Turecko), Julio C. ORELLANA (32 Argentina), Masafumi YAMADA (392 Japonsko), Tomohiro MORIO (392 Japonsko), Diana LIBERATORE (32 Argentina), Yoshitoshi OHTSUKA (392 Japonsko), Yu-Lung LAU (156 Čína), Ryuta NISHIKOMORI (392 Japonsko), Carlos TORRES-LOZANO (484 Mexiko), Juliana T.L. MAZZUCCHELLI (76 Brazílie), Maria M.S. VILELA (76 Brazílie), Fabiola S. TAVARES (76 Brazílie), Luciana CUNHA (76 Brazílie), Jorge A. PINTO (76 Brazílie), Sara E. ESPINOSA-PADILLA (484 Mexiko), Leticia HERNANDEZ-NIETO (484 Mexiko), Reem A. ELFEKY (818 Egypt), Tadashi ARIGA (392 Japonsko), Heike TOSHIO (392 Japonsko), Figen DOGU (792 Turecko), Funda CIPE (792 Turecko), Renata FORMANKOVA (203 Česká republika), Enriqueta M. NUNEZ-NUNEZ (484 Mexiko), Liliana BEZRODNIK (32 Argentina), Jose Goncalo MARQUES (620 Portugalsko), María I. PEREIRA (32 Argentina), Viviana LISTELLO (32 Argentina), Mary A. SLATTER (826 Velká Británie a Severní Irsko), Zohreh NADEMI (826 Velká Británie a Severní Irsko), Danuta KOWALCZYK (616 Polsko), Thomas A. FLEISHER (840 Spojené státy), Graham DAVIES (826 Velká Británie a Severní Irsko), Bénédicte NEVEN (250 Francie) a Sergio D. ROSENZWEIG (840 Spojené státy)

Vydání

Journal of allergy and clinical immunology, New York, Mosby-Elsevier, 2014, 0091-6749

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30102 Immunology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 11.476

Kód RIV

RIV/00216224:14110/14:00077681

Organizační jednotka

Lékařská fakulta

UT WoS

000333531700025

Klíčová slova anglicky

Primary immunodeficiency; severe combined immunodeficiency; vaccine; BCG; mycobacteria; newborn screening; hematopoietic stem cell transplant; immune reconstitution syndrome

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 8. 12. 2014 10:57, Soňa Böhmová

Anotace

V originále

Background: Severe combined immunodeficiency (SCID) is a syndrome characterized by profound T-cell deficiency. BCG vaccine is contraindicated in patients with SCID. Because most countries encourage BCG vaccination at birth, a high percentage of patients with SCID are vaccinated before their immune defect is detected. Objectives: We sought to describe the complications and risks associated with BCG vaccination in patients with SCID. Methods: An extensive standardized questionnaire evaluating complications, therapeutics, and outcomes regarding BCG vaccination in patients given a diagnosis of SCID was widely distributed. Summary statistics and association analysis was performed. Results: Data on 349 BCG-vaccinated patients with SCID from 28 centers in 17 countries were analyzed. Fifty-one percent of the patients had BCG-associated complications, 34% disseminated and 17% localized (a 33,000- and 400-fold increase, respectively, over the general population). Patients receiving early vaccination (<= 3 1 month) showed an increased prevalence of complications (P = 5.006) and death caused by BCG-associated complications (P < .0001). The odds of experiencing complications among patients with T-cell numbers of 250/mu L or less at diagnosis was 2.1 times higher (95% CI, 1.4-3.4 times higher; P = .001) than among those with T-cell numbers of greater than 250/mL. BCG-associated complications were reported in 2 of 78 patients who received antimycobacterial therapy while asymptomatic, and no deaths caused by BCG-associated complications occurred in this group. In contrast, 46 BCG-associated deaths were reported among 160 patients treated with antimycobacterial therapy for a symptomatic BCG infection (P < .0001). Conclusions: BCG vaccine has a very high rate of complications in patients with SCID, which increase morbidity and mortality rates. Until safer and more efficient antituberculosis vaccines become available, delay in BCG vaccination should be considered to protect highly vulnerable populations from preventable complications.