Bacille Calmette-Cuerin (BCG) Meningitis in an AIDS Patient 12 Years After Vaccination with BCG

Deutekom, H. van; Smulders, YM; Roozendaal, K. J.; Soolingen, Dick van

doi:10.1093/clinids/22.5.870

Cited by 22 publications

(10 citation statements)

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“…Upon administration to the skin, BCG is ordinarily not expected to persist in immunocompetent humans, although rare cases of persistence and reactivation of BCG have been reported in individuals who developed immune deficiencies many years after vaccination (1,27,35,36). It therefore seems unlikely that BCG in the skin will encounter the necessary environmental triggers needed to express the latency antigens and subsequently to trigger immune responses.…”

Section: Discussionmentioning

confidence: 99%

Lack of Immune Responses to Mycobacterium tuberculosis DosR Regulon Proteins following Mycobacterium bovis BCG Vaccination

et al. 2007

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Mycobacterium bovis BCG is widely used as a vaccine against tuberculosis (TB),Tuberculosis (TB) remains a major global health threat. Each year, about eight million new TB cases occur and two million people die from TB. It is estimated that one-third of the world population is latently infected with Mycobacterium tuberculosis. From this vast latent reservoir, about 10% of infected people are expected to develop overt TB disease during their lifetimes. However, with the expanding human immunodeficiency virus type 1-AIDS pandemic, this number is expected to soar in the next few decades (11, http://www.who.int /mediacentre/factsheets/fs104/en/).The current TB vaccine is the live attenuated bacterium Mycobacterium bovis Bacillus Calmette-Guérin (BCG). BCG is known to protect against severe forms of TB in young children and against leprosy. However, it does not efficiently and consistently protect against pulmonary TB in adults, the most prevalent and contagious form of TB; BCG also does not offer protection from reactivation of latent TB infection. This partly explains why BCG has little impact on the global TB epidemic despite its widespread use as a prophylactic TB vaccine (http: //www.who.int/wer/2004/en/wer7904.pdf). Over the years, many hypotheses have been put forward to explain the apparent variability in the protective efficacy of BCG, which varies from 0 to 80% (16). Explanations for this inconsistency include differences in trial methodology, host population genetics, use of different BCG vaccine strains (2), and heterogeneous immunity to a variety of environmental mycobacteria that may interfere with or mask the protection provided by BCG (7,26).Immune response profiles following BCG vaccination comprise myriad effector mechanisms, multiple T-cell subsets, and many targeted antigens. BCG is capable of inducing Th1 responses (38), which are critical in mycobacterial infections (17). In addition, BCG is also capable of inducing both CD4 ϩ and CD8ϩ T-cell responses to antigens shared with M. tuberculosis, such as secreted antigens of the mycolyl transferase family (Ag85) (19,20,33) and nondeleted members of the ESAT-6 family (e.g., TB10.4) (32), but also heat shock proteins like Hsp65 and Hsp70 (15). However, it is still not completely known how these and other antigen-specific immune responses contribute to protection against TB.Recently we studied human T-cell responses to DosR (Rv3133c) regulon-encoded antigens (referred to as TB latency antigens) of M. tuberculosis (24). We observed preferential recognition of latency antigens by Mantoux skin test-positive individuals with latent TB compared to patients with TB disease, suggesting that these immune responses are associated with latent TB disease (13,24). The DosR regulon is expressed by tubercle bacilli under in vitro conditions of hypoxia and

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Section: Discussionmentioning

confidence: 99%

Lack of Immune Responses to Mycobacterium tuberculosis DosR Regulon Proteins following Mycobacterium bovis BCG Vaccination

et al. 2007

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“…Most cases involve infants previously infected with HIV and occur within short intervals between BCG vaccination and the onset of symptoms (5). To rule out this possibility, serum samples from the present patient were tested for HIV, yielding a negative result.…”

Section: Introductionmentioning

confidence: 91%

BCG lymphadenopathy detected in a BCG-vaccinated infant

Barouni

Augusto²,

Queiroz

et al. 2004

Braz J Med Biol Res

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“…Whatever the origin of these MTG sequences, the organisms are likely to have been carried to the site of disease by inflammatory cells, as is probably likely with the many other organisms found in these diseased tissues (28). M. bovis BCG is known to persist in vaccinated individuals for long periods of time, as has been suggested from emerging case reports on individuals with human immunodeficiency virus who after progression to AIDS succumb to recrudescent M. bovis BCG infection some considerable time after receiving vaccination (4,8,53,60,64).…”

Section: Figmentioning

confidence: 99%

Detection ofMycobacterium tuberculosisGroup Organisms in Human and Mouse Joint Tissue by Reverse Transcriptase PCR: Prevalence in Diseased Synovial Tissue Suggests Lack of Specific Association with Rheumatoid Arthritis

et al. 2001

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Bacille Calmette-Cuerin (BCG) Meningitis in an AIDS Patient 12 Years After Vaccination with BCG

Cited by 22 publications

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Lack of Immune Responses to Mycobacterium tuberculosis DosR Regulon Proteins following Mycobacterium bovis BCG Vaccination

Lack of Immune Responses to Mycobacterium tuberculosis DosR Regulon Proteins following Mycobacterium bovis BCG Vaccination

BCG lymphadenopathy detected in a BCG-vaccinated infant

Detection ofMycobacterium tuberculosisGroup Organisms in Human and Mouse Joint Tissue by Reverse Transcriptase PCR: Prevalence in Diseased Synovial Tissue Suggests Lack of Specific Association with Rheumatoid Arthritis

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