Effectiveness of BCG Vaccination Against Mycobacterium tuberculosis Infection in Adults: A Cross-sectional Analysis of a UK-Based Cohort
Effectiveness of BCG Vaccination Against Mycobacterium tuberculosis Infection in Adults: A Cross-sectional Analysis of a UK-Based Cohort
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DOI：
10.1093/infdis/jiz430
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发表时间：
2020-01-01
影响因子：
6.4
通讯作者：
Abubakar, Ibrahim
中科院分区：
文献类型：
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作者：
Katelaris, Anthea L.;Jackson, Charlotte;Abubakar, Ibrahim
背景使用干扰素-γ释放试验（IGRAs）测量，BCG似乎可以减少儿童结核分枝杆菌感染。我们探讨了卡介苗接种是否继续与M的患病率下降有关。成人结核病感染。我们对参加英国队列研究的结核病病例成年接触者的数据进行了横断面分析。采用多变量logistic回归分析评估BCG对潜伏性结核感染（LTBI）的疫苗有效性（VE），该有效性是根据是否存在瘢痕或接种史确定的，通过IGRA测量。还探讨了接种卡介苗的年龄和接种时间的影响。在3453例近期结核病接触者中，27.5%有LTBI。有强有力的证据表明BCG和LTBI之间存在关联（调整后的比值比= 0.70; 95%置信区间，0.56 - 0.87; P = 0.0017），导致VE为30%。VE随着接种疫苗后时间的推移而下降，但有证据表明，与未接种疫苗的参与者相比，接种疫苗的个体甚至在接种疫苗后>20年，LTBI的患病率也较低。BCG与结核病成人接触者中LTBI的低患病率相关。这些结果有助于越来越多的证据表明BCG可以预防M。结核病感染以及疾病。这对全世界的免疫规划、疫苗开发和结核病控制工作都有影响。
Background. BCG appears to reduce acquisition of Mycobacterium tuberculosis infection in children, measured using interferon-gamma release assays (IGRAs). We explored whether BCG vaccination continues to be associated with decreased prevalence of M. tuberculosis infection in adults.Methods. We conducted a cross-sectional analysis of data from adult contacts of tuberculosis cases participating in a UK cohort study. Vaccine effectiveness (VE) of BCG, ascertained based on presence of a scar or vaccination history, against latent tuberculosis infection (LTBI), measured via IGRA, was assessed using multivariable logistic regression. The effects of age at BCG and time since vaccination were also explored.Results. Of 3453 recent tuberculosis contacts, 27.5% had LTBI. There was strong evidence of an association between BCG and LTBI (adjusted odds ratio = 0.70; 95% confidence interval, .56-.87; P = .0017) yielding a VE of 30%. VE declined with time since vaccination but there was evidence that LTBI prevalence was lower amongst vaccinated individuals even >20 years after vaccination, compared with nonvaccinated participants.Conclusions. BCG is associated with lower prevalence of LTBI in adult contacts of tuberculosis. These results contribute to growing evidence that suggests BCG may protect against M. tuberculosis infection as well as disease. This has implications for immunization programs, vaccine development, and tuberculosis control efforts worldwide.