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. 2007 Jan 1;195(1):118-23.
doi: 10.1086/509896. Epub 2006 Nov 20.

Baseline mycobacterial immune responses in HIV-infected adults primed with bacille Calmette-Guérin during childhood and entering a tuberculosis booster vaccine trial

Mecky Matee  1 , Timothy Lahey, Jenni M Vuola, Lillian Mtei, Bernard F Cole, Muhammad Bakari, Robert D Arbeit, C Robert Horsburgh, Kisali Pallangyo, C Fordham von Reyn
Affiliations

Baseline mycobacterial immune responses in HIV-infected adults primed with bacille Calmette-Guérin during childhood and entering a tuberculosis booster vaccine trial

Mecky Matee et al. J Infect Dis. .

Abstract

Background: Most new tuberculosis vaccines will be administered as a booster to subjects primed with bacille Calmette-Guérin (BCG) during childhood.

Methods: We investigated in vivo and in vitro immune responses to mycobacteria in human immunodeficiency virus (HIV)-positive subjects in Tanzania primed with BCG during childhood and entering a tuberculosis booster vaccine trial. Tests included intradermal skin testing for Mycobacterium tuberculosis purified protein derivative (PPD) and Mycobacterium avium sensitin (MAS); lymphocyte proliferation assays and interferon (IFN)-gamma levels after stimulation with Mycobacterium vaccae sonicate (MVS), M. tuberculosis early secreted antigen (ESAT)-6, M. tuberculosis antigen 85 (Ag85), or M. tuberculosis whole-cell lysate (WCL); and determination of serum antibody to lipoarabinomannin (LAM).

Results: A total of 888 subjects with CD4 cell counts > or = 200 cells/mm3 were enrolled. PPD and MAS test results were positive in 34% and 30% of the subjects, respectively. Proliferative responses were detected as follows: MVS, 6%; Ag85, 24%; ESAT-6, 21%; and WCL, 59%. IFN-gamma responses were 2%, 6%, 12%, and 38%, respectively. LAM antibody was detected in 28% of the subjects. Subjects were more likely to have detectable proliferative and IFN-gamma responses if they had positive PPD test results or CD4 cell counts > or = 500 cells/mm3. Overall, 94% of the subjects had evidence of primed mycobacterial immune responses.

Conclusion: Of HIV-positive BCG-immunized adults with CD4 cell counts > or = 200 cells/mm3 in Tanzania, 94% are primed for booster mycobacterial immunization.

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Conflict of interest statement

Potential conflicts of interest: none reported.

Figures

Figure 1
Figure 1
Percentage of subjects with detectable immune responses to mycobacterial antigens by in vivo and in vitro tests. IFN, interferon; LAM, antibody to Mycobacterium tuberculosis lipoarabinomannin; LPA, lymphocyte proliferation assay; MAS, Mycobacterium avium sensitin; PPD, M. tuberculosis purified protein derivative.
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