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BCG Vaccination in HIV-Infected Children英文文献资料.doc

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BCG Vaccination in HIV-Infected Children英文文献资料

HindawiPublishingCorporation TuberculosisResearchandTreatment Volume2011,ArticleID712736,6pages doi:10.1155/2011/712736 ReviewArticle BCGVaccinationinHIV-InfectedChildren JamesJ.C.NuttallandBrianS.Eley PaediatricInfectiousDiseasesUnit,RedCrossChildren’sHospitalandUniversityofCapeTown,Rondebosch7700,SouthAfrica CorrespondenceshouldbeaddressedtoJamesJ.C.Nuttall,james.nuttall@uct.ac.za Received29November2010;Revised2February2011;Accepted17February2011 AcademicEditor:A.S.Apt Copyright?2011J.J.C.NuttallandB.S.Eley.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. DespitetheuseofBacillusCalmette-Gu′erin(BCG)vaccinationformanyyears,infantsandyoungchildrenexposedtoadultswith infectiousformsoftuberculosis(TB)areathighriskofdevelopingcomplicatedTBdisease.ThisriskismuchhigheramongHIV- infectedchildren,anddataonBCGprotectivee?cacyinHIV-infectedchildrenislacking.RecentresearchonBCGsafetyinHIV- infectedinfantshasresultedinpolicyshifts,butimplementationischallenging.NewapproachestopreventingTBamonginfants andchildren,particularlyHIV-infectedinfants,areneeded.Thispaperbrie?yreviewsBCGsafetyande?cacyconsiderationsin HIV-infectedinfantsanddiscussesotherapproachestopreventingTB,includingnewTBvaccinesandvaccinationstrategies. 1.Introduction individualsthatisattributabletovaccination.E?cacyrepre- sentsacompositeoutcomeofthreeevents:(1)thepropor- tionofvaccine“take”,(2)thedegreeofvaccineprotection, and(3)thedurationofprotectiveimmunity[3]. Research on BCG e?cacy has been hampered by the failuretoidentifyareliableclinicalorimmunologicalparam- eterthatindicatesprotectionagainstthedevelopmentofTB diseasefollowingBCGvaccination.Neitherthepresenceof aBCGscarnortuberculinskintestreactivitycorrelateswith protectionagainstTB[4]. InanattempttobetterunderstandBCG-inducedimmu- nity, investigators have described the nature of immune responses following BCG vacci