Resumo

SICILIANO, Luigina et al. Enfermedad inducida por vacuna bcg en pacientes con infección vertical por el virus de inmunodeficiencia humana. Arch Venez Puer Ped [online]. 2011, vol.74, n.4, pp.138-143. ISSN 0004-0649.

Background. Although the BCG vaccine can reduce the severity of tuberculosis, its application in patients with HIV infection involves a potential risk of disease due to Mycobacterium bovis. Objective. To determine BCG vaccine-induced complications in patients with vertical HIV infection. Method. A clinical cross-sectional study was performed. Patients with perinatal-acquired HIV infection attended at Hospital de Niños "J. M. De los Ríos "(Caracas - Venezuela), between 1999-2010 and who were vaccinated with BCG were included. Recorded data included: presence of vaccine complications and age at that time, age at time of HIV diagnosis, immune status, treatment and outcome. Statistical analysis was done using descriptive tests. Results. 96 patients were included, of whom 16.7% (n=16) had complications: 14.6% (14/96) with local or regional findings, specifically 100% (14/14) adenitis, 28.6% abscess or fistula and 7.1% ulcer; 2.1 (2/96) had distant or diseminated disease. Average age at time of complication was 0.7 ± 0.4 years. At that time 81.3% (14/16) had immunosuppresion. HIV diagnosis was made because of the complication in 7.3% (7/96) With highly active antiretroviral therapy and medical or surgical therapy for the complication, 87.5% (14/16) of patients had satisfactory outcome. The vaccine-associated mortality was 1.1% (1/96) and occurred in a patient with disseminated disease and severe immunosuppression. Conclusions. Complications occurred in 16.7% of recipients: disease was local or regional in 14.6%, mainly axillary adenitis and distant disease or disseminated in 2.1%. Appropriate medical treatment for the virus and Mycobacterium bovis and in some cases, surgical resection resulted in satisfactory outcome in 87.5% (14/16) of patients. Mortality due to disseminated disease occurred in 1.1%.

Palavras-chave : BCG vaccine; complications; vertical HIV infection; antiretroviral therapy.