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Effect of high-dose vitamin A supplementation on the immune response to Bacille Calmette-Guerin vaccines

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Author

  • Birgitte R. Diness
  • Ane B. Fisker
  • Adam Roth
  • Maria Yazdanbakhsh
  • Erliyani Sartono
  • Hilton Whittle
  • Jose E. Nante
  • Ida M. Lisse
  • Henrik Ravn
  • Amabelia Rodrigues
  • Peter Aaby
  • Christine S. Benn
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Summary, in English

Background: Vitamin A supplementation (VAS) at birth has been associated with decreased mortality in Asia. Bacille Calmette-Guerin (BCG) vaccine is given at birth in tuberculosis-endemic countries. Previous studies suggest that VAS may influence the immune response to vaccines. Objective: Our objective was to examine whether VAS influences the immune response to simultaneously administered BCG vaccine. Design: Within a randomized trial of 50 000 IU vitamin A or placebo Given with BCG vaccine at birth in Guinea-Bissau, 27 10 infants were examined for BCG scar formation and delayed-type hypersensitivity (DTH) to purified protein derivative of Mycobacterium tuberculosis (PPD) at 2 and 6 mo of age. The ex vivo cytokine response to PPD was measured in 607 infants. Results: At 2 mo of age, 39% (43% of the boys and 34% of the girls) responded to PPD. The prevalence ratio of a measurable PPD reaction for VAS compared with placebo recipients was 0.90 (95% CI: 0.80, 1.02) for all infants. 0.81 (95% CI: 0.69, 0.95) for boys, and 1.04 (95% CI: 0.86, 1.26) for girls. At 6 mo of age, 42% of the infants responded to PPD. No difference was observed between VAS and placebo recipients. The prevalence of BCG scar was not affected by VAS. The ex vivo interferon-gamma response to PPD was increased by VAS (means ratio: 1.40: 95% CI: 1.03, 1.91). Conclusions: VAS with BCG vaccination does not appear to interfere with the long-term immune response to BCG. However, VAS temporarily altered the DTH reaction to PPD in boys at 2 mo of age, suggesting sex differences in the immunologic response to VAS Given with BCG. This trial was registered at www.clinicaltrials.gov as #NCT00168597.

Publishing year

2007

Language

English

Pages

1152-1159

Publication/Series

American Journal of Clinical Nutrition

Volume

86

Issue

4

Document type

Journal article

Publisher

Oxford University Press

Topic

  • Nutrition and Dietetics

Keywords

  • BCG vaccination
  • Bacille Calmette-Guerin
  • vitamin A
  • purified protein derivative of Mycobacterium tuberculosis response
  • PPD response
  • sex-differential effects
  • randomized trial

Status

Published

Research group

  • Clinical Microbiology, Malmö

ISBN/ISSN/Other

  • ISSN: 1938-3207