Surgical complications of bacille Calmette-Guérin (BCG) infection in HIV-infected children: Time for a change in policy?
| dc.contributor.author | Karpelowsky, J S | |
| dc.contributor.author | Alexander, A G | |
| dc.contributor.author | Dix Peek, S | |
| dc.contributor.author | Millar, A J W | |
| dc.contributor.author | Rode, H | |
| dc.date.accessioned | 2016-04-25T10:51:21Z | |
| dc.date.available | 2016-04-25T10:51:21Z | |
| dc.date.issued | 2008 | |
| dc.date.updated | 2016-01-13T07:10:11Z | |
| dc.description.abstract | AIM: Bacille Calmette-Guérin (BCG) immunisation is well established as part of the South African national expanded programme for immunisation (EPI). The World Health Organization (WHO) currently recommends that BCG be given to all asymptomatic infants irrespective of HIV exposure at birth but does not recommend BCG vaccination for children with symptomatic HIV infection. This approach, however, has led to HIV-infected neonates who are asymptomatic at birth, developing severe vaccine-related complications. We present a surgical case series, representative of a minority of the cases in circulation, in support of a change to the timing of BCG administration to HIV-exposed neonates. METHODS: A case series of 17 HIV-infected patients with surgical complications of BCG vaccination. RESULTS: Seventeen patients are presented. The first two illustrate disseminated systemic BCG infection, resulting in BCG infection of the lymph nodes, liver, spleen and tibia, and the second with gastrointestinal involvement causing bowel obstruction. The other 15 patients represent a series of severe ulcerating lymphadenitis secondary to BCG. CONCLUSION: The risks of BCG in HIV-infected infants are significant. Current recommendations are not satisfactory, and a change in policy is required to prevent the harmful effects of this vaccine in a high-risk group of patients. We believe that there is sufficient need to adequately stratify patients and vaccinate them according to a protocol that takes impaired immunity into consideration. | en_ZA |
| dc.identifier.apacitation | Karpelowsky, J. S., Alexander, A. G., Dix Peek, S., Millar, A. J. W., & Rode, H. (2008). Surgical complications of bacille Calmette-Guérin (BCG) infection in HIV-infected children: Time for a change in policy?. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/19192 | en_ZA |
| dc.identifier.chicagocitation | Karpelowsky, J S, A G Alexander, S Dix Peek, A J W Millar, and H Rode "Surgical complications of bacille Calmette-Guérin (BCG) infection in HIV-infected children: Time for a change in policy?." <i>South African Medical Journal</i> (2008) http://hdl.handle.net/11427/19192 | en_ZA |
| dc.identifier.citation | Karpelowsky, J. S., Alexander, A. G., Dix Peek, S., Millar, A. J. W., & Rode, H. (2008). Surgical complications of bacille Calmette-Guérin (BCG) infection in HIV-infected children: Time for a change in policy?. SAMJ: South African Medical Journal, 98(10), 801-804. | en_ZA |
| dc.identifier.issn | 0256-9574 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Karpelowsky, J S AU - Alexander, A G AU - Dix Peek, S AU - Millar, A J W AU - Rode, H AB - AIM: Bacille Calmette-Guérin (BCG) immunisation is well established as part of the South African national expanded programme for immunisation (EPI). The World Health Organization (WHO) currently recommends that BCG be given to all asymptomatic infants irrespective of HIV exposure at birth but does not recommend BCG vaccination for children with symptomatic HIV infection. This approach, however, has led to HIV-infected neonates who are asymptomatic at birth, developing severe vaccine-related complications. We present a surgical case series, representative of a minority of the cases in circulation, in support of a change to the timing of BCG administration to HIV-exposed neonates. METHODS: A case series of 17 HIV-infected patients with surgical complications of BCG vaccination. RESULTS: Seventeen patients are presented. The first two illustrate disseminated systemic BCG infection, resulting in BCG infection of the lymph nodes, liver, spleen and tibia, and the second with gastrointestinal involvement causing bowel obstruction. The other 15 patients represent a series of severe ulcerating lymphadenitis secondary to BCG. CONCLUSION: The risks of BCG in HIV-infected infants are significant. Current recommendations are not satisfactory, and a change in policy is required to prevent the harmful effects of this vaccine in a high-risk group of patients. We believe that there is sufficient need to adequately stratify patients and vaccinate them according to a protocol that takes impaired immunity into consideration. DA - 2008 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2008 SM - 0256-9574 T1 - Surgical complications of bacille Calmette-Guérin (BCG) infection in HIV-infected children: Time for a change in policy? TI - Surgical complications of bacille Calmette-Guérin (BCG) infection in HIV-infected children: Time for a change in policy? UR - http://hdl.handle.net/11427/19192 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/19192 | |
| dc.identifier.vancouvercitation | Karpelowsky JS, Alexander AG, Dix Peek S, Millar AJW, Rode H. Surgical complications of bacille Calmette-Guérin (BCG) infection in HIV-infected children: Time for a change in policy?. South African Medical Journal. 2008; http://hdl.handle.net/11427/19192. | en_ZA |
| dc.language | eng | en_ZA |
| dc.publisher | Health and Medical Publishing Group | en_ZA |
| dc.publisher.department | Division of Paediatric Surgery | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights | Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) | * |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | en_ZA |
| dc.source | South African Medical Journal | en_ZA |
| dc.source.uri | http://www.samj.org.za/index.php/samj | |
| dc.title | Surgical complications of bacille Calmette-Guérin (BCG) infection in HIV-infected children: Time for a change in policy? | en_ZA |
| dc.type | Journal Article | en_ZA |
| uct.type.filetype | Text | |
| uct.type.filetype | Image | |
| uct.type.publication | Research | en_ZA |
| uct.type.resource | Article | en_ZA |