Portal de Periódicos da CAPES

Effect of high-dose vitamin A supplementation on the immune response to Bacille Calmette-Guérin vaccine

2007; Elsevier BV; Volume: 86; Issue: 4 Linguagem: Inglês

10.1093/ajcn/86.4.1152

1938-3207

Birgitte Rode Diness, Ane Bærent Fisker, Adam Roth, Maria Yazdanbakhsh, Erliyani Sartono, Hilton Whittle, Jose Ernesto Nante, Ida Maria Lisse, Henrik Ravn, Amabélia Rodrigues, Peter Aaby, Christine Stabell Benn,

Tuberculosis Research and Epidemiology

Background: Vitamin A supplementation (VAS) at birth has been associated with decreased mortality in Asia. Bacille Calmette-Guérin (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, 2710 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-γ 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.