Individual-level factors associated with variation in mycobacterial-specific immune response: Gender and previous BCG vaccination status.


Rhodes, SJ; Knight, GM; Fielding, K; Scriba, TJ; Pathan, AA; McShane, H; Fletcher, H; White, RG; (2015) Individual-level factors associated with variation in mycobacterial-specific immune response: Gender and previous BCG vaccination status. Tuberculosis (Edinburgh, Scotland), 96. pp. 37-43. ISSN 1472-9792 DOI: 10.1016/j.tube.2015.10.002

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Abstract

A more effective tuberculosis (TB) vaccine is needed to eliminate TB disease. Many new vaccine candidates enhance the immunogenicity of the existing vaccine, Bacillus Calmette-Guérin (BCG). Understanding BCG induced immune variation is key to developing a new vaccine. We aimed to establish if individual-level covariates were associated with cell-mediated immune response (interferon gamma (IFN-γ)) at vaccine trial enrolment (baseline) in a long-term retrospective analysis (LTR) and after BCG vaccination in a short-term prospective analysis (STP). Four covariates were analysed: gender, country, BCG vaccination history and monocyte/lymphocyte cell count ratio. Univariable and multivariable linear regression were conducted on IFN-γ response at baseline for LTR, and area under the curve (AUC), 24 week and peak IFN-γ response for STP. Previous BCG vaccination was strongly associated with higher IFN-γ response at baseline (LTR analysis) (p-values < 0.05). Being male showed a weak association with higher baseline response (p-value = 0.1). BCG revaccination was strongly associated with a larger response increase than primary-vaccination (AUC & peak p-values < 0.01), but did not differ at 24 weeks (STP analysis). All other covariates were non-significant (p-values > 0.1). This analysis suggests that previous BCG vaccination and gender are associated with durable IFN-γ responses. Vaccine trials may need to stratify by BCG vaccination history and gender.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Research Centre: Vaccine Centre
Tropical Epidemiology Group
TB Centre
PubMed ID: 26786653
Web of Science ID: 368138500006
URI: http://researchonline.lshtm.ac.uk/id/eprint/2534081

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