Mark Cotton, a paediatrician and HIV researcher from Stellenbosch University, has pointed out that research published in The Forum for Collaborative HIV Research has shown a 75% mortality rate in children with BCG disease and that 70% of these children were infected with HIV.
The BCG vaccine is usually given at birth but as it uses a live bacteria, in those with weakened immune systems it can itself cause disease. According to Dr. Cotton an estimated 400 per 100,000 HIV-infected infants in the Western Cape of South Africa had become sick from the BCG vaccine. Infants are not tested for HIV until they are about six weeks, but the vaccine is given at birth, so those who are infected with HIV are inadvertently given the live vaccine. On top of this, there is a delay in providing antiretroviral medication.
Cotton says it may be possible to simply vaccinate children with BCG after it is known whether they are HIV-infected but he says such changes interfere with programmes and complicate the issue still further.
The best solution, according to Cotton, would be earlier diagnosis and treatment of HIV so that children infected with HIV can be given isoniazid, to prevent TB infection.
