ArticleOpen forum infectious diseases2017
The Effect of Smallpox and Bacillus Calmette-Guérin Vaccination on the Risk of Human Immunodeficiency Virus-1 Infection in Guinea-Bissau and Denmark.
Article in Open forum infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Immune mechanisms mediating the heterologous effects of BCG vaccination: a systematic review.Frontiers in immunology · 2025Pooled it
- Review
- A Risk Management Approach to Global Pandemics of Infectious Disease and Anti-Microbial Resistance.Tropical medicine and infectious disease · 2024Review
- The mark of success: The role of vaccine-induced skin scar formation for BCG and smallpox vaccine-associated clinical benefits.Seminars in immunopathology · 2024Review
- Exploring HIV Vaccine Progress in the Pre-Clinical and Clinical Setting: From History to Future Prospects.Viruses · 2024Review
- The global landscape of smallpox vaccination history and implications for current and future orthopoxvirus susceptibility: a modelling study.The Lancet. Infectious diseases · 2023Article
- Beneficial non-specific effects of live vaccines against COVID-19 and other unrelated infections.The Lancet. Infectious diseases · 2023Review
- Trained Immunity Contribution to Autoimmune and Inflammatory Disorders.Frontiers in immunology · 2022Review
- Heterologous vaccine interventions: boosting immunity against future pandemics.Molecular medicine (Cambridge, Mass.) · 2021Review
- Optimize Prime/Boost Vaccine Strategies: Trained Immunity as a New Player in the Game.Frontiers in immunology · 2021Review
- Phase-out of smallpox vaccination and the female/male HIV-1 prevalence ratio: an ecological study from Guinea-Bissau.BMJ open · 2019Article
- Heterologous Immunity: Role in Natural and Vaccine-Induced Resistance to Infections.Frontiers in immunology · 2019Review
- Long-term effects of smallpox vaccination on expression of the HIV-1 co-receptor CCR5 in women.PloS one · 2018Article
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Authors and funding
11 authors.
Funding
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Abstract
backgroundThe live smallpox and Bacillus Calmette-Guérin (BCG) vaccinations have been associated with better adult survival in both Guinea-Bissau and Denmark. In Guinea-Bissau, human immunodeficiency virus (HIV)-1 became an important cause of death after smallpox vaccination was phased out globally in 1980. We hypothesised that smallpox and BCG vaccinations were associated with a lower prevalence of HIV-1 infection, and we tested this hypothesis in both Guinea-Bissau and Denmark.
methodsWe conducted 2 studies: (1) a cross-sectional study of HIV infection and vaccination scars in Guinea-Bissau including 1751 individuals and (2) a case-base study with a background population of 46239 individuals in Denmark. In Guinea-Bissau, HIV-1 transmission was almost exclusively sexually transmitted. In Denmark, we excluded intravenous drug users. Data were analyzed using logistic regression.
resultsBacillus Calmette-Guérin and/or smallpox vaccination compared with neither of these vaccines was associated with an adjusted odds ratio (aOR) for HIV-1 of 0.62 (95% confidence interval [CI], 0.36-1.07) in Guinea-Bissau and 0.70 (95% CI, 0.43-1.15) in Denmark. We combined the results from both settings in a meta-analysis (aOR = 0.66; 95% CI, 0.46-0.96). Data from Guinea-Bissau indicated a stronger effect of multiple smallpox vaccination scars (aOR = 0.27; 95% CI, 0.10-0.75) as follows: women, aOR = 0.18 (95% CI, 0.05-0.64); men, aOR = 0.52 (95% CI, 0.12-2.33); sex-differential effect,
conclusionsThe studies from Guinea-Bissau and Denmark, 2 very different settings, both suggest that the BCG and smallpox vaccines could be associated with a decreased risk of sexually transmitted HIV-1. It might be informative to pursue this observation and explore possible protective mechanisms as part of the search for an HIV-1 vaccine.
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