Vaccinia scars associated with improved survival among adults in rural Guinea-Bissau.
Mette Lundsby Jensen, Sangeeta Dave, Maarten Schim van der Loeff, Carlos da Costa, Tim Vincent, Aleksandra Leligdowicz, Christine Stabell Benn, Adam Roth, Henrik Ravn, Ida Maria Lisse, Hilton Whittle, Peter Aaby
Author Information
Mette Lundsby Jensen: Projecto de Saúde de Bandim, Statens Serum Institut, Bissau, Guinea-Bissau.
BACKGROUND: In urban Guinea-Bissau, adults with a vaccinia scar had better survival but also a higher prevalence of HIV-2 infection. We therefore investigated the association between vaccinia scar and survival and HIV infection in a rural area of Guinea-Bissau. METHODOLOGY/PRINCIPAL FINDINGS: In connection with a study of HIV in rural Guinea-Bissau, we assessed vaccinia and BCG scars in 193 HIV-1 or HIV-2 infected and 174 uninfected participants. Mortality was assessed after 2(1/2)-3 years of follow-up. The analyses were adjusted for age, sex, village, and HIV status. The prevalence of vaccinia scar was associated with age, village, and HIV-2 status but not with sex and schooling. Compared with individuals without any scar, individuals with a vaccinia scar had better survival (mortality rate ratio (MR) = 0.22 (95% CI 0.08-0.61)), the MR being 0.19 (95% CI 0.06-0.57) for women and 0.40 (95% CI 0.04-3.74) for men. Estimates were similar for HIV-2 infected and HIV-1 and HIV-2 uninfected individuals. The HIV-2 prevalence was higher among individuals with a vaccinia scar compared to individuals without a vaccinia scar (RR = 1.57 (95% CI 1.02-2.36)). CONCLUSION: The present study supports the hypothesis that vaccinia vaccination may have a non-specific beneficial effect on adult survival.
References
AIDS Res Hum Retroviruses. 2002 Nov 1;18(16):1167-73
[PMID: 12487822]
