To the Editor.—
The recent article1 on the use of BCG vaccine in the control of tuberculosis is an important, authoritative statement that places in perspective the weaknesses in BCG protection and outlines its proper role in the prevention and control of tuberculosis, at least in the developed world.Especially welcome are the discontinuation of recommendations for giving BCG to health care workers and the (implied) recommendation that all high-risk reactors by American Thoracic Society/Centers for Disease Control criteria,2 especially health care workers, receive preventive therapy whether or not they have a history of BCG vaccination!I am, however, concerned about the role of BCG in individuals at high risk of human immunodeficiency virus (HIV) infection, especially in areas with a high prevalence of HIV and frequent use of BCG. While stating that BCG should not be given to persons whose immunologic responses are impaired and while admitting
Reichman LB. Why Hasn't BCG Proved Dangerous in HIV-Infected Patients? JAMA. 1989;261(22):3246. doi:10.1001/jama.1989.03420220060025
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