Self-assessment questions: Global progress in tuberculosis vaccine development
The incidence of tuberculosis (TB) disease:
Is consistently falling in all regions of the world
Is higher in regions where human immunodeficiency virus (HIV) is endemic
Is a key indicator of progress towards control and elimination of tuberculosis, according to the World Health Organization (WHO)'s Global plan to stop TB
Is accurately measured using current diagnostic tools
Would be reduced by an effective preventative vaccine
A new vaccine strategy against TB is likely to include the Bacillus Calmette-Guérin (BCG) vaccine because:
It is known to prevent multidrug-resistant TB
The mechanisms of the protective immune response induced by the BCG vaccine are fully understood
It is safe in HIV-infected individuals
It protects children against TB
Giving a second dose of the BCG vaccine is known to improve efficacy
All candidate TB vaccines in current clinical development:
Are live vaccines
Contain antigens present in M tuberculosis
Utilise recombinant gene technology
Have been tested in animals
Are primarily targeting the humoral arm of the immune system
With regard to human immune responses in TB:
Interferon gamma is necessary for an intact immune response
CD4-positive T cells are not important in immunity
Tumour necrosis factor plays a role in containment of latent TB infection
mVA85A strongly boosts the immune response induced by the BCG vaccine
Large-scale clinical trials of MVA85A and other new TB vaccines may allow the identification of immune correlates of protection
Answers to these self-assessment questions can be found on page s92.
- © 2012 Royal College of Physicians
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