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Correspondence
BCG and infection with Mycobacterium tuberculosis
  1. Richard D Turner,
  2. Conor D Tweed,
  3. Jilna Shukla,
  4. Graham H Bothamley
  1. Department of Respiratory Medicine, Homerton University Hospital, London, UK
  1. Correspondence to Dr Richard D Turner, Department of Respiratory Medicine, Homerton University Hospital, Homerton Row, London E9 6SR, UK; richard.turner{at}homerton.nhs.uk

https://doi.org/10.1136/thoraxjnl-2014-206128

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    Michelsen and colleagues1 usefully add to the evidence for the protective effect of BCG against active TB. However, we are puzzled by the conclusion that BCG also prevents Mycobacterium tuberculosis (Mtb) infection. Others have similarly used interferon gamma release assay (IGRA) responses as a surrogate for Mtb infection with similar conclusions.2 ,3

    A positive IGRA response represents a previous interaction with Mtb that was sufficient to lead to an acquired immune response. The authors demonstrate a reduced incidence of IGRA response in individuals vaccinated with BCG despite continued risk of Mtb exposure.

    The authors’ hypothesis that …

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    Footnotes

    • Contributors JS identified the original article for discussion among all authors, GHB conceived the letter, CDT advised on the content, RDT drafted it and all authors approved the final version. RDT is the guarantor of the manuscript.

    • Funding None.

    • Competing interests None.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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