Vaccinia scars associated with improved survival among adults in rural Guinea-Bissau

PLoS One. 2006 Dec 20;1(1):e101. doi: 10.1371/journal.pone.0000101.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • BCG Vaccine / administration & dosage
  • BCG Vaccine / immunology
  • Cicatrix / etiology
  • Cohort Studies
  • Female
  • Guinea-Bissau / epidemiology
  • HIV Infections / immunology*
  • HIV Infections / mortality*
  • HIV Infections / virology
  • HIV-1
  • HIV-2
  • Humans
  • Male
  • Middle Aged
  • Smallpox Vaccine / administration & dosage*
  • Smallpox Vaccine / immunology*


  • BCG Vaccine
  • Smallpox Vaccine