Tuberculin Skin Test Reactivity among Adults Infected with Human Immunodeficiency Virus

Johnson, Michael P.; Coberly, Jacqueline S.; Clermont, H C; Chaisson, Richard E.; Davis, Homer; Losikoff, Phyllis; Ruff, Andrea; Boulos, Reginald; Halsey, Neal A.

doi:10.1093/infdis/166.1.194

Cited by 57 publications

(22 citation statements)

References 6 publications

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“…Despite the effect of HIV on TST conversion, reactivity, and anergy (7,18), the observed reactivity among HIV-positive persons (40.5%) was still lower than those in the United States (52.3%), Haiti (65%), and Uganda (73.8%) (17,18,24). This could partially be explained by the presence of lower absolute CD4 ϩ T-cell counts in Ethiopians (33).…”

Section: Discussionmentioning

confidence: 99%

Tuberculin Skin Test Conversion and Reactivity Rates among Adults with and without Human Immunodeficiency Virus in Urban Settings in Ethiopia

Tegbaru

Wolday

Messele

et al. 2006

Clin Vaccine Immunol

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To investigate whether low CD4؉ T-cell counts in healthy and human immunodeficiency virus (HIV)-infected Ethiopians influence tuberculosis (TB) immunological memory, tuberculin skin test (TST) conversion and reactivity rates were investigated among adults with and without HIV infection in urban settings in Ethiopia. Reaction to the TST was analyzed with purified protein derivative by the Mantoux technique. A total of 1,286 individuals with TST results of >5-mm (n ‫؍‬ 851) and <4-mm (n ‫؍‬ 435) induration diameters were included. Individuals with <4-mm induration sizes were followed up for 21.4 ؎ 9.5 months (mean ؎ standard deviation) to observe skin test conversion. The overall TST reactivity (>5-mm induration diameter) was 66.2% (n ‫؍‬ 851). Reactivity was significantly lower among HIV-positive persons (40.5%) than among HIV-negative persons (68.7%) (P < 0.001). Of the above persons, 32 incident TB patients were checked for their TST status 13.05 ؎ 11.1 months before diagnosis and reactivity was found among 22 (68.7%) of them. Of the TST-negative persons with 0-to 4-mm indurations who were followed up for 3 years, the conversion rate to positivity was 17.9/100 person-years of observation (PYO) (14.4/100 PYO and 18.3/100 PYO in HIV-positive and -negative persons, respectively). Despite lower absolute CD4 ؉ T-cell numbers in Ethiopians, higher TST conversion and reactivity rates show the presence of a higher rate of latent TB infection and/or transmission. The lower TST positivity rate before a diagnosis of TB disease showed the lower sensitivity of the test. This indicates the need for other sensitive and specific diagnostic and screening methods to detect TB infection, particularly among HIV-positive persons, so that they can be given prophylactic isoniazid therapy.

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Section: Discussionmentioning

confidence: 99%

Tuberculin Skin Test Conversion and Reactivity Rates among Adults with and without Human Immunodeficiency Virus in Urban Settings in Ethiopia

Tegbaru

Wolday

Messele

et al. 2006

Clin Vaccine Immunol

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“…Myer et al [19] reported a reduction in the DTH reaction in sheep infected with MVV, which, however, was not confirmed in a second series of experiments [16]. The finding of a reduction is analagous to the reduction of DTH skin reactions in the later stages of HIV infection [20][21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Immunohistological study of the depressed cutaneous DTH response in sheep naturally infected with an ovine lentivirus (Maedi-Visna virus)

Pyrah

Watt

1996

Clinical and Experimental Immunology

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SUMMARYThe gross and immunohistological characteristics of the purified protein derivative (PPD)-induced cutaneous DTH reaction were studied in a group of sheep naturally infected with Maedi-Visna virus (MVV), and compared with reactions obtained in a matched control group. There was a marked, but variable, depression in the DTH lesion in the MVV group associated with a decreased density of polymorphonuclear neutrophils (PMN) and CD4 cells in the early reaction. There were no significant differences in the densities of CD8 ,°/± T cells, macrophages, B cells and MHC class II-expressing cells. This work indicates that there is a significant alteration in the initial trafficking of PMN and CD4 cells into a DTH response area in sheep infected with MVV.

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“…Interestingly, when the serum test was used to identify individuals with M. tuberculosis infection in a group of HIV-infected persons as a model of deficient cellmediated immunity [17], the western blot showed a significant degree of concordance with the PPD skin test scored using 5 mm induration as the threshold, suggesting that this test may attain the same sensitivity as the skin test when it is used in its most sensitive mode.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a western blot serum test for the diagnosis of Mycobacterium tuberculosis infection

Rovatti¹,

Corradi²,

Amicosante³

et al. 1996

Eur Respir J

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E Ev va al lu ua at ti io on n o of f a a w we es st te er rn n b bl lo ot t s se er ru um m t te es st t f fo or r t th he e d di ia ag g--The discriminant score identified 57 out of 57 (100%) PPD-positives and none (0%) of the 47 PPD-negatives. In the BCG vaccinated subjects, 1.4% tested positive before vaccination and 90% after vaccination. In the HIV-positive subjects, 90% of the PPD-positive and 5% of the PPD-negative subjects had a positive score.This study suggests that the western blot discriminant score is an accurate test to survey M. tuberculosis infection in serum samples.

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Tuberculin Skin Test Reactivity among Adults Infected with Human Immunodeficiency Virus

Cited by 57 publications

References 6 publications

Tuberculin Skin Test Conversion and Reactivity Rates among Adults with and without Human Immunodeficiency Virus in Urban Settings in Ethiopia

Tuberculin Skin Test Conversion and Reactivity Rates among Adults with and without Human Immunodeficiency Virus in Urban Settings in Ethiopia

Immunohistological study of the depressed cutaneous DTH response in sheep naturally infected with an ovine lentivirus (Maedi-Visna virus)

Evaluation of a western blot serum test for the diagnosis of Mycobacterium tuberculosis infection

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