The effects of BCG immunization and human immunodeficiency virus infection on dual skin test reactions to purified protein derivative and Mycobacterium avium sensitin among adults in Zambia.

Abstract

SETTING:

University hospital in Lusaka, Zambia.

OBJECTIVE:

To determine the effects of childhood bacille Calmette-Guerin (BCG) immunization and human immunodeficiency virus (HIV) infection on dual skin test reactions to purified protein derivative (PPD) and Mycobacterium avium sensitin (MAS) in a developing country.

DESIGN:

Descriptive cross-sectional study.

RESULTS:

Dual skin testing was performed on 112 adults, 58 HIV-positive and 54 HIV-negative. Forty-seven (42%) of 112 had PPD reactions > or =10 mm and 52 (46%) had MAS reactions > or =10 mm. PPD reactions > or =10 mm were present in 30 (63%) of 48 BCG-positive subjects compared to 17 (27%) of 64 BCG-negative subjects (P<0.001). Nineteen (33%) of 58 PPD or MAS skin test positive subjects were PPD dominant, 15 (26%) were MAS dominant, and 24 (41%) were non-dominant. MAS dominant and non-dominant reactions were significantly reduced in HIV-positive subjects, and non-dominant reactions were increased in BCG-positive subjects.

CONCLUSIONS:

Childhood BCG immunization is associated with PPD reactions > or =10 mm among adults. Reduced PPD reaction rates in HIV-positive adults appear to be due to a loss of BCG-induced PPD reactivity. Prior infection with M. avium complex is detectable in a significant proportion of adults in a developing country.

• Authors: R D Waddell, C F von Reyn, K S Baboo, A Mwinga, C Chintu, A Zumla
• Journal: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease (Int J Tuberc Lung Dis) Vol. 3 Issue 3 Pg. 255-60 (Mar 1999) ISSN: 1027-3719 [Print] France
• PMID: 10094328 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens
• Antigens, Bacterial
• BCG Vaccine
• sensitin

Topics

• Adult
• Antigens
• Antigens, Bacterial
• BCG Vaccine
• Cross-Sectional Studies
• Female
• HIV Infections (complications)
• Humans
• Immunocompromised Host
• Male
• Tuberculin Test
• Tuberculosis (complications, diagnosis)
• Zambia