Waddell R D, von Reyn C F, Baboo K S, Mwinga A, Chintu C, Zumla A
Infectious Disease Section, Dartmouth-Hitchcock Medical Center and Dartmouth Medical School, Lebanon, New Hamshire 03756, USA.
Int J Tuberc Lung Dis. 1999 Mar;3(3):255-60.
University hospital in Lusaka, Zambia.
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.
Descriptive cross-sectional study.
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.
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.
赞比亚卢萨卡的大学医院。
确定在一个发展中国家，儿童期卡介苗（BCG）免疫接种和人类免疫缺陷病毒（HIV）感染对纯化蛋白衍生物（PPD）和鸟分枝杆菌敏感素（MAS）双重皮肤试验反应的影响。
描述性横断面研究。
对112名成年人进行了双重皮肤试验，其中58名HIV阳性，54名HIV阴性。112名受试者中有47名（42%）PPD反应≥10 mm，52名（46%）MAS反应≥10 mm。48名卡介苗阳性受试者中有30名（63%）PPD反应≥10 mm，而64名卡介苗阴性受试者中有17名（27%）（P<0.001）。58名PPD或MAS皮肤试验阳性受试者中，19名（33%）以PPD为主，15名（26%）以MAS为主，24名（41%）为非优势型。HIV阳性受试者中MAS优势型和非优势型反应显著降低，卡介苗阳性受试者中非优势型反应增加。
儿童期卡介苗免疫接种与成年人PPD反应≥10 mm有关。HIV阳性成年人PPD反应率降低似乎是由于卡介苗诱导的PPD反应性丧失。在一个发展中国家，相当比例的成年人可检测到既往鸟分枝杆菌复合群感染。
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