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结核菌素皮肤试验反应不受高度流行的肠道蠕虫感染和合并感染严重程度的影响。

Tuberculin skin-test reactions are unaffected by the severity of hyperendemic intestinal helminth infections and co-infections.

机构信息

Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru.

出版信息

Am J Trop Med Hyg. 2010 Aug;83(2):319-25. doi: 10.4269/ajtmh.2010.10-0073.

Abstract

The tuberculin skin test (TST) quantifies cell-mediated immunity to tuberculosis antigens. Helminths suppress cell-mediated immunity, so we studied the effect of helminth infection and deworming on the TST in a randomized, double-blind, placebo-controlled study in an indigenous Amazon community (N = 195). Stool microscopy diagnosed helminths in 98% and co-infection with multiple species in 24% of study subjects. The TST was positive (> or = 10 mm) for 49%, and responses increased with age (P < 0.001), Bacille Calmette Guerin (BCG) vaccination (P = 0.01), and tuberculosis contact (P = 0.05). TST results had no association with helminth-egg concentrations, species, or co-infections (all P > 0.1). One month after deworming with albendazole (three daily 400-mg doses), helminths were reduced, but 63% remained infected with helminths. Albendazole did not cause a change in TST size (P = 0.8) or positivity (P = 0.9) relative to placebo. Thus, TST reactions were unaffected by albendazole therapy that partially cured intestinal helminth infections, and TST interpretation was unaffected by high-burden helminth infections and co-infection with multiple helminth species.

摘要

结核菌素皮肤试验(TST)定量检测针对结核抗原的细胞介导免疫。蠕虫会抑制细胞介导免疫,因此我们在一个随机、双盲、安慰剂对照的研究中,在一个土着亚马逊社区(N=195)中研究了蠕虫感染和驱虫对 TST 的影响。粪便显微镜检查在 98%的研究对象中诊断出蠕虫,在 24%的研究对象中检测到多种物种的混合感染。TST 阳性(>或=10mm)的比例为 49%,且反应随年龄增加(P<0.001)、卡介苗(BCG)接种(P=0.01)和结核接触(P=0.05)而增加。TST 结果与蠕虫卵浓度、种类或混合感染均无关联(均 P>0.1)。用阿苯达唑(每日 3 次,每次 400mg)驱虫 1 个月后,蠕虫减少,但仍有 63%的人感染蠕虫。与安慰剂相比,阿苯达唑治疗并未导致 TST 大小(P=0.8)或阳性率(P=0.9)发生变化。因此,TST 反应不受部分治愈肠道蠕虫感染的阿苯达唑治疗的影响,TST 解释也不受高负担的蠕虫感染和多种蠕虫混合感染的影响。

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