Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru.
Am J Trop Med Hyg. 2010 Aug;83(2):319-25. doi: 10.4269/ajtmh.2010.10-0073.
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.
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。