Switch to
| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
6
|
| pubmed:dateCreated |
1999-1-25
|
| pubmed:abstractText |
Anergy testing has been used as an adjunct to tuberculin testing for assessing M. tuberculosis (MTB) infection and indications for isoniazid preventive therapy in HIV-infected persons. We examined factors associated with the stability of skin test responses to purified protein derivative (PPD) and candida antigens in a cohort of HIV-infected adults followed prospectively in a tuberculosis preventive therapy trial in Uganda. PPD-positive and anergic subjects in the placebo arms of the preventive therapy study underwent repeat skin testing and immunologic testing including measurement of MTB culture filtrate (CF)-stimulated interferon gamma (IFN-gamma) and tumor necrosis factor alpha (TNF-alpha) levels in whole-blood culture supernatants. Anergy was present in 27% of 4,058 HIV-infected subjects screened for the tuberculosis preventive therapy trial compared with 10% of 682 HIV-non-infected persons. On follow-up testing of enrolled subjects, 42% of 139 initially anergic subjects were no longer anergic; two thirds of these had PPD reactions >= 5 mm. Stability of anergy was associated with intercurrent opportunistic infections and AIDS-associated dermatitis at baseline. Thirty-five percent of 313 subjects with an initial positive PPD had a negative PPD test at follow-up, 26% of whom had a positive candida skin test at the same time as the negative PPD test. Baseline MTBCF-stimulated IFN-gamma levels were significantly higher among PPD-positive subjects who remained PPD-positive than in those who were falsely negative. We conclude first that anergy is unstable and second that anergy testing is unreliable in identifying HIV-infected adults who are not infected with MTB and should not be used routinely for this purpose in assessing indications for isoniazid preventive therapy.
|
| pubmed:grant | |
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
AIM
|
| pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/Antigens, Fungal,
http://linkedlifedata.com/resource/pubmed/chemical/Antitubercular Agents,
http://linkedlifedata.com/resource/pubmed/chemical/Interferon-gamma,
http://linkedlifedata.com/resource/pubmed/chemical/Isoniazid,
http://linkedlifedata.com/resource/pubmed/chemical/Placebos,
http://linkedlifedata.com/resource/pubmed/chemical/Tuberculin,
http://linkedlifedata.com/resource/pubmed/chemical/Tumor Necrosis Factor-alpha
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Dec
|
| pubmed:issn |
1073-449X
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
158
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
1790-6
|
| pubmed:dateRevised |
2008-11-21
|
| pubmed:meshHeading |
pubmed-meshheading:9847269-AIDS-Related Opportunistic Infections,
pubmed-meshheading:9847269-Adolescent,
pubmed-meshheading:9847269-Adult,
pubmed-meshheading:9847269-Antigens, Fungal,
pubmed-meshheading:9847269-Antitubercular Agents,
pubmed-meshheading:9847269-Candida,
pubmed-meshheading:9847269-Cohort Studies,
pubmed-meshheading:9847269-False Negative Reactions,
pubmed-meshheading:9847269-Female,
pubmed-meshheading:9847269-Follow-Up Studies,
pubmed-meshheading:9847269-HIV Infections,
pubmed-meshheading:9847269-Humans,
pubmed-meshheading:9847269-Interferon-gamma,
pubmed-meshheading:9847269-Isoniazid,
pubmed-meshheading:9847269-Male,
pubmed-meshheading:9847269-Middle Aged,
pubmed-meshheading:9847269-Mycobacterium tuberculosis,
pubmed-meshheading:9847269-Placebos,
pubmed-meshheading:9847269-Prospective Studies,
pubmed-meshheading:9847269-Reproducibility of Results,
pubmed-meshheading:9847269-Skin Tests,
pubmed-meshheading:9847269-Tuberculin,
pubmed-meshheading:9847269-Tuberculin Test,
pubmed-meshheading:9847269-Tuberculosis, Pulmonary,
pubmed-meshheading:9847269-Tumor Necrosis Factor-alpha,
pubmed-meshheading:9847269-Uganda
|
| pubmed:year |
1998
|
| pubmed:articleTitle |
Instability of tuberculin and Candida skin test reactivity in HIV-infected Ugandans. The Uganda-Case Western Reserve University Research Collaboration.
|
| pubmed:affiliation |
Department of Medicine, Division of Infectious Diseases, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Cleveland, Ohio, USA. jlj@po.cwru.edu
|
| pubmed:publicationType |
Journal Article,
Clinical Trial,
Comparative Study,
Research Support, U.S. Gov't, P.H.S.,
Research Support, U.S. Gov't, Non-P.H.S.,
Randomized Controlled Trial,
Research Support, Non-U.S. Gov't
|