Selection of skin test antigens to evaluate PPD anergy.

Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.

Selection of skin test antigens to evaluate PPD anergy.

J Fam Pract. 1995 Jul;41(1):59-64. Unique Identifier : AIDSLINE MED/95318692
Wright PW; Crutcher JE; Holiday DB; Department of Family Practice, University of Texas Health Center; at Tyler 75710, USA.

Abstract: BACKGROUND. A purified protein derivative (PPD) tuberculin skin test may be nonreactive because of cutaneous anergy, technical problems with the test, or absence of tuberculosis infection. This study investigated the sensitivity and specificity of five test agents in measuring cutaneous anergy when the PPD test is nonreactive. Agents evaluated include antigens for Candida, mumps, histoplasmin, tetanus, and Trichophyton. METHODS. Delayed-type hypersensitivity skin test records were analyzed in 1113 patients admitted to the University of Texas Health Center at Tyler from December 1988 through June 1993. These patients were admitted with initial diagnoses of diseases other than active tuberculosis or human immunodeficiency virus infection. RESULTS. Patients with a negative PPD test reacted most often to the control skin test Candida (63.5%), followed by mumps (52.2%), histoplasmosis (37.2%), tetanus (35.7%), and Trichophyton (6.1%). Analysis of these data indicates that the use of more than three of the four most commonly reactive control tests (Candida, mumps, and histoplasmin or tetanus) yielded minimal additional precision in the determination of skin test anergy compared with using all five control skin tests. This finding remained constant whether the PPD was considered negative at < 5 mm, < 10 mm, or < 15 mm of induration. CONCLUSIONS. In controlling for false-negative PPD tests, the use of three skin test antigens, Candida, mumps, and tetanus, should provide reliable control for delayed-type hypersensitivity anergy.

Keywords: Animal Antigens/*IMMUNOLOGY Candida/IMMUNOLOGY *Clonal Anergy Evaluation Studies False Negative Reactions Hamsters Human Hypersensitivity, Delayed/IMMUNOLOGY HIV Infections/IMMUNOLOGY Mumps Virus/IMMUNOLOGY Sensitivity and Specificity Skin Tests Tetanus Toxoid/IMMUNOLOGY Tuberculin/*IMMUNOLOGY *Tuberculin Test Tuberculosis, Pulmonary/*DIAGNOSIS/IMMUNOLOGY JOURNAL ARTICLE
951030
M95A0703

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, Gill Foundation, the National Library of Medicine, Quest Diagnostics, Roche and Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 1995. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1995. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .