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Free Content Lack of direct correlation between CD4 T-lymphocyte counts and induration sizes of the tuberculin skin test in human immunodeficiency virus type 1 seropositive patients

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Abstract:

Setting: The study was conducted in Bobo-Dioulasso, Burkina Faso, where Mycobacterium tuberculosis infection and human immunodeficiency virus type 1 (HIV-1) infection are prevalent.

Objective: To identify proportions of representative (test) populations who are reactive to the tuberculin skin test, and to study the relationship between CD4 T-lymphocyte counts and the induration size of the tuberculin skin test in these groups.

Design: A group of 435 healthy students was tuberculin skin tested in order to evaluate the intensity of skin testing in a ‘normal’ population. The study group consisted of 195 subjects with or without tuberculosis, and with or without HIV-1 infection, who received a tuberculin skin test and a CD4 T lymphocyte count on the same day.

Results: In total, 90% of the control (nontuberculous, HIV negative) subjects, 32% of the HIV-1 seropositive subjects, 76.5% of the tuberculous patients and 57% of the tuberculous HIV-1 seropositive patients were tuberculin positive. There was no direct correlation between the induration size of reactions to the tuberculin skin test and CD4 T-lymphocyte count in these study groups using linear regression analysis.

Conclusion: In vivo skin testing using tuberculin yields clinically significant information on the degree of immunodeficiency which is different from that of CD4 T-lymphocyte counts. The tuberculin skin test should therefore be used as an independent marker of the weakened immunological status of HIV-1 seropositive subjects.

Keywords: CD4+; HIV; PPD; T-lymphocytes

Document Type: Regular Paper

Affiliations: 1: Centre MURAZ, Organisation de Coordination et de Coopération pour la lutte contre les Grandes Endémies (OCCGE), Bobo-Dioulasso, Burkina Faso 2: Centre MURAZ, Organisation de Coordination et de Coopération pour la lutte contre les Grandes Endémies (OCCGE), Bobo-Dioulasso, Burkina Faso; and INSERM U 399, Faculté de Médecine de la Timone, Marseille, France 3: Service MST/SIDA, Direction Provinciale de la Santé, Bobo-Dioulasso, Burkina Faso 4: Centre Régional de Lutte Anti-Tuberculeuse, Bobo-Dioulasso, Burkina Faso 5: Unité de Physiopathologie de l'Infection, Institut Pasteur, Paris, France

Publication date: April 1, 1998

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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