The effects of BCG immunization and human immunodeficiency virus infection on dual skin test reactions to purified protein derivative and Mycobacterium avium sensitin among adults in Zambia

Int J Tuberc Lung Dis. 1999 Mar;3(3):255-60.

Abstract

Setting: University hospital in Lusaka, Zambia.

Objective: To determine the effects of childhood bacille Calmette-Guerin (BCG) immunization and human immunodeficiency virus (HIV) infection on dual skin test reactions to purified protein derivative (PPD) and Mycobacterium avium sensitin (MAS) in a developing country.

Design: Descriptive cross-sectional study.

Results: Dual skin testing was performed on 112 adults, 58 HIV-positive and 54 HIV-negative. Forty-seven (42%) of 112 had PPD reactions > or =10 mm and 52 (46%) had MAS reactions > or =10 mm. PPD reactions > or =10 mm were present in 30 (63%) of 48 BCG-positive subjects compared to 17 (27%) of 64 BCG-negative subjects (P<0.001). Nineteen (33%) of 58 PPD or MAS skin test positive subjects were PPD dominant, 15 (26%) were MAS dominant, and 24 (41%) were non-dominant. MAS dominant and non-dominant reactions were significantly reduced in HIV-positive subjects, and non-dominant reactions were increased in BCG-positive subjects.

Conclusions: Childhood BCG immunization is associated with PPD reactions > or =10 mm among adults. Reduced PPD reaction rates in HIV-positive adults appear to be due to a loss of BCG-induced PPD reactivity. Prior infection with M. avium complex is detectable in a significant proportion of adults in a developing country.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antigens*
  • Antigens, Bacterial*
  • BCG Vaccine*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / complications
  • Humans
  • Immunocompromised Host
  • Male
  • Tuberculin Test*
  • Tuberculosis / complications
  • Tuberculosis / diagnosis*
  • Zambia

Substances

  • Antigens
  • Antigens, Bacterial
  • BCG Vaccine
  • sensitin