Delayed tuberculin reactivity in persons of Indochinese origin: Implications for preventive therapy

J. M. Robertson, D. S. Burtt, K. L. Edmonds, P. L. Molina, C. I. Kiefe, J. J. Ellner

Research output: Contribution to journalArticle

Abstract

Objectives: To 1) study a variant delayed reaction to tuberculin testing as a way to enhance screening for tuberculosis among high-risk persons and 2) correlate the delayed reaction with lymphocyte blastogenesis. Design: Cross- sectional study. Setting: 2 public health department clinics in North Carolina. Participants: 121 adults who had recently emigrated from Vietnam to North Carolina and who were ethnic Vietnamese and ethnic Dega, a minority population group from the central highlands region of Vietnam. Measurements: Medical history, physical examination, laboratory evaluation, and standard purified protein derivative (PPD) testing (Mantoux method). Skin test results were read at 72 hours and again at 6 days. Variant reactivity was defined as induration of less than 10 mm at 72 hours that, when reassessed at 6 days, had increased in size to 10 mm or greater. Persons with negative (n = 54) and variant (n = 32) PPD results also had booster testing at 10 to 12 weeks. Serum samples were obtained from 57 participants for lymphocyte blastogenesis studies. Results: 26% of participants had variant tuberculin reactivity. Variant reactivity was strongly associated with booster positivity: Sixty- five percent of persons with variant PPD results had booster positivity compared with 16% of persons with negative PPD results (P <0.001). The lymphocyte blastogenesis response of persons with variant PPD results was between the response of persons with negative PPD results and that of persons with positive PPD results. Conclusions: Variant reactivity in this high-risk group was a predictor of booster positivity. Together with the blastogenic response pattern, this association strongly suggests that variant reactivity has a high positive predictive value for tuberculous infection. Clinicians should incorporate these findings into their approach for choosing candidates for preventive therapy.

Original languageEnglish (US)
Pages (from-to)779-784
Number of pages6
JournalAnnals of Internal Medicine
Volume124
Issue number9
StatePublished - May 1 1996
Externally publishedYes

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Tuberculin
Lymphocyte Activation
Proteins
Vietnam
Lymphocytes
Therapeutics
Minority Groups
Skin Tests
Population Groups
Physical Examination
Tuberculosis
Public Health
Cross-Sectional Studies
Infection
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Robertson, J. M., Burtt, D. S., Edmonds, K. L., Molina, P. L., Kiefe, C. I., & Ellner, J. J. (1996). Delayed tuberculin reactivity in persons of Indochinese origin: Implications for preventive therapy. Annals of Internal Medicine, 124(9), 779-784.

Delayed tuberculin reactivity in persons of Indochinese origin : Implications for preventive therapy. / Robertson, J. M.; Burtt, D. S.; Edmonds, K. L.; Molina, P. L.; Kiefe, C. I.; Ellner, J. J.

In: Annals of Internal Medicine, Vol. 124, No. 9, 01.05.1996, p. 779-784.

Research output: Contribution to journalArticle

Robertson, JM, Burtt, DS, Edmonds, KL, Molina, PL, Kiefe, CI & Ellner, JJ 1996, 'Delayed tuberculin reactivity in persons of Indochinese origin: Implications for preventive therapy', Annals of Internal Medicine, vol. 124, no. 9, pp. 779-784.
Robertson JM, Burtt DS, Edmonds KL, Molina PL, Kiefe CI, Ellner JJ. Delayed tuberculin reactivity in persons of Indochinese origin: Implications for preventive therapy. Annals of Internal Medicine. 1996 May 1;124(9):779-784.
Robertson, J. M. ; Burtt, D. S. ; Edmonds, K. L. ; Molina, P. L. ; Kiefe, C. I. ; Ellner, J. J. / Delayed tuberculin reactivity in persons of Indochinese origin : Implications for preventive therapy. In: Annals of Internal Medicine. 1996 ; Vol. 124, No. 9. pp. 779-784.
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