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. 1998;6(1):13–17. doi: 10.1002/(SICI)1098-0997(1998)6:1<13::AID-IDOG4>3.0.CO;2-8

Cutaneous anergy in pregnant and nonpregnant women with human immunodeficiency virus.

N L Eriksen 1, A W Helfgott 1
PMCID: PMC1784769  PMID: 9678142

Abstract

OBJECTIVE: To determine the prevalence of cutaneous anergy in pregnant and nonpregnant women who are seropositive for human immunodeficiency virus. METHODS AND MATERIALS: The medical records of 159 women seropositive for human immunodeficiency virus were reviewed. Demographic characteristics and tuberculin skin test results were abstracted from the chart. Tuberculin skin testing was performed by the Mantoux method (5 tuberculin units of purified protein derivative injected intradermally). Anergy testing was performed using any two of the three following antigens; tetanus toxoid, mumps, or Candida skin test antigen. A positive tuberculin test was defined as induration of 5 mm or more, and a positive test for the other antigens was defined as any amount of induration over the skin test area. Anergy was defined as any amount of induration to the other antigens. A CD4+T lymphocyte count was obtained at the time of skin testing. Continuous variables were analyzed using the Mann Whitney-U test. Categorical data were analyzed with the chi-square or Fisher's exact test as appropriate. A two-tailed P value < 0.05 was considered significant. RESULTS: There were 102 nonpregnant and 57 pregnant women who returned to have their skin test results read. There was no significant difference in the prevalence of positive, negative or anergic skin test results between groups. The CD4+T lymphocyte count (mean +/- standard deviation) in patients with anergic results was similar between pregnant (375 +/- 256/mm3) and nonpregnant (358 +/- 305/mm3) women (P = 0.64). CONCLUSION: The prevalence of cutaneous anergy is similar among pregnant and nonpregnant women seropositive for human immunodeficiency virus.

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Selected References

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  1. Antonucci G., Girardi E., Raviglione M. C., Ippolito G. Risk factors for tuberculosis in HIV-infected persons. A prospective cohort study. The Gruppo Italiano di Studio Tubercolosi e AIDS (GISTA). JAMA. 1995 Jul 12;274(2):143–148. doi: 10.1001/jama.274.2.143. [DOI] [PubMed] [Google Scholar]
  2. Barnes P. F., Bloch A. B., Davidson P. T., Snider D. E., Jr Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med. 1991 Jun 6;324(23):1644–1650. doi: 10.1056/NEJM199106063242307. [DOI] [PubMed] [Google Scholar]
  3. Blatt S. P., Hendrix C. W., Butzin C. A., Freeman T. M., Ward W. W., Hensley R. E., Melcher G. P., Donovan D. J., Boswell R. N. Delayed-type hypersensitivity skin testing predicts progression to AIDS in HIV-infected patients. Ann Intern Med. 1993 Aug 1;119(3):177–184. doi: 10.7326/0003-4819-119-3-199308010-00001. [DOI] [PubMed] [Google Scholar]
  4. Burns D. N., Nourjah P., Minkoff H., Korelitz J., Biggar R. J., Landesman S., Rubinstein A., Wright D., Nugent R. P. Changes in CD4+ and CD8+ cell levels during pregnancy and post partum in women seropositive and seronegative for human immunodeficiency virus-1. Am J Obstet Gynecol. 1996 May;174(5):1461–1468. doi: 10.1016/s0002-9378(96)70589-6. [DOI] [PubMed] [Google Scholar]
  5. Caiaffa W. T., Graham N. M., Galai N., Rizzo R. T., Nelson K. E., Vlahov D. Instability of delayed-type hypersensitivity skin test anergy in human immunodeficiency virus infection. Arch Intern Med. 1995 Oct 23;155(19):2111–2117. [PubMed] [Google Scholar]
  6. Chin D. P., Osmond D., Page-Shafer K., Glassroth J., Rosen M. J., Reichman L. B., Kvale P. A., Wallace J. M., Poole W. K., Hopewell P. C. Reliability of anergy skin testing in persons with HIV infection. The pulmonary Complications of HIV Infection Study Group. Am J Respir Crit Care Med. 1996 Jun;153(6 Pt 1):1982–1984. doi: 10.1164/ajrccm.153.6.8665065. [DOI] [PubMed] [Google Scholar]
  7. Franks A. L., Binkin N. J., Snider D. E., Jr, Rokaw W. M., Becker S. Isoniazid hepatitis among pregnant and postpartum Hispanic patients. Public Health Rep. 1989 Mar-Apr;104(2):151–155. [PMC free article] [PubMed] [Google Scholar]
  8. Gordin F. M., Matts J. P., Miller C., Brown L. S., Hafner R., John S. L., Klein M., Vaughn A., Besch C. L., Perez G. A controlled trial of isoniazid in persons with anergy and human immunodeficiency virus infection who are at high risk for tuberculosis. Terry Beirn Community Programs for Clinical Research on AIDS. N Engl J Med. 1997 Jul 31;337(5):315–320. doi: 10.1056/NEJM199707313370505. [DOI] [PubMed] [Google Scholar]
  9. Graham N. M., Nelson K. E., Solomon L., Bonds M., Rizzo R. T., Scavotto J., Astemborski J., Vlahov D. Prevalence of tuberculin positivity and skin test anergy in HIV-1-seropositive and -seronegative intravenous drug users. JAMA. 1992 Jan 15;267(3):369–373. [PubMed] [Google Scholar]
  10. Johnstone F. D., Thong K. J., Bird A. G., Whitelaw J. Lymphocyte subpopulations in early human pregnancy. Obstet Gynecol. 1994 Jun;83(6):941–946. doi: 10.1097/00006250-199406000-00008. [DOI] [PubMed] [Google Scholar]
  11. Jones B. E., Young S. M., Antoniskis D., Davidson P. T., Kramer F., Barnes P. F. Relationship of the manifestations of tuberculosis to CD4 cell counts in patients with human immunodeficiency virus infection. Am Rev Respir Dis. 1993 Nov;148(5):1292–1297. doi: 10.1164/ajrccm/148.5.1292. [DOI] [PubMed] [Google Scholar]
  12. Margono F., Mroueh J., Garely A., White D., Duerr A., Minkoff H. L. Resurgence of active tuberculosis among pregnant women. Obstet Gynecol. 1994 Jun;83(6):911–914. doi: 10.1097/00006250-199406000-00001. [DOI] [PubMed] [Google Scholar]
  13. Markowitz N., Hansen N. I., Wilcosky T. C., Hopewell P. C., Glassroth J., Kvale P. A., Mangura B. T., Osmond D., Wallace J. M., Rosen M. J. Tuberculin and anergy testing in HIV-seropositive and HIV-seronegative persons. Pulmonary Complications of HIV Infection Study Group. Ann Intern Med. 1993 Aug 1;119(3):185–193. doi: 10.7326/0003-4819-119-3-199308010-00002. [DOI] [PubMed] [Google Scholar]
  14. Miotti P. G., Liomba G., Dallabetta G. A., Hoover D. R., Chiphangwi J. D., Saah A. J. T lymphocyte subsets during and after pregnancy: analysis in human immunodeficiency virus type 1-infected and -uninfected Malawian mothers. J Infect Dis. 1992 Jun;165(6):1116–1119. doi: 10.1093/infdis/165.6.1116. [DOI] [PubMed] [Google Scholar]
  15. Mofenson L. M., Rodriguez E. M., Hershow R., Fox H. E., Landesman S., Tuomala R., Diaz C., Daniels E., Brambilla D. Mycobacterium tuberculosis infection in pregnant and nonpregnant women infected with HIV in the Women and Infants Transmission Study. Arch Intern Med. 1995 May 22;155(10):1066–1072. [PubMed] [Google Scholar]
  16. Moreno S., Baraia-Etxaburu J., Bouza E., Parras F., Pérez-Tascón M., Miralles P., Vicente T., Alberdi J. C., Cosín J., López-Gay D. Risk for developing tuberculosis among anergic patients infected with HIV. Ann Intern Med. 1993 Aug 1;119(3):194–198. doi: 10.7326/0003-4819-119-3-199308010-00003. [DOI] [PubMed] [Google Scholar]
  17. Purified protein derivative (PPD)-tuberculin anergy and HIV infection: guidelines for anergy testing and management of anergic persons at risk of tuberculosis. MMWR Recomm Rep. 1991 Apr 26;40(RR-5):27–32. [PubMed] [Google Scholar]
  18. Rieder H. L., Cauthen G. M., Kelly G. D., Bloch A. B., Snider D. E., Jr Tuberculosis in the United States. JAMA. 1989 Jul 21;262(3):385–389. [PubMed] [Google Scholar]
  19. Selwyn P. A., Sckell B. M., Alcabes P., Friedland G. H., Klein R. S., Schoenbaum E. E. High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy. JAMA. 1992 Jul 22;268(4):504–509. [PubMed] [Google Scholar]

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