title: Coincident filarial, intestinal helminth, and mycobacterial infection: helminths fail to influence tuberculin reactivity, but BCG influences hookworm prevalence.
abstract: The prevalence of helminth and tuberculosis infections is high in South India, whereas Bacille-Calmette-Guerin (BCG) vaccine efficacy is low. Our aim was to determine whether concurrent helminth infection alters the ability to mount a delayed-type hypersensitivity response to tuberculin. In a cross-sectional study in southern India, individuals 6-65 years of age were screened for intestinal helminths, circulating filarial antigenemia, tuberculin reactivity, active tuberculosis, and history of BCG vaccination; 54% were purified protein derivative (PPD) positive, 32% had intestinal helminth infection, 9% were circulating filarial antigen positive, and 0.5% had culture-confirmed active tuberculosis. Only age and BCG vaccination were significantly associated with PPD reactivity; however, BCG vaccination was associated with a lower prevalence of hookworm infection relative to those without prior BCG vaccination. Neither intestinal helminth infection nor filarial infection was associated with diminished frequencies of PPD positivity. Our findings suggest that preceding helminth infection does not influence significantly the delayed-type hypersensitivity response to tuberculin.
authors: Office of Global Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA. elipner@niaid.nih.gov
authors: Ettie M
authors: EM
authors: Lipner
authors: P G
authors: PG
authors: Gopi
authors: R
authors: R
authors: Subramani
authors: C
authors: C
authors: Kolappan
authors: K
authors: K
authors: Sadacharam
authors: Paul
authors: P
authors: Kumaran
authors: D Rebecca
authors: DR
authors: Prevots
authors: P R
authors: PR
authors: Narayanan
authors: Thomas B
authors: TB
authors: Nutman
authors: V
authors: V
authors: Kumaraswami