Cutaneous delayed-type hypersensitivity (DTH) reactions were assessed by the CMI-Multitest (Merieux, Lyon, France) in patients with different stages of human immunodeficiency virus (HIV) infection in Kinshasa, Zaire. Skin tests were read after 48-72 h. A reaction to an antigen was considered positive if there was induration of greater than 2 mm. Cutaneous anergy occurred more often in HIV-seropositive patients than in healthy controls (p less than 0.001) and was most prevalent in patients with advanced HIV illness. HIV-seropositive patients with a positive tuberculin reaction were more likely to have active tuberculosis (TB) than HIV-seropositive patients without a positive tuberculin reaction (p less than 0.001). Therefore, a TB diagnosis should be pursued in HIV-seropositive patients with a positive tuberculin reaction.
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