Document 0691
 DOCN  M95A0691
 TI    Some HIV clinics changing protocols on anergy. 
 DT    9510
 SO    AIDS Alert. 1995 Apr;10(4):suppl 1-2. Unique Identifier : AIDSLINE
       AIDS/95700230
 AB    The Centers for Disease Control and Prevention (CDC) has advised health
       care workers to evaluate HIV-positive people for delayed-type
       hypersensitivity (DTH) anergy at the time of PPD (purified protein
       derivative) testing. However, controversy remains among those that feel
       anergy testing is either unnecessary or inaccurate. A study conducted by
       researchers at the Johns Hopkins University in Baltimore, MD,
       demonstrated that anergy test results were not stable. If CD4 counts are
       above 500, it is highly unlikely that they will be anergic. Anergy
       testing may be just as unnecessary in patients with low CD4 counts.
       People with CD4 counts less than 200 are very likely to be anergic. The
       CDC recommends that if patients are anergic, those with a high risk of
       TB infection should be given prophylaxis. Researchers at Hopkins suggest
       that clinicians look closely at rates of prevalence and incidence within
       the patient's community. Given limited resources, and limited incidence
       and prevalence of TB, Hopkins representatives suggest providers
       concentrate efforts on PPD-positive patients.
 DE    HIV Infections/*COMPLICATIONS  Human  Hypersensitivity,
       Delayed/IMMUNOLOGY  Tuberculin Test/*UTILIZATION
       Tuberculosis/*DIAGNOSIS  NEWSLETTER ARTICLE

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