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J Infect. 2014 Aug;69(2):161-4. doi: 10.1016/j.jinf.2014.03.008. Epub 2014 Mar 15.

Immunogenicity of the Q fever skin test.

Author information

  • 1Department of Internal Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: Teske.Schoffelen@Radboudumc.nl.
  • 2Centre for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
  • 3Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, P.O. Box 9015, 6500 GS Nijmegen, The Netherlands; Department of Internal Medicine, Canisius Wilhelmina Hospital, P.O. Box 9015, 6500 GS Nijmegen, The Netherlands.
  • 4Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, P.O. Box 9015, 6500 GS Nijmegen, The Netherlands.
  • 5Department of Internal Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.

Abstract

OBJECTIVES:

The Q fever skin test is used to measure cell-mediated immunity to Coxiella burnetii in pre-vaccination screening to exclude individuals with pre-existing immunity. We investigated whether this in-vivo test influences subsequent measurements of immune response.

METHODS:

We assessed the humoral and cellular immune responses before, and 6 and 12 months after skin testing in 63 individuals who were not vaccinated because of either a positive skin test or positive serology in screening. IgG anti-C. burnetii antibodies were measured using immune-fluorescence assay (IFA). The cellular immune response was assessed by measuring in-vitro C. burnetii-specific interferon (IFN)-γ production in blood.

RESULTS:

Of the 35 subjects with a positive skin test and negative serology, 15/35 (43%) showed seroconversion at 6 months, and 7/32 (22%) seropositivity at 12 months. The mean ± SE specific IFN-γ production in this group increased from 185 ± 88 pg/mL (at baseline) to 422 ± 141 pg/mL at 6 months (P = 0.009) and 223 ± 91 pg/mL at 12 months (P = 0.17). Of the 28 subjects with positive serology (and unknown skin test results), 21/28 (75%) showed an increase in IgG anti-phase I titres at 6 months, and 11/25 (44%) at 12 months. The mean ± SE specific IFN-γ production was significantly increased at 6 months, but not at 12 months.

CONCLUSIONS:

Q fever skin testing causes higher antibody titres and higher in-vitro IFN-γ to C. burnetii, and therefore affects subsequent Q fever diagnostics.

Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:

Booster effect; Coxiella burnetii; Diagnostic test; Immunogenicity; Interferon-gamma; Q fever; Serology; Skin test

PMID:
24642208
[PubMed - indexed for MEDLINE]
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