Controlled double-blind study of the effect of rifampin on humoral and cellular immune responses in patients with pulmonary tuberculosis and in tuberculosis contacts.

Abstract

The effect of rifampin on humoral and cellular immunity was investigated in a double-blind comparison in which 33 patients were treated with streptomycin, isoniazid, and rifampin or with streptomycin, isoniazid, and pyrazinamide, and 41 healthy control subjects (all contacts of cases of pulmonary tuberculosis) were given chemoprophylaxis with rifampin or a placebo. Treatment was given for 6 months, and all subjects were followed for a further year. On admission, the patients had lower concentrations of plasma albumin and elevated concentrations of globulin, IgG, IgA, IgM, and C3 compared with the control subjects. The patients also had lower T cell concentrations and reduced lymphocyte transformation to PPD and suboptimal dosages of PHA. During chemotherapy, the concentrations of globulin, IgG, IgA, IgM, and C3 in the patients returned within 6 to 11 wk to that of the control subjects. The primary antibody responses to tetanus toxoid and pneumococcal polysaccharide, injected at 5 wk, and the antibody titr...