CONTROLLED DOUBLE-BLIND-STUDY OF THE EFFECT OF RIFAMPIN ON HUMORAL AND CELLULAR IMMUNE-RESPONSES IN PATIENTS WITH PULMONARY TUBERCULOSIS AND IN TUBERCULOSIS CONTACTS

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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 mo. and all subjects were followed for 1 yr. On admission, the patients had lower concentrations of plasma albumin and elevated concentrations of globulin, IgG, IgA, IgM and C3 [complement component 3] compared with the control subjects. The patients had lower T cell concentrations and reduced lymphocyte transformation to PPD [purified protein derivative] and suboptimal dosages of PHA [purified hemagglutinin]. During chemotherapy, the concentrations of globulin, IgG, IgA, IgM and C3 in the patients returned within 6-11 wk to that of the control subjects. The primary antibody responses to tetanus toxin and pneumococcal polysaccharide, injected at 5 wk, and the antibody titers to Escherichia coli were greater in the patients than in the control subjects. Subsequent responses to secondary and tertiary challenges at 21 and 36 wk, to E. coli after 21 wk and to blood group antigens were similar in patients and control subjects. The depressed T cell concentrations and reduced lymphocyte responses to purified hemagglutinin (PHA) and purified protein derivative (PPD) returned within the 1st 6 wk of therapy to that of the control subjects. No difference between patients and control subjects was found in their skin test reactions to Candida, trichophyton, varidase, or PPD. No effect of rifampin could be demonstrated on any of the measures of humoral or cellular immunity studied.