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Anergy tests draw strong reaction from experts.


 After growing controversy about the usefulness and effectiveness of anergy testing, the Centers for Disease Control and Prevention (CDC) may change its four-year-old recommendation that all HIV-positive people at risk for Tuberculosis (TB) be tested for anergy at the time of their TB skin test. Anergy, a condition in which immunosuppressed people cannot mount a reaction to a PPD (purified protein derivative) skin test, is common in HIV-positive patients. Although anergy testing has been common practice, an unpublished study from the Johns Hopkins University in Baltimore suggests that anergy testing is not an accurate diagnosis for infection. As a result, health officials are revising recommendations to underscore the controversy. Earlier this year, the CDC's Advisory Council for the Elimination of Tuberculosis (ACET) revised its guidelines on TB screening in high risk populations, stating that the scientific basis for anergy testing is tenuous and is generally not part of screening for TB infection. However, those at high risk for TB may be evaluated for anergy, taking into account that anergy practices are not well standardized. The Hopkins study found high rates of change in anergy status in both seropositive and seronegative groups although they found that anergy did tend to stabilize in HIV-positive patients with CD4 counts below 350.
