Is tuberculin skin test sensitivity depressed by oral contraceptives?
QUESTION: In the "Journal of the American Medical Association" editorial "Oral contraceptives and immune responses" (209: 410, 1969) the following statement appears: "Other reactions of delayed hypersensitivity, such as the tuberculin response, are similarly suppressed by estrogens and presumably by oral contraceptives also." Does this mean that women taking birth control pills may have a false-negative tuberculin skin test reaction? ANSWER: I am not aware of any studies of tuberculin skin test reaction in women taking birth control pills. However, in the immunologic studies which have been done, the birth control pills have had primarily the same effect as estrogen. There are experiemntal studies in animals in which the findings point to a considerable reduction, though not an abolition, of tuberculin skin test sensitivity in animals given estrogen. It seems likely, therefore, that the tuberculin sensitivity in the skin may well be somewhat reduced in women taking oral contraceptives, though direct evidence is lacking.