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Caroline J. Gallant, PhD; Aurelie Cobat, MD; Eileen G. Hoal, PhD; Erwin Schurr, PhD
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From the McGill Centre for the Study of Host Resistance and the Departments of Human Genetics and Medicine (Drs Gallant and Schurr), McGill University; the Faculté de Médecine Necker (Dr Cobat), Université de Paris Descartes; and the Department of Molecular Biology and Human Genetics (Dr Hoal), Medical Research Council Centre for Molecular and Cellular Biology, Department of Science and Technology/National Research Foundation Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University.

Correspondence to: Erwin Schurr, PhD, Montreal General Hospital Research Institute, 1650 Cedar Ave, Room L11-521, Montreal, QC, H3G 1A4, Canada; e-mail: erwin.schurr@mcgill.ca


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(2):461. doi:10.1378/chest.10-1000
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To the Editor:

Two interesting points are raised by Drs Khurana and Khurana about our study in CHEST (May 2010).1 As correctly pointed out, we did not attempt to verify the Bacillus Calmette-Guérin (BCG) vaccination status of our study subjects. However, BCG vaccination at birth has been mandatory in the study area since 1975,2 and vaccine coverage in the Western Cape is very high at 99% (95% CI, 99%-99.5%).3 Hence, we can safely assume that the majority of our study subjects were BCG vaccinated.

The other point concerns redundancy of in vivo and in vitro assays. Our study was not designed to evaluate the possible redundancy of cutoff points and positive vs negative responses. Rather, we focused on the correlation in the extent of responsiveness between assays and detected low correlation between assay readouts. From this, we inferred biologic nonredundancy of the different assays. We agree that further studies into the mycobacterial host responses, including the immune assays currently used for diagnosis of latent TB infection, are needed.

Gallant CJ, Cobat A, Simkin L, et al. Tuberculin skin test andin vitroassays provide complementary measures of antimycobacterial immunity in children and adolescents. Chest. 2010;1375:1071-1077. [CrossRef] [PubMed]
 
Cobat A, Gallant CJ, Simkin L, et al. High heritability of antimycobacterial immunity in an area of hyperendemicity for tuberculosis disease. J Infect Dis. 2010;2011:15-19. [CrossRef] [PubMed]
 
Corrigall J, Coetzee D, Cameron N. Is the Western Cape at risk of an outbreak of preventable childhood diseases? Lessons from an evaluation of routine immunisation coverage. S Afr Med J. 2008;981:41-45. [PubMed]
 

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Gallant CJ, Cobat A, Simkin L, et al. Tuberculin skin test andin vitroassays provide complementary measures of antimycobacterial immunity in children and adolescents. Chest. 2010;1375:1071-1077. [CrossRef] [PubMed]
 
Cobat A, Gallant CJ, Simkin L, et al. High heritability of antimycobacterial immunity in an area of hyperendemicity for tuberculosis disease. J Infect Dis. 2010;2011:15-19. [CrossRef] [PubMed]
 
Corrigall J, Coetzee D, Cameron N. Is the Western Cape at risk of an outbreak of preventable childhood diseases? Lessons from an evaluation of routine immunisation coverage. S Afr Med J. 2008;981:41-45. [PubMed]
 
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