Abstract: Objective To evaluate the value of drug-induced lymphocyte stimulation test (DLST) for the dia-gnosis of anti-tuberculosis (TB) drug-induced hypersensitivity reaction. Methods One hundred and fourteen patients with first treatment pulmonary tuberculosis who had adverse drug reactions were served as case group. Ninety-six patients without adverse drug reactions were served as control group. After the DLST was completed, the sensitivity, specificity, false positive rate and false negative rate were compared with “gold standard” drug provocation test (DPT) for each reaction event and each drug. Results Of 114 patients in case group, a total of 127 times of anti-TB drug-associated adverse reactions occurred, including 37 cases of drug rash, 65 cases of drug-induced liver injury, and 25 cases of drug-associated fever. The sensitivities of DLST in the diagnosis of hypersensitivity reactions induced by isoniazid (INH), rifampicin (RFP), ethambutol (EMB), and pyrazinamide (PZA) were 64.5% (20/31), 48.3% (28/58), 54.2% (13/24) and 31.6% (6/19), respectively. Their specificities were 93.3% (167/179), 94.7% (144/152), 97.3% (181/186) and 98.4% (188/191), respectively. Their false-positive rates were 6.7% (12/179), 5.3% (8/152), 2.7% (5/186) and 1.6% (3/191), respectively. Their false-negative rates were 35.5% (11/31), 51.7% (30/58), 45.8% (11/24) and 68.4% (13/19), respectively. Conclusion DLST have high specificity and limited sensitivity in the diagnosis of anti-TB drug-induced hypersensitivity reaction, and is helpful for the clinicians to predict the causative drugs.

Key words: Tuberculosis, pulmonary/drug therapy, Antitubercular agents, Drug hypersensitivity, Lymphocyte activation