Tuberculin skin test conversion among HIV patients on antiretroviral therapy in Uganda.
Int J Tuberc Lung Dis
; 17(3): 336-41, 2013 Mar.
Article
in En
| MEDLINE
| ID: mdl-23407223
ABSTRACT
SETTING:
A human immunodeficiency virus (HIV) clinic in a setting of high tuberculosis (TB) and HIV prevalence.OBJECTIVE:
To study the incidence of and factors associated with tuberculin skin test (TST) conversion in HIV patients on antiretroviral therapy (ART).DESIGN:
Prospective cohort study of TST-negative, ART-naïve HIV patients (CD4 cell count < 250 cells/l) without active TB. TST was repeated at 2 months and, if negative, at 6 months. TST positivity was defined as an induration of ≥5 mm. Clinical examination, chest X-ray and CD4 cell counts were performed at baseline and follow-up. Proportions and incidence of TST conversion were calculated, and logistic regression analyses were performed.RESULTS:
Of the 142 patients, 105 (75.5%) were females. The mean age was 35.9 years (standard deviation 8.1) and the median CD4 cell count was 119 cells/l (interquartile range 42168). The incidence of TST conversion was 30.2/100 person years (95%CI 19.546.8). Conversion was not associated with clinical, CD4 cell count or chest radiography findings.CONCLUSIONS:
A high incidence of TST conversion was observed, supporting the World Health Organization recommendation to provide isoniazid preventive therapy (IPT) to all HIV patients in high TB prevalence settings. If case-control programmes choose to provide IPT only to TST-positive patients, repeat TST should be considered following initiation of ART.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tuberculosis
/
Tuberculin Test
/
HIV Infections
/
Anti-Retroviral Agents
/
Coinfection
Type of study:
Diagnostic_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Africa
Language:
En
Journal:
Int J Tuberc Lung Dis
Year:
2013
Document type:
Article
Affiliation country:
Uganda