Missed opportunities for prevention of tuberculosis among persons with HIV infection--selected locations, United States, 1996-1997.

Public health contact investigations are conducted to find persons who have been exposed to patients with active tuberculosis (TB) and to evaluate and treat those contacts for TB infection and active TB. Persons in close (i.e., prolonged, frequent, or intense) contact with patients with active TB are at high risk for TB infection. The risk for TB infection is increased greatly if the close contact is infected with human immunodeficiency virus (HIV) (1,2). Isoniazid (INH) treatment for latent TB infection (LTBI) reduces the riskfor developing active TB by 41%-92% (1). This study examined the clinic records of TB programs to determine whether these programs used recommended practices to manage HIV-positive persons exposed to TB (3-8). The study suggests TB programs need to review their contact investigation policies, procedures, and outcomes to reduce missed opportunities for preventing active TB among HIV-positive close contacts.