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.
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 HIVpatients on antiretroviral therapy (ART). DESIGN: Prospective cohort study of TST-negative, ART-naïve HIVpatients (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 HIVpatients 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.
Authors: S Jonnalagadda; S M LaCourse; P Otieno; B Lohman-Payne; E Maleche-Obimbo; L M Cranmer; G C John-Stewart Journal: Int J Tuberc Lung Dis Date: 2015-07 Impact factor: 2.373
Authors: Molebogeng X Rangaka; Robert J Wilkinson; Andrew Boulle; Judith R Glynn; Katherine Fielding; Gilles van Cutsem; Katalin A Wilkinson; Rene Goliath; Shaheed Mathee; Eric Goemaere; Gary Maartens Journal: Lancet Date: 2014-05-13 Impact factor: 79.321
Authors: Lucy C K Bell; Gabriele Pollara; Mellissa Pascoe; Gillian S Tomlinson; Rannakoe J Lehloenya; Jennifer Roe; Richard Meldau; Robert F Miller; Alan Ramsay; Benjamin M Chain; Keertan Dheda; Mahdad Noursadeghi Journal: PLoS Pathog Date: 2016-03-17 Impact factor: 6.823
Authors: Winsley Rose; Ian Kitai; Fatima Kakkar; Stanley E Read; Marcel A Behr; Ari Bitnun Journal: BMC Infect Dis Date: 2014-09-23 Impact factor: 3.090