Abstract
Identifying persons infected with both human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (MTB) is often difficult because of the reduced sensitivity of tuberculin skin testing in HIV-infected persons. To determine the value of two-step tuberculin skin testing (TTST) as a method of increasing the sensitivity of tuberculin skin testing in HIV-infected persons, a consecutive sample of 58 HIV-infected persons being screened for a TB preventive therapy trial in Uganda with an initial purified protein derivative (PPD) response <5 mm completed two-step tuberculin and candida skin testing. The mean change in PPD size between the two tests, placed a mean of 8 d apart, was +2.1 mm (SD 4.4 mm, range -4 to +16 mm). Seventeen subjects (29%) had a boosted response (PPD1 <5 and PPD2 ≤ 5). In a multiple logistic regression model, boosted responses were independently associated with a CD4 count between 200 and 500 μl-1 (p = 0.02) and a higher body mass index (p = 0.05). TTST may be valuable in identifying MTB infection and in preventing misclassification of boosted responses as skin test conversions in HIV-infected persons, especially persons with CD4 counts between 200 and 500 μl-1 from areas with a high prevalence of MTB infection or from areas with a low prevalence of MTB infection who have other risk factors for MTB infection.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 81-86 |
| Number of pages | 6 |
| Journal | American Journal of Respiratory and Critical Care Medicine |
| Volume | 155 |
| Issue number | 1 |
| State | Published - 1997 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Two-step tuberculin skin testing in HIV-infected persons in Uganda. / Hecker, Michelle T.; Johnson, John L.; Whalen, Christopher C.; Nyole, Sam; Mugerwa, Roy D.; Ellner, Jerrold J.
In: American Journal of Respiratory and Critical Care Medicine, Vol. 155, No. 1, 1997, p. 81-86.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Two-step tuberculin skin testing in HIV-infected persons in Uganda
AU - Hecker, Michelle T.
AU - Johnson, John L.
AU - Whalen, Christopher C.
AU - Nyole, Sam
AU - Mugerwa, Roy D.
AU - Ellner, Jerrold J.
PY - 1997
Y1 - 1997
N2 - Identifying persons infected with both human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (MTB) is often difficult because of the reduced sensitivity of tuberculin skin testing in HIV-infected persons. To determine the value of two-step tuberculin skin testing (TTST) as a method of increasing the sensitivity of tuberculin skin testing in HIV-infected persons, a consecutive sample of 58 HIV-infected persons being screened for a TB preventive therapy trial in Uganda with an initial purified protein derivative (PPD) response <5 mm completed two-step tuberculin and candida skin testing. The mean change in PPD size between the two tests, placed a mean of 8 d apart, was +2.1 mm (SD 4.4 mm, range -4 to +16 mm). Seventeen subjects (29%) had a boosted response (PPD1 <5 and PPD2 ≤ 5). In a multiple logistic regression model, boosted responses were independently associated with a CD4 count between 200 and 500 μl-1 (p = 0.02) and a higher body mass index (p = 0.05). TTST may be valuable in identifying MTB infection and in preventing misclassification of boosted responses as skin test conversions in HIV-infected persons, especially persons with CD4 counts between 200 and 500 μl-1 from areas with a high prevalence of MTB infection or from areas with a low prevalence of MTB infection who have other risk factors for MTB infection.
AB - Identifying persons infected with both human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (MTB) is often difficult because of the reduced sensitivity of tuberculin skin testing in HIV-infected persons. To determine the value of two-step tuberculin skin testing (TTST) as a method of increasing the sensitivity of tuberculin skin testing in HIV-infected persons, a consecutive sample of 58 HIV-infected persons being screened for a TB preventive therapy trial in Uganda with an initial purified protein derivative (PPD) response <5 mm completed two-step tuberculin and candida skin testing. The mean change in PPD size between the two tests, placed a mean of 8 d apart, was +2.1 mm (SD 4.4 mm, range -4 to +16 mm). Seventeen subjects (29%) had a boosted response (PPD1 <5 and PPD2 ≤ 5). In a multiple logistic regression model, boosted responses were independently associated with a CD4 count between 200 and 500 μl-1 (p = 0.02) and a higher body mass index (p = 0.05). TTST may be valuable in identifying MTB infection and in preventing misclassification of boosted responses as skin test conversions in HIV-infected persons, especially persons with CD4 counts between 200 and 500 μl-1 from areas with a high prevalence of MTB infection or from areas with a low prevalence of MTB infection who have other risk factors for MTB infection.
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UR - http://www.scopus.com/inward/citedby.url?scp=0031028315&partnerID=8YFLogxK
M3 - Article
C2 - 9001293
AN - SCOPUS:0031028315
VL - 155
SP - 81
EP - 86
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 1
ER -