Routine analysis of induced sputum is not an effective strategy for screening persons infected with human immunodeficiency virus for Mycobacterium tuberculosis or Pneumocystis carinii. Pulmonary Complications of HIV Infection Study Group.
A prospective multicenter cohort study comprising 1,171 individuals who were seropositive for human immunodeficiency virus (HIV) but did not have AIDS at the time of enrollment and 182 HIV-seronegative controls, was studied by means of routine induced-sputum analysis in an attempt to detect occult tuberculosis or Pneumocystis carinii pneumonia. One occult case of tuberculosis was discovered upon the patient's enrollment (at baseline); none were discovered during follow-up. Two additional Mycobacterium tuberculosis isolates were recovered (one at baseline, one during follow-up) from subjects with symptoms or abnormalities evident on chest roentgenograms. Three specimens were false-positive (one for M. tuberculosis, two for P. carinii). Five pathogenic nontuberculous mycobacteria isolates were recovered during follow-up. Nonpathogenic, nontuberculous mycobacteria were recovered from 51 (4.6%) of 1,113 baseline specimens and 56 (3.7%) of 1,518 follow-up specimens, primarily at a center where the water supply was contaminated. We conclude that routine induced-sputum analysis is not an effective strategy for screening HIV-infected asymptomatic subjects for tuberculosis or P. carinii pneumonia before the onset of clinically recognizable disease activity.
Kvale
P A
PA
Henry Ford Hospital, Division of Pulmonary and Critical Care Medicine, Detroit, Michigan 48202.
Hansen
N I
NI
Markowitz
N
N
Rosen
M J
MJ
Jordan
M C
MC
Meiselman
L
L
Glassroth
J
J
Reichman
L B
LB
Wallace
J M
JM
Stansell
J D
JD
D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications / Q000382:microbiology*; D006716:Homosexuality; D006801:Humans; D008297:Male; D008403:Mass Screening; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011010:Pneumocystis / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000382:microbiology*; D011446:Prospective Studies; D012747:Sexual Partners; D013183:Sputum / Q000382:microbiology*; D015819:Substance Abuse, Intravenous; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000382:microbiology*