Effectiveness of isoniazid treatment for latent tuberculosis infection among human immunodeficiency virus (HIV)-infected and HIV-uninfected injection drug users in methadone programs.
Injection drug users (IDUs) were heavily affected by the tuberculosis (TB) resurgence in New York City in the 1990s. We assessed the effectiveness of screening for latent TB infection in methadone users and of selective treatment with isoniazid. Risk for future TB was classified as low or high on the basis of tuberculin, anergy, and HIV test results. The cohort of 2212 IDUs was followed up for a median of 4.2 years; 25 IDUs, of whom 20 (80%) were infected with human immunodeficiency virus (HIV), developed TB. In an adjusted Cox proportional hazards model of high-risk IDUs, the risk of TB was associated with HIV infection (HR 10.3; 95% CI, 3.4-31.3); receipt of <6 months of isoniazid therapy (HR 7.6; 95% CI, 1.02-57.1); a CD4+ T lymphocyte count of <200 cells/mm3 (HR 6.6; 95% CI, 1.7-25.9); and tuberculin positivity (HR 4.0; 95% CI, 1.6-10.2). Treatment with isoniazid was beneficial in HIV-infected, tuberculin-positive IDUs.
Scholten
Jerod N
JN
New York City Department of Health and Mental Hygiene, New York, USA.
Driver
Cynthia R
CR
Munsiff
Sonal S
SS
Kaye
Katherine
K
Rubino
Mary Ann
MA
Gourevitch
Marc N
MN
Trim
Caroline
C
Amofa
James
J
Seewald
Randy
R
Highley
Esther
E
Fujiwara
Paula I
PI
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000188:drug therapy*; D016896:Treatment Outcome; D014374:Tuberculin Test; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents; D008691:Methadone; D007538:Isoniazid