Two-step tuberculin skin testing in drug users.
To assess the utility of booster testing and to identify factors associated with a positive booster test, two-step tuberculin testing was performed in drug users recruited from methadone treatment. Participants also received a standardized interview on demographics and testing for HIV and CD4+ lymphocyte count. Of 619 enrollees completing the protocol, 174 (28%) had a positive PPD and 24 of the remaining 445 (5%) had a positive booster test. On multivariate analysis, boosting was associated with older age (adjusted odds ratio [ORadj] 2.38/decade, 95% confidence interval [CI] 1.34-4.22), history of using crack cocaine (ORadj 2.61, 95% CI 1.10-6.18) and a history of working as a home health aide (ORadj 4.23, 95% CI 1.39-12.86). Two-step tuberculin skin testing increased the proportion of participants with latent tuberculosis infection from 22% to 25%. Given the effectiveness of chemoprophylaxis, booster testing should be considered when drug users are screened for tuberculosis infection.
Swaminathan
Shobha
S
Department of Medicine, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ 07101, USA. swaminsh@umdnj.edu
Schoenbaum
Ellie E
EE
Klein
Robert S
RS
Howard
Andrea A
AA
Lo
Yungtai
Y
Gourevitch
Marc N
MN
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D009519:New York City; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D014374:Tuberculin Test / Q000379:methods*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control
D009294:Narcotics; D008691:Methadone