title: Assessment of risk for pulmonary tuberculosis after non-reactive tuberculin skin testing among patients with HIV infection in a resource-limited setting.
abstract: A cross-sectional study of 350 patients with HIV-1 infection was conducted to identify risks for pulmonary Mycobacterium tuberculosis (TB) after non-reactive two-step tuberculin skin tests (TST). Among 219 patients (62.6%) with non-reactive TST, independent risks for active pulmonary TB were prior known TB exposure (adjusted odds ratio [aOR] = 16.00, 95% confidence interval [CI] = 2.00-26.36, P = 0.008), CD4 <100 cells/microL (aOR = 2.50, 95% CI = 1.30-6.50, P = 0.04) and less than secondary-school education (aOR = 2.60, 95% CI = 1.50-6.90, P = 0.02). Our findings suggest that further diagnostic work-up for pulmonary TB is warranted among patients with HIV infection, non-reactive TSTs and either prior known TB exposure, CD4 counts <100 cells/microL or limited formal education.
authors.affiliation: Division of Infectious Diseases, Faculty of Medicine, Thammasart University Hospital, Pratumthani, Thailand.
authors.forename: T
authors.initials: T
authors.lastname: Khawcharoenporn
authors.forename: A
authors.initials: A
authors.lastname: Apisarnthanarak
authors.forename: L M
authors.initials: LM
authors.lastname: Mundy
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D011203:Poverty; D018570:Risk Assessment; D012307:Risk Factors; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult