[Factors related to non-prescription of tuberculin skin testing in a cohort of HIV-infected people].
BACKGROUND
Tuberculin skin testing (TST) for tuberculosis (TB) is recommended for all patients with HIV infection because of the known relationship between these two conditions. In this report we analyze the incidence and variables associated with non-prescription of TST in a cohort of HIV-infected people.


METHODS
Longitudinal study conducted between 2000 and 2002 at 10 HIV hospital-based clinics. All HIV-infected patients who had not been regularly followed-up previously in dedicated clinics were identified. Data about TST and other variables related to TB were obtained from the clinical records. We calculated the percentage of patients who did not undergo TST and the associated factors, using odds ratios (ORs) and the 95% CI to investigate associations. A multivariate logistic regression analysis was performed.


RESULTS
A total of 1242 patients met the inclusion criteria. TST was not performed in 185 patients (17.6% of those eligible). The fact of being an intravenous drug abuser was associated with a higher probability of TST non-prescription (OR: 2.6, 95% CI 1.1-6.5), whereas being unemployed (OR: 0.6, 95% CI 0.3-1.0), having a CD4 cell count >200 (CD4 200-499: OR 0.5, 95% CI 0.3-0.9. CD4> or =500: OR 0.3, 95% CI 0.2-0.6), and contact with persons with TB (OR 0.2, 95% CI 0.1-0.5) were associated with a lower probability.


CONCLUSIONS
In this study, the percentage of TST non-prescription was quite high. The results suggest that TST non-prescription in this population is related to the clinicians' expectations regarding the results of the test and the patients' adherence to treatment for latent TB infection.
Díaz
Asunción
A
Unidad de Epidemiología del VIH/SIDA, Instituto de Salud Carlos III, Madrid, España. adiaz@isciii.es
Diez
Mercedes
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Bleda
María José
MJ
Aldamiz
Mikel
M
Camafort
Mikel
M
Camino
Xavier
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Cepeda
Concepción
C
Costa
Asunción
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Ferrero
Oscar
O
Geijo
Paloma
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Iribarren
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JA
Moreno
Santiago
S
Moreno
María Elena
ME
Labarga
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Pinilla
Javier
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Portu
Joseba
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Pulido
Federico
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Rosa
Carmen
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Santamaría
Juan Miguel
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Telenti
Mauricio
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Trapiella
Luis
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Trastoy
Mónica
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Viciana
Pompeyo
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D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D057210:Delayed Diagnosis; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D065227:Transfusion Reaction; D014374:Tuberculin Test / Q000706:statistics & numerical data*; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult