title: Risk factors for tuberculin skin test conversion among HIV-infected patients in New York City.
abstract: BACKGROUND
  We assessed the incidence of and risk factors for tuberculin skin test (TST) conversion among HIV-infected adults at a New York City clinic.
  
  
  METHODS
  All adult HIV-infected patients were eligible for inclusion if they had a negative baseline TST result and at least one subsequent documented TST test result.
  
  
  RESULTS
  A total of 414 HIV-infected patients had a negative baseline TST result; 288 (69.6%) were male. Among 348 patients who had a place of birth documented, 50% were born outside of mainland USA. Twenty-two (5.3%) of 414 patients had documented TST conversions, giving a crude incidence rate of 1.77 per 100 person-years. Being a foreign-born Asian individual (p=0.02), having lived in a shelter (p=0.004), and having an increase in CD4 cell count (p=0.02) while under care were independent risk factors for TST conversion.
  
  
  CONCLUSIONS
  We found a high TST conversion rate among HIV-infected patients attending an urban clinic. Annual TST testing is particularly important for patients who are foreign-born from high-endemic countries, those with a history of homelessness, and those with an increase in CD4 cell count since the baseline negative TST test.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, New York University School of Medicine, 550 First Avenue, BCD, Room 649, New York, NY 10016, USA.
authors.forename: Saumil
authors.initials: S
authors.lastname: Doshi
authors.forename: Tina Fang
authors.initials: TF
authors.lastname: Chen
authors.forename: Josue
authors.initials: J
authors.lastname: Zapata
authors.forename: Robert S
authors.initials: RS
authors.lastname: Holzman
authors.forename: Luis C
authors.initials: LC
authors.lastname: Zapata
authors.forename: Judith A
authors.initials: JA
authors.lastname: Aberg
authors.forename: Sumathi
authors.initials: S
authors.lastname: Sivapalasingam
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D014374:Tuberculin Test; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult