title: Tuberculin skin test conversion among HIV patients on antiretroviral therapy in Uganda.
abstract: METHODS
  A human immunodeficiency virus (HIV) clinic in a setting of high tuberculosis (TB) and HIV prevalence.
  
  
  OBJECTIVE
  To study the incidence of and factors associated with tuberculin skin test (TST) conversion in HIV patients on antiretroviral therapy (ART).
  
  
  METHODS
  Prospective  cohort study of TST-negative, ART-naïve HIV patients (CD4 cell count < 250 cells/l) without active TB. TST was repeated at 2 months and, if negative, at 6 months. TST positivity was defined as an induration of ≥5 mm. Clinical examination, chest X-ray and CD4 cell counts were performed  at baseline and follow-up. Proportions and incidence of TST conversion were calculated, and logistic regression analyses were performed.
  
  
  RESULTS
  Of the 142 patients, 105 (75.5%) were females. The mean age was 35.9 years (standard deviation 8.1) and the median CD4 cell count was 119 cells/l  (interquartile range 42168). The incidence of TST conversion was 30.2/100 person years (95%CI 19.546.8). Conversion was not associated with clinical, CD4 cell count or chest radiography findings.
  
  
  CONCLUSIONS
  A high incidence of TST conversion was observed, supporting the World Health Organization  recommendation to provide isoniazid preventive therapy (IPT) to all HIV patients in high TB prevalence settings. If case-control programmes choose to provide IPT only to TST-positive patients, repeat TST should be considered following initiation of ART.
authors: Pulmonology Unit, Department of Medicine, Mulago Hospital, Kampala, Uganda. brucekirenga@yahoo.co.uk
authors: B J
authors: BJ
authors: Kirenga
authors: W
authors: W
authors: Worodria
authors: M
authors: M
authors: Massinga-Loembe
authors: T
authors: T
authors: Nalwoga
authors: Y C
authors: YC
authors: Manabe
authors: L
authors: L
authors: Kestens
authors: R
authors: R
authors: Colebunders
authors: H
authors: H
authors: Mayanja-Kizza
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D013902:Radiography, Thoracic; D013997:Time Factors; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology; D014454:Uganda / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents