title: Latent tuberculosis among injection drug users in a methadone maintenance treatment program, Taipei, Taiwan: TSPOT.TB versus tuberculin skin test.
abstract: BACKGROUND
  Taiwan has a growing HIV/AIDS epidemic that has recently shifted to an increase among injection drug users (IDUs). IDUs co-infected with HIV and tuberculosis (TB) have a high risk of progression from latent tuberculosis infection (LTBI) to active TB.
  
  
  METHODS
  This study aimed to determine the prevalence and correlates of LTBI among IDUs by TSPOT.TB and tuberculin skin test (TST), in a large methadone program in Taipei, Taiwan. Consenting participants were interviewed by a trained worker regarding sociodemographics, substance use history, and health factors.
  
  
  RESULTS
  Multivariate analysis was used to determine risks associated with each test outcome. Of 287 participants, 165 (58.7%) tested TSPOT.TB-positive and 244 (85.0%) tested TST-positive. The mean age was 44 y, and 7.3% were HIV-infected. Kappa statistics indicated slight concordance between TSPOT.TB and TST. In multivariate analysis, after controlling for potential confounders, TSPOT.TB positivity was significantly associated with age ≥ 50 y (reference, 20-34 y). A history of ever having had contact with a TB-infected person was associated with TST positivity, whereas HIV infection was inversely associated with TSPOT.TB positivity and TST positivity.
  
  
  CONCLUSIONS
  This study shows a high prevalence of LTBI in individuals at risk for HIV infection in Taipei, Taiwan. Future TB prevention programs should particularly focus on IDUs.
authors.affiliation: Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan.
authors.forename: Yung-Feng
authors.initials: YF
authors.lastname: Yen
authors.forename: Bor-Shen
authors.initials: BS
authors.lastname: Hu
authors.forename: Yu-Shiuan
authors.initials: YS
authors.lastname: Lin
authors.forename: Lan-Huei
authors.initials: LH
authors.lastname: Li
authors.forename: Lien-Wen
authors.initials: LW
authors.lastname: Su
authors.forename: Peing
authors.initials: P
authors.lastname: Chuang
authors.forename: Nai-Ching
authors.initials: NC
authors.lastname: Lin
authors.forename: Xiao-Ru
authors.initials: XR
authors.lastname: Jiang
authors.forename: Ying-Huei
authors.initials: YH
authors.lastname: Shie
authors.forename: Hsiao-Hui
authors.initials: HH
authors.lastname: Chang
authors.forename: Wei-Xian
authors.initials: WX
authors.lastname: Ou
authors.forename: Hong-Jun
authors.initials: HJ
authors.lastname: Zhan
authors.forename: Winnie
authors.initials: W
authors.lastname: Yang
authors.forename: Muh-Yong
authors.initials: MY
authors.lastname: Yen
mesh_terms: D000328:Adult; D000818:Animals; D003430:Cross-Sectional Studies; D055030:Drug Users; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests / Q000379:methods*; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000188:drug therapy; D013624:Taiwan / Q000453:epidemiology; D014374:Tuberculin Test / Q000379:methods*
chemical_list: D009294:Narcotics; D008691:Methadone