Incidence of tuberculin skin test conversion among HIV-infected and -uninfected women: Results of a 6-year study

Audrey L. French, Charlesnika T. Evans, Kathryn Anastos, Ruth M. Greenblatt, Ronald Hershow, Robin Huebner, Michael Augenbraun, Mary Young, Hugo Lopez-Gatell, Douglas J. Passaro

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE: To define the incidence of tuberculin skin test (TST) conversion and to evaluate the yield of annual testing in an era of declining tuberculosis incidence rate in the United States. METHODS: Annual TSTs were performed on initially TST-negative women (HIV infected, 995; uninfected, 260) from October 1995 through March 2002. RESULTS: A total of 4622 repeat TSTs were performed during 5530 person-years. The incidence of TST conversion was 0.8 case per 100 person-years for HIV-infected and 1.0 case per 100 person-years for uninfected women. Non-Hispanic blacks, women younger than 40 years of age, and HIV-infected women who had recently initiated active therapy were more likely to experience TST conversion. The incidence of conversion decreased over the course of the study from a peak of 21 cases per 937 tests in 1996 to 1 case per 179 tests in 2002 (P = 0.046 for trend). Twenty-one of 47 conversions occurred on the second TST, implying that boosting accounted for a number of conversions. CONCLUSIONS: The yield of annual skin testing diminished from 1996 to 2002. Our data suggest that repeating testing after initiation of HIV therapy, regardless of CD4 cell change, is warranted. If serial testing is undertaken, initial 2-step testing should be performed to allow for accurate interpretation of subsequent tests and earlier identification of persons with latent Mycobacterium tuberculosis infection.

Original languageEnglish (US)
Pages (from-to)592-596
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Volume42
Issue number5
DOIs
StatePublished - Aug 2006
Externally publishedYes

Fingerprint

Tuberculin Test
Skin Tests
HIV
Incidence
Latent Tuberculosis
Mycobacterium Infections
Mycobacterium tuberculosis
Tuberculosis
Skin
Therapeutics

Keywords

  • Latent TB infection
  • Purified protein derivative
  • Screening
  • Tuberculin skin test
  • Tuberculosis

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Incidence of tuberculin skin test conversion among HIV-infected and -uninfected women : Results of a 6-year study. / French, Audrey L.; Evans, Charlesnika T.; Anastos, Kathryn; Greenblatt, Ruth M.; Hershow, Ronald; Huebner, Robin; Augenbraun, Michael; Young, Mary; Lopez-Gatell, Hugo; Passaro, Douglas J.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 42, No. 5, 08.2006, p. 592-596.

Research output: Contribution to journalArticle

French, AL, Evans, CT, Anastos, K, Greenblatt, RM, Hershow, R, Huebner, R, Augenbraun, M, Young, M, Lopez-Gatell, H & Passaro, DJ 2006, 'Incidence of tuberculin skin test conversion among HIV-infected and -uninfected women: Results of a 6-year study', Journal of Acquired Immune Deficiency Syndromes, vol. 42, no. 5, pp. 592-596. https://doi.org/10.1097/01.qai.0000229995.25493.8b
French, Audrey L. ; Evans, Charlesnika T. ; Anastos, Kathryn ; Greenblatt, Ruth M. ; Hershow, Ronald ; Huebner, Robin ; Augenbraun, Michael ; Young, Mary ; Lopez-Gatell, Hugo ; Passaro, Douglas J. / Incidence of tuberculin skin test conversion among HIV-infected and -uninfected women : Results of a 6-year study. In: Journal of Acquired Immune Deficiency Syndromes. 2006 ; Vol. 42, No. 5. pp. 592-596.
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abstract = "OBJECTIVE: To define the incidence of tuberculin skin test (TST) conversion and to evaluate the yield of annual testing in an era of declining tuberculosis incidence rate in the United States. METHODS: Annual TSTs were performed on initially TST-negative women (HIV infected, 995; uninfected, 260) from October 1995 through March 2002. RESULTS: A total of 4622 repeat TSTs were performed during 5530 person-years. The incidence of TST conversion was 0.8 case per 100 person-years for HIV-infected and 1.0 case per 100 person-years for uninfected women. Non-Hispanic blacks, women younger than 40 years of age, and HIV-infected women who had recently initiated active therapy were more likely to experience TST conversion. The incidence of conversion decreased over the course of the study from a peak of 21 cases per 937 tests in 1996 to 1 case per 179 tests in 2002 (P = 0.046 for trend). Twenty-one of 47 conversions occurred on the second TST, implying that boosting accounted for a number of conversions. CONCLUSIONS: The yield of annual skin testing diminished from 1996 to 2002. Our data suggest that repeating testing after initiation of HIV therapy, regardless of CD4 cell change, is warranted. If serial testing is undertaken, initial 2-step testing should be performed to allow for accurate interpretation of subsequent tests and earlier identification of persons with latent Mycobacterium tuberculosis infection.",
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N2 - OBJECTIVE: To define the incidence of tuberculin skin test (TST) conversion and to evaluate the yield of annual testing in an era of declining tuberculosis incidence rate in the United States. METHODS: Annual TSTs were performed on initially TST-negative women (HIV infected, 995; uninfected, 260) from October 1995 through March 2002. RESULTS: A total of 4622 repeat TSTs were performed during 5530 person-years. The incidence of TST conversion was 0.8 case per 100 person-years for HIV-infected and 1.0 case per 100 person-years for uninfected women. Non-Hispanic blacks, women younger than 40 years of age, and HIV-infected women who had recently initiated active therapy were more likely to experience TST conversion. The incidence of conversion decreased over the course of the study from a peak of 21 cases per 937 tests in 1996 to 1 case per 179 tests in 2002 (P = 0.046 for trend). Twenty-one of 47 conversions occurred on the second TST, implying that boosting accounted for a number of conversions. CONCLUSIONS: The yield of annual skin testing diminished from 1996 to 2002. Our data suggest that repeating testing after initiation of HIV therapy, regardless of CD4 cell change, is warranted. If serial testing is undertaken, initial 2-step testing should be performed to allow for accurate interpretation of subsequent tests and earlier identification of persons with latent Mycobacterium tuberculosis infection.

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