A prospective study of positive tuberculin reactions in women with or at risk for HIV-1 infection
Abstract:We prospectively studied 1310 women with or at risk for HIV-1 infection to assess subsequent tuberculin reactions in those with ≥10 mm induration. Forty-seven HIV-positive and 57 negative women had tuberculin reactions ≥10 mm induration; reversions to reactions <10 mm occurred in 44% and 46% of those retested, respectively (P = NS). Among seropositives, reversions were associated with lower CD4+ lymphocyte count (P = 0.02). Of a total of 45 subsequent tuberculin tests in seropositive women, only two (4%) resulted in 5–9 mm induration, both at CD4+ counts <500/mm3. Three (30%) of an additional 10 seropositive women with maximal reactions of 5–9 mm induration reported prior tuberculosis exposure, a significantly lower proportion than the 36/47 (77%) with reactions ≥10 mm induration (P < 0.01), but not different than women with maximal reaction sizes <5 mm (219/814, 27%). This study suggests that reversions of ≥10 mm tuberculin reactions to 5–9 mm are rare. In HIV-positive persons, especially those with CD4+ lymphocyte counts ≥500/mm3, reaction sizes of 5–9 mm often may not indicate Mycobacterium tuberculosis infection.
Document Type: Short Communication
Affiliations: 1: Division of Infectious Diseases, Departments of Medicine and Epidemiology and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA 2: Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3: Division of Infectious Diseases, Department of Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA 4: Division of Clinical Immunology, Department of Medicine, the Miriam Hospital and Brown University School of Medicine, Providence, Rhode Island, USA 5: Departments of Molecular Microbiology and Immunology, Epidemiology, and Environmental Health Sciences, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
Publication date: July 1, 2000
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