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Free Content A prospective study of positive tuberculin reactions in women with or at risk for HIV-1 infection

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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.
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Keywords: HIV-1; skin tests; tuberculin testing; women

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: 01 July 2000

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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