Authors: Vitek, E.¹; Gusseinova, N.²; Laricheva, N.²; Vasiliev, S.²; Molotilov, V.²; Sofronova, R.²; Kazionny, B.²; Cegielski, P.³; Nguyen, M.L.⁴; Nelson, L.³; Agerton, T.³; Wells, C.³

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 7, July 2009 , pp. 829-835(7)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

BACKGROUND: The treatment of persons living with human immunodeficiency virus/acquired immune-deficiency syndrome (PLWHAs) for latent tuberculosis infection (LTBI) reduces tuberculosis (TB) morbidity. Despite a high TB burden and an expanding human immunodeficiency virus epidemic, Russia had limited data on the utility of the tuberculin skin test (TST) for LTBI diagnosis in PLWHAs.

OBJECTIVE: To determine the prevalence and predictors of positive TSTs in PLWHAs in Orel Oblast.

METHODS: A total of 150 consenting PLWHAs being followed up at the AIDS Center were administered a TST and a questionnaire for risk factors for LTBI. A positive TST result was defined as ≥5 mm induration.

RESULTS: Of the 150 subjects, 67% were male and 74% were aged <30 years. Of the PLWHAs tested, 26% had a positive TST result, while among PLWHAs with CD4⁺ >500 cells/ml, 36% were TST-positive. TST positivity varied inversely with CD4⁺ cell count. Among PLWHAs with a history of injection drug use, the primary risk factor for HIV, 29 (31.9%) were positive.

CONCLUSIONS: A high proportion of tested PLWHAs had a positive TST and could benefit from preventive therapy (PT) to reduce the risk of TB. A TB control programme in Russia should therefore include TST screening among PLWHAs and PT, besides active TB case finding and treatment.

Keywords: HIV; tuberculin skin test; latent tuberculosis infection

Document Type: Regular paper

Affiliations: 1: Division of TB Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA; US Civilian Research Development Foundation, Moscow, Russia 2: Orel Center for Prevention of AIDS and Infectious Diseases, TB Dispensary and Ministry of Health, Orel, Russia 3: Division of TB Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA 4: Emory University School of Medicine, Atlanta, Georgia, USA

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