Lack of association of induration size with HIV infection among drug users reacting to tuberculin
Lack of association of induration size with HIV infection among drug users reacting to tuberculin
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DOI：
10.1164/ajrccm.154.4.8887602
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发表时间：
1996-10-01
影响因子：
24.7
通讯作者：
Klein, RS
中科院分区：
文献类型：
--
作者：
Gourevitch, MN;Hartel, D;Klein, RS
较小的结核菌素试验硬结的大小表明适合结核病化学预防的HIV血清阳性比HIV血清阴性的人。为了确定人类免疫缺陷病毒（HIV）感染是否与结核菌素反应者的硬结大小相关，对HIV血清阳性和血清阴性吸毒者进行了横断面研究。160名HIV血清阳性患者中有24名（15%）和284名HIV血清阴性患者中有68名（24%）对纯化蛋白衍生物（PPD）的反应大于或等于2 mm（OR = 0.56，95%CI 0.32至0.96）。然而，结核菌素反应的患病率是平等的nonanergic受试者与无HIV感染。中位硬结大小是相似的HIV血清阳性（20.5毫米）和血清阴性（17.5毫米）反应。因此，虽然HIV血清阳性患者不太可能，由于皮肤无反应性，PPD反应，硬结的大小与HIV感染的反应。虽然使用降低的临界点来确定HIV-血清阳性者的化学预防的适用性可能是谨慎的，但逻辑上的假设，即特异性的丧失伴随着检测结核分枝杆菌感染的灵敏度的增加，仍有待证明。
Smaller tuberculin test induration sizes suggest eligibility for tuberculosis chemoprophylaxis in HIV-seropositive than in HIV-seronegative persons. To determine whether human immunodeficiency virus (HIV) infection is associated with induration size among tuberculin reactors, a cross-sectional study of HIV-seropositive and -seronegative drug users was performed. Twenty-four of 160 (15%) HIV-seropositive and 68 of 284 (24%) HIV-seronegative patients had reactions to purified protein derivative (PPD) of greater than or equal to 2 mm (OR = 0.56, 95% CI 0.32 to 0.96). However, the prevalence of tuberculin reactivity was equal among nonanergic subjects with and without HIV infection. Median induration size was similar among HIV-seropositive (20.5 mm) and -seronegative (17.5 mm) reactors. Thus, although HIV-seropositive patients were less likely, due to cutaneous anergy, to be PPD reactors, induration size was not associated with HIV infection among reactors. Although using a reduced cutpoint to determine suitability of chemoprophylaxis in HIV-seropositive persons may be prudent, the logical assumption that the loss of specificity this entails is accompanied by an increase in sensitivity for detecting Mycobacterium tuberculosis infection remains to be proved.