Association of Tuberculosis Risk With the Degree of Tuberculin Reaction in HIV-Infected Patients

摘要: Background: The risk of developing active tuberculosis associated with a different size induration to purified protein derivative (PPD) has not been prospectively assessed among individuals infected human immunodeficiency virus (HIV). quantification this is important more appropriately identify candidates for preventive therapy tuberculosis. Methods: A prospective, multicenter, cohort study on in HIV-infected patients was conducted 23 infectious disease units public hospitals Italy. Two thousand six hundred ninety-five were enrolled the study. Of these, 1054 who nonanergic at time entry included present analysis. median duration follow-up 102 weeks. main outcome measure diagnosis confirmed by isolation Mycobacterium culture. Results: Among 252 PPD reactivity, an 2 4 mm had CD4 + lymphocyte count 0.34X10 9 /L (interquartile [IQ] range, 0.14X 10 -0.56X ), those response 5 9mm 0.38X10 /L(IQrange, 0.24X10 and or higher 0.37X (IQ 0.23X -0.52X10 ) ( P =.38). Compared 802 PPD-negative patients, hazard ratios 2.1 (95% confidence interval [CI], 0.2-18.3) 55 mm, 5.7 CI, 1.6-19.8) 128 23.1 7.8-68.6) 69 higher. Conclusions: degree tuberculin does appear reflect immunosuppression strongly correlated subsequent incidence To are increased may benefit from therapy, appears be appropriate cutoff point. Arch Intern Med. 1997;157:797-800