Scholten Jerod N, Driver Cynthia R, Munsiff Sonal S, Kaye Katherine, Rubino Mary Ann, Gourevitch Marc N, Trim Caroline, Amofa James, Seewald Randy, Highley Esther, Fujiwara Paula I
New York City Department of Health and Mental Hygiene, New York, USA.
Clin Infect Dis. 2003 Dec 15;37(12):1686-92. doi: 10.1086/379513. Epub 2003 Nov 17.
Injection drug users (IDUs) were heavily affected by the tuberculosis (TB) resurgence in New York City in the 1990s. We assessed the effectiveness of screening for latent TB infection in methadone users and of selective treatment with isoniazid. Risk for future TB was classified as low or high on the basis of tuberculin, anergy, and HIV test results. The cohort of 2212 IDUs was followed up for a median of 4.2 years; 25 IDUs, of whom 20 (80%) were infected with human immunodeficiency virus (HIV), developed TB. In an adjusted Cox proportional hazards model of high-risk IDUs, the risk of TB was associated with HIV infection (HR 10.3; 95% CI, 3.4-31.3); receipt of <6 months of isoniazid therapy (HR 7.6; 95% CI, 1.02-57.1); a CD4+ T lymphocyte count of <200 cells/mm3 (HR 6.6; 95% CI, 1.7-25.9); and tuberculin positivity (HR 4.0; 95% CI, 1.6-10.2). Treatment with isoniazid was beneficial in HIV-infected, tuberculin-positive IDUs.
注射吸毒者（IDUs）在20世纪90年代纽约市结核病（TB）卷土重来时受到了严重影响。我们评估了对美沙酮使用者进行潜伏性结核感染筛查以及使用异烟肼进行选择性治疗的有效性。根据结核菌素、无反应性和HIV检测结果，将未来患结核病的风险分为低风险或高风险。对2212名注射吸毒者队列进行了中位数为4.2年的随访；25名注射吸毒者患了结核病，其中20名（80%）感染了人类免疫缺陷病毒（HIV）。在对高风险注射吸毒者进行校正的Cox比例风险模型中，结核病风险与HIV感染相关（风险比[HR]10.3；95%置信区间[CI]，3.4 - 31.3）；接受异烟肼治疗<6个月（HR 7.6；95% CI，1.02 - 57.1）；CD4 + T淋巴细胞计数<200个细胞/mm3（HR 6.6；95% CI，1.7 - 25.9）；以及结核菌素阳性（HR 4.0；95% CI，1.6 - 10.2）。对感染HIV且结核菌素阳性的注射吸毒者使用异烟肼治疗有益。
