纽约市 HIV 感染者结核菌素皮肤试验转化的危险因素。
Risk factors for tuberculin skin test conversion among HIV-infected patients in New York City.
机构信息
Division of Infectious Diseases, Department of Medicine, New York University School of Medicine, 550 First Avenue, BCD, Room 649, New York, NY 10016, USA.
出版信息
Int J Infect Dis. 2012 Jul;16(7):e518-21. doi: 10.1016/j.ijid.2012.03.002. Epub 2012 Apr 26.
BACKGROUND
We assessed the incidence of and risk factors for tuberculin skin test (TST) conversion among HIV-infected adults at a New York City clinic.
METHODS
All adult HIV-infected patients were eligible for inclusion if they had a negative baseline TST result and at least one subsequent documented TST test result.
RESULTS
A total of 414 HIV-infected patients had a negative baseline TST result; 288 (69.6%) were male. Among 348 patients who had a place of birth documented, 50% were born outside of mainland USA. Twenty-two (5.3%) of 414 patients had documented TST conversions, giving a crude incidence rate of 1.77 per 100 person-years. Being a foreign-born Asian individual (p=0.02), having lived in a shelter (p=0.004), and having an increase in CD4 cell count (p=0.02) while under care were independent risk factors for TST conversion.
CONCLUSIONS
We found a high TST conversion rate among HIV-infected patients attending an urban clinic. Annual TST testing is particularly important for patients who are foreign-born from high-endemic countries, those with a history of homelessness, and those with an increase in CD4 cell count since the baseline negative TST test.
背景
我们评估了纽约市一家诊所中感染 HIV 的成年人中结核菌素皮肤试验（TST）转化的发生率和危险因素。
方法
如果基线 TST 结果为阴性且至少有一次后续记录的 TST 检测结果，所有成年 HIV 感染患者均符合纳入标准。
结果
共有 414 名 HIV 感染患者的基线 TST 结果为阴性；288 名（69.6%）为男性。在有记录出生地的 348 名患者中，50%出生于美国大陆以外。414 名患者中有 22 名（5.3%）有记录的 TST 转化，粗发病率为每 100 人年 1.77 例。出生在国外的亚洲人（p=0.02）、居住在收容所（p=0.004）以及在护理期间 CD4 细胞计数增加（p=0.02）是 TST 转化的独立危险因素。
结论
我们发现，在一家城市诊所就诊的 HIV 感染患者中 TST 转化率很高。对于来自高流行国家的外国出生者、有 homelessness 史者以及自基线阴性 TST 检测以来 CD4 细胞计数增加者，每年进行 TST 检测尤为重要。
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