Division of Infectious Diseases, Department of Medicine, New York University School of Medicine, 550 First Avenue, BCD, Room 649, New York, NY 10016, USA.
Int J Infect Dis. 2012 Jul;16(7):e518-21. doi: 10.1016/j.ijid.2012.03.002. Epub 2012 Apr 26.
We assessed the incidence of and risk factors for tuberculin skin test (TST) conversion among HIV-infected adults at a New York City clinic.
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.
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.
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.
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。
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。
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。
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。
