简报：巴西 HIV 感染者重复结核菌素皮肤试验的结果。
Brief Report: Yield of Repeat Tuberculin Skin Testing for People Living With HIV in Brazil.
机构信息
Department of Medicine, University of Illinois at Chicago, Chicago, IL.
Municipal Health Secretariat, Rio de Janeiro, Brazil.
出版信息
J Acquir Immune Defic Syndr. 2021 Dec 1;88(4):329-332. doi: 10.1097/QAI.0000000000002779.
OBJECTIVES
In Brazil, annual tuberculin skin tests (TSTs) are recommended for people living with HIV (PLWH) with CD4 >350, with tuberculosis preventive therapy provided on test conversion. We aimed to determine the yield of repeat TSTs for PLWH.
DESIGN
Secondary analysis of the stepped-wedge, cluster-randomized THRio trial for isoniazid preventive therapy (IPT) to prevent tuberculosis (TB).
METHODS
We analyzed data from newly registered PLWH with negative baseline TST results. We calculated the number of TST conversions after 1 and/or 2 years among patients eligible for follow-up TSTs, the proportion of converters initiating IPT, and incidence of TB/death.
RESULTS
Among 1770 PLWH with a negative baseline TST, 679 (38%) were female and median age was 36 years (IQR 29-43). Eighty-six (5%) developed TB or died within 1 year. Among 1684 eligible for a follow-up 1-year TST, 582 (35%) were tested and 53 (9%) were positive. Forty-nine converters (92%) started IPT. Of 529 patients with a negative 1-year TST, 7 (1%) developed TB or died over the following year. Of 522 patients eligible for a 2-year TST, 158 (30%) were tested and 13 (8%) were positive. Ten converters (77%) started IPT. Of 1102 patients who did not receive a 1-year TST, 33 (3%) developed TB or died. Of the 1069 patients eligible for a 2-year TST, 259 (24%) were tested and 34 (13%) were positive. Thirty converters (88%) started IPT.
CONCLUSIONS
In this cohort of PLWH in Brazil, TST conversion was high among those retested, but only 48% received a follow-up TST within 2 years.
目的
在巴西，建议 CD4 ＞350 的 HIV 感染者（PLWH）每年进行结核菌素皮肤试验（TST），并在 TST 转为阳性时提供结核预防治疗。我们旨在确定 PLWH 重复 TST 的检出率。
设计
异烟肼预防治疗（IPT）预防结核病（TB）的 stepped-wedge、cluster-randomized THRio 试验的二次分析。
方法
我们分析了基线 TST 结果为阴性的新登记的 PLWH 数据。我们计算了有随访 TST 资格的患者在 1 年和/或 2 年后 TST 转阳的数量、转阳者开始 IPT 的比例以及 TB/死亡的发生率。
结果
在 1770 例基线 TST 阴性的 PLWH 中，679 例（38%）为女性，中位年龄为 36 岁（IQR 29-43）。86 例（5%）在 1 年内发生 TB 或死亡。在 1684 例有资格接受 1 年 TST 随访的患者中，582 例（35%）接受了检测，53 例（9%）呈阳性。49 例转阳者（92%）开始接受 IPT。在 529 例 1 年 TST 阴性的患者中，有 7 例（1%）在随后的 1 年内发生 TB 或死亡。在 522 例有资格接受 2 年 TST 的患者中，158 例（30%）接受了检测，13 例（8%）呈阳性。10 例转阳者（77%）开始接受 IPT。在 1102 例未接受 1 年 TST 的患者中，有 33 例（3%）发生 TB 或死亡。在 1069 例有资格接受 2 年 TST 的患者中，259 例（24%）接受了检测，34 例（13%）呈阳性。30 例转阳者（88%）开始接受 IPT。
结论
在巴西的这一 PLWH 队列中，再次检测的患者 TST 转阳率较高，但只有 48%的患者在 2 年内接受了后续 TST。
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