Duncan L E, Elliott A M, Hayes R J, Hira S K, Tembo G, Mumba G T, Ebrahim S H, Quigley M, Pobee J O, McAdam K P
School of Medicine, University of Zambia, Lusaka.
Trans R Soc Trop Med Hyg. 1995 Jan-Feb;89(1):37-40. doi: 10.1016/0035-9203(95)90649-5.
A cross-sectional study to estimate the prevalence of latent tuberculosis (TB) in a group of Zambians at high risk of human immunodeficiency virus type 1 (HIV-1) infection and to examine the effect of HIV-1 infection on the tuberculin response was conducted in the University Teaching Hospital in Lusaka, Zambia during July to September 1990. Patients were selected from those presenting to the out-patient clinic for first referral with either sexually transmitted or skin disease. 268 adults were included in the study; 158 (59%; 95% confidence interval [CI] = 53-65%) were HIV-1 antibody positive. Of 82 HIV-1 negative participants who returned for Mantoux skin test reading, 51 (62%; 95% CI = 57-67%) had a positive test reaction (diameter > or = 10 mm) after receiving 2 units of RT-23 tuberculin. Of 106 HIV-1 positive participants who returned, only 32 (30%; 95% CI = 26-34%) had a diameter > or = 10 mm. Nine (28%) of the HIV-1 positive and Mantoux positive participants had large reactions > or = 30 mm, compared to 4 (8%) of the HIV-1 negative, Mantoux positive participants (P = 0.03). Results in the HIV-1 negative group indicated a prevalence of latent TB of 62% in this population. HIV-1 infection was associated with a much higher frequency of negative response to tuberculin and with a few large skin test responses. Thus, in populations where HIV seropositivity is high, Mantoux skin tests cannot be used to assess those with latent TB who might benefit from chemoprophylaxis.
1990年7月至9月期间，在赞比亚卢萨卡的大学教学医院开展了一项横断面研究，以估计一组高风险感染1型人类免疫缺陷病毒（HIV-1）的赞比亚人群中潜伏性结核病（TB）的患病率，并研究HIV-1感染对结核菌素反应的影响。患者从因性传播疾病或皮肤病首次转诊至门诊的人群中选取。268名成年人纳入研究；其中158人（59%；95%置信区间[CI]=53-65%）HIV-1抗体呈阳性。在82名返回进行结核菌素皮肤试验读数的HIV-1阴性参与者中，51人（62%；95%CI=57-67%）在接受2单位RT-23结核菌素后试验反应呈阳性（直径≥10mm）。在106名返回的HIV-1阳性参与者中，只有32人（30%；95%CI=26-34%）直径≥10mm。HIV-1阳性且结核菌素试验阳性的参与者中有9人（28%）反应较大（≥30mm），而HIV-1阴性且结核菌素试验阳性的参与者中有4人（8%）（P=0.03）。HIV-1阴性组的结果表明该人群中潜伏性结核病的患病率为62%。HIV-1感染与结核菌素阴性反应的频率高得多以及少数较大的皮肤试验反应相关。因此，在HIV血清阳性率高的人群中，结核菌素皮肤试验不能用于评估那些可能从化学预防中受益的潜伏性结核病患者。
