Journal Article

Effectiveness of Isoniazid Treatment for Latent Tuberculosis Infection among Human Immunodeficiency Virus (HIV)–Infected and HIV–Uninfected Injection Drug Users in Methadone Programs

Jerod N. Scholten, Cynthia R. Driver, Sonal S. Munsiff, Katherine Kaye, Mary Ann Rubino, Marc N. Gourevitch, Caroline Trim, James Amofa, Randy Seewald, Esther Highley and Paula I. Fujiwara

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 12, pages 1686-1692
Published in print December 2003 | ISSN: 1058-4838
Published online December 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/379513
Effectiveness of Isoniazid Treatment for Latent Tuberculosis Infection among Human Immunodeficiency Virus (HIV)–Infected and HIV–Uninfected Injection Drug Users in Methadone Programs

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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.

Journal Article.  3682 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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