Latent tuberculous infection testing among HIV-infected persons in clinical care, United States, 2010-2012

Int J Tuberc Lung Dis. 2017 Oct 1;21(10):1118-1126. doi: 10.5588/ijtld.17.0041.

Abstract

Setting: Current guidelines recommend latent tuberculous infection (LTBI) testing at the time of human immunodeficiency virus (HIV) diagnosis and annually thereafter for persons at high risk of LTBI.

Objectives: To estimate LTBI testing prevalence and describe the characteristics of HIV-infected persons who would benefit from annual LTBI testing.

Design: We estimated the proportions of LTBI testing among a nationally representative sample of HIV-infected adults in care between 2010 and 2012, and compared the patient characteristics of those with a positive LTBI test result to those with a negative result using χ2 tests.

Results: Among 2772 patients, 68.8% had been tested for LTBI at least once since HIV diagnosis, and 39.4% had been tested during the previous 12 months. Among patients tested at least once, 6.9% tested positive, 80.7% tested negative, and 12.4% had an indeterminate or undocumented result. Patients with a positive test were significantly more likely to be foreign-born, have lower educational attainment, and a household income at or below the federal poverty level.

Conclusions: More than 30% of HIV-infected patients had never been tested for LTBI. Providers should test all patients for LTBI at the time of HIV diagnosis. The patient characteristics associated with a positive LTBI test result may guide provider decisions about annual testing.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Educational Status
  • Emigrants and Immigrants / statistics & numerical data
  • Female
  • HIV Infections / epidemiology*
  • Humans
  • Latent Tuberculosis / diagnosis*
  • Latent Tuberculosis / epidemiology
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Poverty / statistics & numerical data*
  • Prevalence
  • United States / epidemiology
  • Young Adult