"Tuberculosis and HIV Infection"

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.

"Tuberculosis and HIV Infection"

New England Journal of Medicine (12/26/91) Vol. 325, No. 26, P. 1883
Nolan, Charles M.; Goldbaum, Gary M.; and Wood, Robert W.

Abstract: Tuberculin reactivity differs both geographically and by risk groups for HIV infection. Each community should therefore address the issue of testing for delayed-type hypersensitivity anergy even to its own population at risk for both HIV infection and tuberculosis, write Charles Nolan et al. of the Seattle--King County Department of Public Health. In the June 6 New England Journal of Medicine, Barnes et al. suggest that testing for delayed type hypersensitivey anergy be included with tuberculin skin testing in the initial analyzation of HIV-infected patients. Anergy testing would take more time and money at public health clinics and other sites where many patients at risk for HIV infection are screened. As a result, its use should be limited to patients for whom the knowledge of their delayed-type hypersensitivity status would be of use in management decisions. It would be best to institute basic pretest criteria, under which it would be appropriate to provide preventive therapy using isoniazid to an anergic HIV-infected patient, the researchers conclude.

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