Latent tuberculosis among injection drug users in a methadone maintenance treatment program, Taipei, Taiwan: TSPOT.TB versus tuberculin skin test.

Abstract

BACKGROUND:

Taiwan has a growing HIV/AIDS epidemic that has recently shifted to an increase among injection drug users (IDUs). IDUs co-infected with HIV and tuberculosis (TB) have a high risk of progression from latent tuberculosis infection (LTBI) to active TB.

METHODS:

This study aimed to determine the prevalence and correlates of LTBI among IDUs by TSPOT.TB and tuberculin skin test (TST), in a large methadone program in Taipei, Taiwan. Consenting participants were interviewed by a trained worker regarding sociodemographics, substance use history, and health factors.

RESULTS:

Multivariate analysis was used to determine risks associated with each test outcome. Of 287 participants, 165 (58.7%) tested TSPOT.TB-positive and 244 (85.0%) tested TST-positive. The mean age was 44 y, and 7.3% were HIV-infected. Kappa statistics indicated slight concordance between TSPOT.TB and TST. In multivariate analysis, after controlling for potential confounders, TSPOT.TB positivity was significantly associated with age ≥ 50 y (reference, 20-34 y). A history of ever having had contact with a TB-infected person was associated with TST positivity, whereas HIV infection was inversely associated with TSPOT.TB positivity and TST positivity.

CONCLUSIONS:

This study shows a high prevalence of LTBI in individuals at risk for HIV infection in Taipei, Taiwan. Future TB prevention programs should particularly focus on IDUs.

• Authors: Yung-Feng Yen, Bor-Shen Hu, Yu-Shiuan Lin, Lan-Huei Li, Lien-Wen Su, Peing Chuang, Nai-Ching Lin, Xiao-Ru Jiang, Ying-Huei Shie, Hsiao-Hui Chang, Wei-Xian Ou, Hong-Jun Zhan, Winnie Yang, Muh-Yong Yen
• Journal: Scandinavian journal of infectious diseases (Scand J Infect Dis) Vol. 45 Issue 7 Pg. 504-11 (Jul 2013) ISSN: 1651-1980 [Electronic] England
• PMID: 23768130 (Publication Type: Comparative Study, Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Narcotics
• Methadone

Topics

• Adult
• Animals
• Cross-Sectional Studies
• Drug Users
• Female
• Humans
• Interferon-gamma Release Tests (methods)
• Latent Tuberculosis (diagnosis, epidemiology)
• Male
• Methadone (therapeutic use)
• Middle Aged
• Narcotics (therapeutic use)
• Substance Abuse, Intravenous (complications, drug therapy)
• Taiwan (epidemiology)
• Tuberculin Test (methods)