Tuberculin reactions among attendees at a methadone clinic: relation to infection with the human immunodeficiency virus

Abstract

We tested 403 clients at an inner-city methadone clinic to determine the rate of positive tuberculin test reactions and to determine how this rate was influenced by race, gender, and infection with the human immunodeficiency virus (HIV). In addition to skin testing, an experimental urine test for antibody to HIV was offered; 73% of the clients provided urine specimens. Positive urine test results were confirmed by serum antibody testing. Of the subjects who returned for follow-up, 33.9% had indurations > or = 10 mm; 49.7% of these subjects were Black, 30% were Hispanic, and 18% were White. Antibodies to HIV were present in 12.5% of urine specimens. Tuberculin reactions of > or = 5 mm were observed for 32.7% of HIV-positive subjects and 48.4% of HIV-negative subjects. Screening of urine for antibodies to HIV proved to be simple, specific, and well accepted by the subjects. Providing prophylaxis for tuberculosis should be a high priority in populations with rates of tuberculin reactions and HIV infection that are comparable to those for clients of our methadone clinic.