THE EFFECT OF LATENT MYCOBACTERIUM-TUBERCULOSIS INFECTION ON HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) DISEASE PROGRESSION AND HIV RNA LOAD AMONG INJECTING DRUG-USERS

To examine the relationship between latent Mycobacterium tuberculosis infection and human immunodeficiency virus (HIV) disease progression, two studies were done among a cohort of HIV-infected injecting drug us ers. First, the decline in CD4 cell count after baseline tuberculin sk in testing was prospectively compared for 37 tuberculin-positive (indu ration greater than or equal to 5 mm) and 284 tuberculin-negative (ind uration less than or equal to 2 mm) persons. After adjustment for base line immune function, the mean 6-month CD4 cell decline was not signif icantly different (34.5 vs. 45.6 cells, respectively, P = .14). Second , the plasma HIV burden at baseline skin testing was compared for 33 t uberculin-positive cases and 33 matched tuberculin-negative controls. HIV RNA was detected in 8 cases and 10 controls (odds ratio = 0.67, 95 % confidence interval = 0.19-2.36). Among the 14 pairs with HIV detect ed in greater than or equal to 1 member, the HIV concentration was hig her for the case in 4 and for the control in 10 (P = .18). These findi ngs suggest that unlike active tuberculosis, latent M. tuberculosis in fection does not hasten HIV progression.