TUBERCULIN SKIN TESTING AND THE DEVELOPMENT OF TUBERCULOSIS IN A COHORT OF HIV-INFECTED INDIVIDUALS

The aim of this study was to assess the usefulness of tuberculin skin testing as an indicator of tuberculous infection in an Irish human imm unodeficiency virus (HIV) infected population, Between February and Se ptember 1988, 38 consecutive HIV positive patients were recruited into the study, A skin test score was derived for each patient using the M ultitest system; which includes tuberculin and six other microbial. an tigens, At review date in January 1991 after a mean follow-up period o f 22, months (range 6-34), ten patients had died, three were lost to f ollow-up, and 25 were alive, Eleven patients were tuberculin positive on entry into the study,one of these developed tuberculosis, Twenty se ven patients were tuberculin negative, three of these developed tuberc ulosis, Twenty-three patients were known to have received BCG eight of these gave a positive tuberculin test, and three developed tuberculos is. Twelve patients were known or suspected not to have received BCG, two of these were tuberculin positive and one developed tuberculosis. There was a strong negative correlation between Multitest score and ad vanced HIV infection (R=-0.7 p<0.001), We conclude that tuberculin ski n test status and BCG vaccination had no relationship to the developme nt of tuberculosis in the population we studied.