RATES OF TUBERCULOSIS INFECTION IN HEALTH-CARE WORKERS PROVIDING SERVICES TO HIV-INFECTED POPULATIONS

OBJECTIVE: To assess the prevalence of tuberculosis (TB) or a positive skin test in healthcare workers (HCWs) providing services to human im munodeficiency virus (HIV)-infected individuals and to determine prosp ectively the incidence of new infections in this population. DESIGN: T his prospective cohort study enrolled 1,014 HCWs working with HN-infec ted populations from 10 metropolitan areas. Purified protein derivativ e (PPD) tuberculin skin tests were placed at baseline and every 6 mont hs afterwards on those without a history of TB or a positive PPD. Demo graphic, occupational, and TB exposure data also were collected. SETTI NG: Outpatient clinics, hospitals, private practice offices, and drug treatment programs providing HIV-related healthcare and research progr ams. PARTICIPANTS: A voluntary sample of staff and volunteers from 16 Community Programs for Clinical Research on AIDS units. RESULTS: Facto rs related to prior TB or a positive skin test at baseline included be ing foreign-born, increased length of time in health care, living in N ew York City, or previous bacille Calmette-Guerin vaccination. The rat e of PPD conversion was 1.8 per 100 person years of follow-up. No inde pendent relation was found between the amount or type of contact with HIV-infected populations and the risk of TB infection. CONCLUSION: The se data provide some reassurance that caring for HIV-infected patients is not related to an increased rate of TB infection among HCWs in the se settings (Infect Control Hosp Epidemiol 1998;19:829-835).