A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection

Article Abstract:

Patients with Acquired Immunodeficiency Syndrome (AIDS) are at a greater risk than others for developing tuberculosis, particularly those who are also intravenous drug users or who are not white. Some studies estimate that 10 percent of AIDS patients develop tuberculosis. A group of intravenous drug users underwent a blood test for the presence of the Human Immunodeficiency Virus (HIV), the virus that causes AIDS, and a skin test for tuberculosis. Before the study began, a number of subjects already had a positive response to a skin test for tuberculosis, indicating a latent tubercular infection: 23 percent of subjects who eventually tested positive for HIV, and 20 percent of those who tested negative to HIV already had positive tuberculosis tests. During the study, all subjects were tested again for tuberculosis. Four percent (eight cases) of HIV-positive patients developed active cases of tuberculosis. Seven of those eight patients had already had positive skin tests for tuberculosis before the study began. No HIV-negative subjects developed tuberculosis. Intravenous drug users who are HIV-positive are at greater risk of developing tuberculosis than those who are HIV-negative. In addition, HIV-infected people most often develop tuberculosis due to a reactivation of a latent tubercular infection. Preventive drug therapy is recommended for HIV-positive patients who also have a positive skin test for tuberculosis.

Analysis, Case studies, Prevention, Complications and side effects, Dosage and administration, Drug abuse, Isoniazid, Tuberculin test, AIDS virus carriers, HIV carriers

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Risk factors for human immunodeficiency virus infection in intravenous drug users

Article Abstract:

To determine the risk behavior of intravenous drug users (IVDU) and their sexual habits, drug users enrolled in a methadone maintenance program were tested and questioned. Of the 452 IVDU included, 39.4 percent tested positive for the AIDS (acquired immune deficiency syndrome) antibody, of whom 49.1 percent were black, 41.8 percent were Hispanic, and 17.2 percent were non-Hispanic white. The rate of infection with the human immunodeficiency virus (HIV) increased with the number of drug injections per month, frequency of used needle use, the number of injections shared with strangers and the number of injections of cocaine. Sharing needles is more common with blacks and Hispanics. The more a woman's sexual partners used intravenous drugs, the more likely she was to be infected with the virus, even if she herself had not used drugs in the previous years. Other risk factors were a more recent last drug injection, frequent shooting of drugs in "shooting galleries", and low income. It is suggested that these cultural and heterosexual habits be considered when planning strategies for AIDS prevention.

Demographic aspects, HIV (Viruses), HIV, Disease transmission, AIDS (Disease), column

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High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy

Article Abstract:

People who have HIV infection and are anergic are at risk of contracting tuberculosis, and should be given prophylactic isoniazid. Anergic people have a reduced immune response to foreign antigens, including the bacterial protein used in the tuberculin skin test. Of 359 intravenous drug users treated at a methadone clinic, 239 had a positive tuberculin test, and 120 did not. Of the 120 who were anergic, 68 were HIV-positive and 18 were HIV-negative. HIV status in 34 was unknown. During the 31-month follow-up, five of the HIV-positive drug users developed tuberculosis, but none of the others did. All five who developed tuberculosis had had a negative tuberculin skin test in the past. Of the 239 drug users who had a positive tuberculin test, 83 received isoniazid and 156 did not. None of those who took isoniazid developed tuberculosis, but seven of those who did not take isoniazid developed tuberculosis.

Risk factors, HIV infection, HIV infections, Diseases

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