Rates of Tuberculosis Infection in Healthcare Workers Providing Services to HIV-Infected Populations

Zahnow, Karen; Matts, John P.; Hillman, David; Finley, Elizabeth; Brown Jr., Lawrence S.; Torres, Ramon A.; Ernst, Jerome; El-Sadr, Wafaa Mahmoud; Perez, George; Webster, Carol; Barber, Beverly; Gordin, Fred M.; Terry Beirn Community Programs for Clinical Research on AIDS

Objective: To assess the prevalence of tuberculosis (TB) or a positive skin test in healthcare workers (HCWs) providing services to human immunodeficiency virus (HIV)-infected individuals and to determine prospectively the incidence of new infections in this population.
Design: This prospective cohort study enrolled 1,014 HCWs working with HIV-infected populations from 10 metropolitan areas. Purified protein derivative (PPD) tuberculin skin tests were placed at baseline and every 6 months afterwards on those without a history of TB or a positive PPD. Demographic, occupational, and TB exposure data also were collected.
Setting: Outpatient clinics, hospitals, private practice offices, and drug treatment programs providing HIV-related healthcare and research programs.
Participants: A voluntary sample of staff and volunteers from 16 Community Programs for Clinical Research on AIDS units.
Results: Factors related to prior TB or a positive skin test at baseline included being foreign-born, increased length of time in health care, living in New York City, or previous bacille Calmette-Guerín vaccination. The rate of PPD conversion was 1.8 per 100 person years of follow-up. No independent relation was found between the amount or type of contact with HIV-infected populations and the risk of TB infection.
Conclusion: These data provide some reassurance that caring for HIV-infected patients is not related to an increased rate ofTB infection among HCWs in these settings.


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Infection Control and Hospital Epidemiology

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Cambridge University Press
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October 20, 2015