Spradling P, McLaughlin S, Drociuk D, Ridzon R, Pozsik C, Onorato I; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. ThPeB5188.

P. Spradling, Centers for Disease Control & Prevention, 1600 Clifton Rd, Mailstop E-10, Atlanta, GA 30333, United States, Tel.: +1 404 639 53 10, Fax: +1 404 639 89 59, E-mail: pps9@cdc.gov

Background: Populations at high risk for tuberculosis (TB) include incarcerated and HIV-infected individuals. In November 1998, the State of South Carolina made segregated housing for all HIV-infected inmates mandatory. In August 1999, an inmate from a prison dormitory (Dormitory A) for HIV-positive men was diagnosed with infectious pulmonary tuberculosis (TB). Methods: The exposed cohort included inmates who resided in Dormitory A at any time between May 1 and September 30, 1999. Data regarding skin testing, serial viral loads and CD4+ counts were collected for inmates in the exposed cohort. Case-patients were interviewed, medical records reviewed, and DNA fingerprints of isolates compared. Results: A total of 324 inmates were exposed. Twenty-nine additional cases of active TB were identified from the two sides of Dormitory A; 26 (87%) were housed on the same (right) side as the index case. Twenty cases (69%) were diagnosed by the end of September 1999. Isolates were sensitive to all drugs tested; all fourteen isolates tested to date have matching DNA fingerprint patterns. In dormitory A, 76/117 (65%) inmates from the right side and 20/135 (15%) from the left converted to a positive skin test (Relative Risk [RR] = 4.6; 95% Confidence Interval [CI] = 2.4-7.1). An additional 66 men in Dormitory A had a previous positive skin test; another 6 were released before any skin testing. Case-patients were more likely to have CD4+ counts > 200 compared to skin test convertors (RR = 2.4; CI = 1.4-4.2). Increasing viral loads were not associated with development of active TB. Conclusions: An unintended consequence of segregation of HIV-infected prison inmates in South Carolina was extensive transmission of M. tuberculosis and rapid development of active TB.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• CD4 Lymphocyte Count
• Case-Control Studies
• DNA Fingerprinting
• HIV Infections
• HIV Seropositivity
• Humans
• Male
• Mycobacterium tuberculosis
• Prisoners
• Prisons
• South Carolina
• Tuberculosis
• Tuberculosis, Pulmonary
• Viral Load
• transmission

Other ID:

• GWAIDS0004165

UI: 102241662

From Meeting Abstracts