Tuberculosis infection among cocaine crack users in Brazil
Tuberculosis infection among cocaine crack users in Brazil
Data
2018
Autores
Oliveira, Sandra Maria do Valle Leone de
Silva, Elizeu Ferreira da
Motta-Castro, Ana Rita Coimbra
Castro, Vivianne de Oliveira Landgraf de
Stábile, Andréa Cristina
Paniago, Anamaria Mello Miranda
Trajman, Anete
Journal Title
Journal ISSN
Volume Title
Publisher
International Journal of Drug Policy
Resumo
Background: WHO recommends treatment for latent tuberculosis infection (LTBI) in the homeless and people
who use drugs (PWUD). The optimal test for LTBI screening is uncertain.
Methods: A cross-sectional study was conducted among the homeless and drug-rehabilitation clinic clients
chronically using crack in Western Brazil. Participants were interviewed and offered HIV testing plus tuberculin
skin testing (TST) and QuantiFeron®-Gold-in-Tube (QFT). We considered LTBI when either TST or QFT were
positive. Factors associated with LTBI were adjusted in a multivariate model.
Results: Among 372 subjects with at least one valid test, 216 (58%) had LTBI. TST was not read in 18.4%; QFT
was indeterminate in 2.5%. TST detected 27 (26%) extra LTBI cases among 75 QFT-negative individuals. PWUD
had over three-fold odds for LTBI. TST was 4.5 times more likely to be positive in BCG-vaccinated individuals.
Conclusion: Given the high risk of progression to disease in this population, the high rates of loss to TST reading
and the possibility of false-positive TST results from BCG vaccination, we endorse current CDC recommendations
to use QFT for LTBI screening among the homeless and PWUD. However, because adding TST to a negative QFT
increased LTBI detection considerably, TST should be considered in QFT-negative individuals.
Description
Palavras-chave
Crack cocaine, Tuberculin test, Interferon-gamma release assays, Latent tuberculosis infection.
Citação
Valle Leone de Oliveira SM, Ferreira da Silva E, Coimbra Motta-Castro AR, de Oliveira Landgraf de Castro V, Stábile AC, Mello Miranda Paniago A, Trajman A. Tuberculosis infection among cocaine crack users in Brazil. Int J Drug Policy. 2018 Sep;59:24-27. doi: 10.1016/j.drugpo.2018.06.012. Epub 2018 Jun 30.